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Glass ceiling effect
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The '''Glass Ceiling Effect''' is the effect whereby people with [[ME/CFS]] often make a degree of improvement over the period course of time, but then reach a point at which they are unable to increase their physical activity, despite high levels of motivation.<ref name="RCPCHguidelines">{{Cite web | url = https://www.whatdotheyknow.com/request/370385/response/925312/attach/5/Appendix%203%20RCPCH%20CFS.pdf | title =Evidence Based Guideline for the Management of CFS/ME (Chronic Fatigue Syndrome/Myalgic Encephalopathy) in Children and Young People |access-date = 2019-02-01 | date =Dec 2004 | website = | last = Royal College of Paediatrics and Child Health | first = | authorlink = Royal College of Paediatrics and Child Health|archive-url=|archive-date=|url-status=}}</ref>{{Rp|58}} The '''glass ceiling''' is the limit of available energy that a person with ME/CFS has.<ref name="RCPCHguidelines" />{{Rp|58}} <ref name="CMOrept2002">{{cite web| url = https://webarchive.nationalarchives.gov.uk/+/http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4064840 | title = A report of the CFS/ME working group: report to the chief medical officer of an independent working group. | author = CFS/ME Working Group| year = 2002| publisher = Department of Health|location=London}}</ref> In a study by Black and McCully, [[chronic fatigue syndrome]] (CFS) patients were asked to [[Graded exercise therapy|increase their daily physical activity]] by 30% by walking a prescribed amount each day for a period of four weeks. Daily activity was assessed by an accelerometer worn at the hip.<ref>{{Cite journal | last = Black | first = ChristopherD. | last2 = O'Connor | first2 = Patrick J. | last3 = McCully | first3 = Kevin K. | date = 2005-03-03 | title = Increased daily physical activity and fatigue symptoms in chronic fatigue syndrome| url = https://www.ncbi.nlm.nih.gov/pubmed/15745455|journal=Dynamic medicine: DM|volume=4|issue=1 | pages = 3|doi=10.1186/1476-5918-4-3|issn=1476-5918|pmid=15745455}}</ref> For the first 10 days, [[Chronic fatigue syndrome|CFS]] patients were able to increase their activity but then experienced a relapse and symptom exacerbation that prevented them from following the activity program any further. According to the authors, "the inability to sustain target activity levels, associated with [[Post-exertional malaise|pronounced worsening of symptomology]], suggests the subjects with CFS had reached their activity limit."<ref>{{Cite journal | last = Black | first = Christopher D | last2 = McCully | first2 = Kevin K | date = 2005-10-28 | title = Time course of exercise induced alterations in daily activity in chronic fatigue syndrome| url = https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1280928/|journal=Dynamic medicine : DM|volume=4 | pages = 10|doi=10.1186/1476-5918-4-10|issn=1476-5918|pmc=1280928|pmid=16255779|issue=|quote=|via=}}</ref> Other studies have shown that ME/CFS patients are not able to increase their fitness<ref>{{Cite journal | last = Pardaens | first = K | last2 = Haagdorens | first2 = L | last3 = Van Wambeke | first3 = P | last4 = Van den Broeck | first4 = A | last5 = Van Houdenhove | first5 = B | date = 2006 | title=How relevant are exercise capacity measures for evaluating treatment effects in chronic fatigue syndrome? Results from a prospective, multidisciplinary outcome study| url = https://journals.sagepub.com/doi/10.1191/0269215506cr914oa|journal=Clinical Rehabilitation|language=en|volume=20|issue=1 | pages = 56β66|doi=10.1191/0269215506cr914oa|issn=0269-2155|quote=|via=}}</ref> or amount of daily activity<ref>{{Cite journal | last = White | first = PD | last2 = Goldsmith | first2 = KA | last3 = Johnson | first3 = AL | last4 = Potts | first4 = L | last5 = Walwyn | first5 = R | last6 = DeCesare | first6 = JC | last7 = Baber | first7 = HL | last8 = Burgess | first8 = M | last9 = Clark | first9 = LV | date = 2011 | title = Comparison of adaptive pacing therapy, cognitive behaviour therapy, graded exercise therapy, and specialist medical care for chronic fatigue syndrome (PACE): a randomised trial| url = https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)60096-2/fulltext|journal=The Lancet|language=English|volume=377|issue=9768 | pages = 823β836|doi=10.1016/S0140-6736(11)60096-2|issn=0140-6736|quote=|via=}}</ref> the way healthy persons or other patient groups can, after following an [[exercise]] therapy. == See also == * [[Post-exertional malaise]] *[[Exercise]] *[[Graded exercise therapy]] *[[PACE trial]] == References == {{Reflist}} [[Category:Medical hypotheses]]
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