Energy Envelope Theory
The Energy Envelope Theory is a self-management tool to reduce symptom severity and the frequency of relapses. This theory suggests that because variations in day-to-day energy levels are often unpredictable in people with ME/CFS, they are to assess their perceived energy levels on a daily basis (or in smaller time increments, as needed) and use that level to gauge their energy expenditure for the day. It encourages people with ME/CFS to accept their daily energy limitations and not exceed or fight them.
Some practitioners of the Energy Envelope Theory take the concept further by recommending that people with ME/CFS do less than their perceived energy would allow in order to have energy left over for recovery.
Under the Energy Envelope Theory, treatment programs that recommend a steady increase in daily activity are discouraged because the person with ME/CFS may exceed the amount of energy available for that day, thereby initiating post-exertional malaise or an increase in symptoms. Those that stay within their daily "envelope" of energy, not only have fewer symptoms but often recover to a higher functioning level than those who don't.
Patient experiences with the Envelope Theory
- The Just ME blogger, Sally Burch, has written about self-pacing and the energy envelope in a post called "Play-Up & Lay-Up" not "Boom & Bust".
- Brain Campbell, PhD, has included the Envelope Theory in chapter 7 of his manual, Recovery from Chronic Fatigue Syndrome: One Person's Story
- 2013, Energy Conservation/Envelope Theory Interventions to Help Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.
- 2008, The Energy Envelope Theory and myalgic encephalomyelitis/chronic fatigue syndrome. (Full text)
- "Play-Up & Lay-Up" not "Boom & Bust" - Sally Burch
- Solve ME/CFS Initiative - Managing Your Energy Envelope by Bruce Campbell (pdf)
- Health Rising - Coping vs Energy Envelope in CFS
- Post-exertional malaise
- Pacing with a heart rate monitor
- Bed rest
- Spoon theory
- Graded exercise therapy
- Activity management based on 2-day cardiopulmonary exercise testing results
- Coping strategies
- Jason, Leonard A.; Muldowney, Kathleen; Torres-Harding, Susan (2008), "The Energy Envelope Theory and myalgic encephalomyelitis/chronic fatigue syndrome", American Association of Occupational Health Nurses, 56 (5): 189-95, doi:10.3928/08910162-20080501-06
- Jason, LA; Brown, M; Brown, A; Evans, M; Flores, S; Grant-Holler, E; Sunnquist, M (2013), "Energy conservation/envelope theory interventions", Fatigue: Biomedicine, Health & Behavior, 1 (1-2): 27-42, doi:10.1080/21641846.2012.733602
- "Play-Up & Lay-Up not Boom & Bust