Anonymous
Not logged in
Talk
Contributions
Create account
Log in
Search
Editing
Jo Nijs
(section)
From MEpedia, a crowd-sourced encyclopedia of ME and CFS science and history
Namespaces
Page
Discussion
More
More
Page actions
Read
Edit
Edit source
History
Warning:
You are not logged in. Your IP address will be publicly visible if you make any edits. If you
log in
or
create an account
, your edits will be attributed to your username, along with other benefits.
Anti-spam check. Do
not
fill this in!
=== A symptom-contingent exercise program === In 2008, Nijs collaborated with Karen Wallman and Lorna Paul to work out an exercise program for ME/CFS that took into account post-exertional malaise. Although it was still instructed to exercise progressively and to build up stamina, the key advice was that patients should listen to their body while doing so. They could for example change their schedule if they were having a bad day. Nijs et al. criticized earlier approaches that used a time-contingent approach where patients have to follow a pre-set plan, regardless of how they were feeling. <blockquote>"Early approaches to graded exercise therapy advised patients to continue exercising at the same level when they developed symptoms in response to the exercise. This led to exacerbation of symptoms and adverse feedback from patients and patient charities."<ref name="NijsSM2008" /></blockquote>To prevent relapses, Nijs, Paul and Wallman advised to build in a long stabilization phase in which patients had to find the right balance between rest and activity. With this approach, symptom fluctuation has to be reduced to a manageable level first. Only when the patient feels that she can cope with a certain level, can it be decided to build up exercises. This form of self-management combined with graded exercise was criticized by Lucy Clark and Peter White. They emphasized that a graded exercise program has to be time-contingent to be effective: <blockquote>"[…] a central concept of GET is that patients maintain their level of exercise as much as possible even after a CFS/ME setback. This is to reduce the many negative consequences of rest and allow the body to habituate to the increase in activity."<ref name="Letter2008" /></blockquote> In 2011, Nijs & Wallman collaborated with Leonard Jason, who had helped develop the [[Energy Envelope Theory]], and [[Ellen Goudsmit]], who had studied the use of pacing. Together they worked out a 'consensus document' about the main principles of the pacing in ME/CFS. According to the authors there was a "lack of information on the efficacy of time-contingent protocols in people with evidence of neurological or immunological disease."<ref name="Pacing2012" /> Nijs and colleagues proposed an approach where patients limited their activities in response to internal cues of post-exertional malaise. Patients were only advised to gently increase their activity levels if their health had stabilized and they were close to about 60 to 70% of their former functioning.
Summary:
Please make sure your edits are consistent with
MEpedia's guidelines
.
By saving changes, you agree to the
Terms of use
, and you irrevocably agree to release your contribution under the
CC BY-SA 3.0 License
and the
GFDL
. You agree that a hyperlink or URL is sufficient attribution under the Creative Commons license.
Cancel
Editing help
(opens in new window)
This page is a member of a hidden category:
Category:CS1 Nederlands-language sources (nl)
Navigation
Navigation
Skip to content
Main page
Browse
Become an editor
Random page
Popular pages
Abbreviations
Glossary
About MEpedia
Links for editors
Contents
Guidelines
Recent changes
Pages in need
Search
Help
Wiki tools
Wiki tools
Special pages
Page tools
Page tools
User page tools
More
What links here
Related changes
Page information
Page logs