Graded exercise therapy

Graded exercise therapy (GET) is an intervention technique that utilizes physical activity as the principal treatment method for addressing the symptoms of chronic fatigue syndrome. It promotes engagement in a program of physical activity that starts very slowly and gradually increases over time. This approach is used as part of a treatment plan for chronic fatigue syndrome (CFS), alternately referred to as myalgic encephalomyelitis (ME), and certain other conditions. This method avoids the extremes of the "push-crash" cycle of over-exercising during remittance or not exercising at all due to concern of relapse.[1]

Graded exercise therapy
Other namesGET

Typically the GET program begins with active stretching, followed by range-of-motion contractions and extensions, done for five minutes per day for a completely inactive individual. Avoiding extremes is key, and activity must be balanced with rest. Exercise sessions should be preset by the number of repetitions or amount of time. The duration is determined by the patient using trial and error, with the goal of stopping before becoming tired. Research has suggested that gradual, guided physical activity can be helpful, though not a cure, for individuals with CFS/ME.[1]

Support and opposition

Some prominent health organisations support the usefulness of GET for chronic fatigue syndrome (UK's NHS,[1] and the Royal Australian College of General Practitioners[2]).


The patient group ME Association's position statement asserts that GET causes adverse reactions in a significant percentage of patients.[3] The United Kingdom’s National Institute for Health and Care Excellence (NICE) has also removed graded exercise therapy from their recommended treatments for patients with chronic fatigue syndrome.

References

  1. , NHS's "Treating chronic fatigue syndrome"
  2. , Royal Australian College of General Practitioners's "Graded exercise therapy: chronic fatigue syndrome"
  3. , ME Association position on graded exercise therapy.
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