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Energy Envelope Theory
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== Criticism == ===Sometimes staying within the envelope doesn’t work === In 2013 the Jason research group published results of a cluster analysis of the 114 ME/CFS patients used in earlier studies. Results showed that there was one group (Cluster 3) of patients with highly impaired functioning and post-exertional malaise, despite staying within their energy envelope. According to the authors, “this suggests that adaptive coping strategies were not associated with improved health.”<ref>{{Cite journal | last = Brown | first = Abigail A. | last2 = Evans | first2 = Meredyth A. | last3 = Jones | first3 = Nev | last4 = Jason | first4 = Leonard A. | date = Dec 2013 | title = Examining the Energy Envelope and Associated Symptom Patterns in ME/CFS: Does Coping Matter?| url = https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3893101/|journal=Chronic illness|volume=9|issue=4 | pages = 302–311|doi=10.1177/1742395313478220|issn=1742-3953|pmc=3893101|pmid=23585632}}</ref> ===More emphasis on doing less? === Some have argued that the envelope theory should put more emphasis on reducing activities, as most ME/CFS patients will overestimate what they can and underestimate the detrimental effects overexertion has on their health.<ref>{{Cite news |url =https://twitter.com/KeelaToo/status/1026727305585074176 | title = Sally Burch on Twitter|work=Twitter|access-date=2018-08-21|language=en}}</ref> ME advocate Gabby Klein, for example, wrote: “My treating physician - Dr. Enlander - always told me to do 50% of what I think I can do. It was the best advice I got. There is much more potential harm from activity/exercise than from rest.”<ref>{{Cite news |url =https://twitter.com/GabbyKlein1/status/1026561377828306947 | title = Gabby Klein on Twitter|work=Twitter|access-date=2018-08-21|language=en}}</ref> These arguments are supported by the average energy quotient found in Jason's research. In one study for example, this quotient was 239; meaning that most patients were overexerting themselves and underactivity was rather rare. In fact, Jason had to redefine the ‘envelope’: instead of a score of 100 - the point where energy availability and expenditure are balanced - a score of 150 was used since few patients had an energy quotient below 100.<ref>{{Cite journal | last = Brown | first = Molly | last2 = Khorana | first2 = Neha | last3 = Jason | first3 = Leonard A. | date = Mar 2011 | title = The Role of Changes in Activity as a Function of Perceived Available and Expended Energy in Non-Pharmacological Treatment Outcomes for ME/CFS| url = https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3164291/|journal=Journal of clinical psychology|volume=67|issue=3 | pages = 253–260|doi=10.1002/jclp.20744|issn=0021-9762|pmc=3164291|pmid=21254053}}</ref>
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