Treating chronic fatigue with exercise

BMJ 1998;317:599 ( 29 August )

Letters

Treating chronic fatigue with exercise

Exercise, and rest, should be tailored to individual needs

Results are contradictory for patients meeting different diagnostic criteria

Exercise improves mood and sleep

Authors' reply

Exercise, and rest, should be tailored to individual needs

The first 150 words of the full text of this article appear below.

EDITOR $---$ While I welcome Sharpe and Wessely's reminder about the dangers of bed rest,¹ I am concerned about the blanket adviceregarding activity levels for patients with chronic fatigue. Chronicfatigue syndrome is now generally acknowledged to be a heterogeneouscondition, not a single entity with a single cause. Accordingly,what may suit one person may be totally inappropriate for another.As research has shown, most patients with chronic fatigue syndromeremain ambulant, spend relatively few daytime hours resting, areno more inactive than people with mild multiple sclerosis, andtend to perform at or near their activity ceiling.² What thesepatients need is not a strict programme in which rest is allowedaccording to a predetermined plan but a flexible approach thatdoes not ignore current energy levels or make people feel guiltyif they increase rest periods when they consider this to be rightforthem.