How Exercise is Good for Chronic Fatigue

What is Chronic Fatigue Syndrome: Symptoms and Treatment

Chronic fatigue syndrome (CFS) is a condition characterised by persistent, medically unexplained fatigue, as well as symptoms such as musculoskeletal pain, sleep disturbance, headaches and impaired concentration and short‐term memory. Estimates of how common CFS is are somewhat rare, but the latest research from the US reports that between 0.2% and 2.0% of people are affected by CFS.1 The symptoms of CFS can cause significant disability and distress for patients, especially as there is no clear medical cause. As a result, patients often deal with a misunderstanding of their condition from family, friends and healthcare professionals.

The National Institute for Health and Care Excellence recommends exercise therapy (a regimen of physical activity designed and prescribed to relieve or heal a disorder) as a possible treatment for individuals with CFS, and there is an interesting body of research to support this.2 A recent large review by a group of researchers from Norway provide a nice summary of this work.3

They found that:

• Exercise therapy was more effective at reducing fatigue compared to ‘passive’ treatment or no treatment;
• Exercise therapy had a positive effect on people’s daily physical functioning, sleep and self‐ratings of overall health;
• Exercise therapy did not worsen symptoms for people with CFS and serious side effects were rare. However, not all studies reported information regarding safety, making it difficult to draw firm conclusions.

Of the studies included in the review, the most effective intervention had an exercise program like this:

• The program was 12 weeks long
• The type of exercise was treadmill walking/jogging
• This was performed 4/5 times per week
• Initially, the exercise was low intensity (50% of a participant’s max heart rate), progressing as high as 80% of their max heart rate over the 12 weeks
• Your max heart rate can be roughly calculated by subtracting your age from 220
• For example, if you are 20 years old, your max heart rate is 200; if you are 50 years old, your max heart rate is 170, etc.

As the physiology behind the development of CFS is not fully understood, it is unclear which biological effects of exercise actually impact on CFS. Some psychological mechanisms such as distraction from symptoms have been demonstrated to positively influence symptom perception,4 but the effect is likely underpinned by a combination of various physiological and psychological mechanisms.

Of course, if you do wish to begin an exercise program to help with your chronic fatigue, please make sure to contact your doctor first! Also keep in mind the words of Pete McCall, Exercise Physiologist at the American Council on Exercise:
"The most important thing with starting an exercise program to combat fatigue is to establish a regular pattern of exercise.”

However, even if you do not have time in your schedule on a particular day, he recommends finding “activities, such as taking the stairs or parking in the spot farthest away from their destination, to help increase your daily activity levels."
Every little bit of activity adds up.

Read more articles in our Cognitive Function and Exercise series

References:

1.   Reeves WC, Jones JF, Maloney E, Heim C, Hoaglin DC, Boneva RS, Morrissey M, Devlin R. Prevalence of chronic fatigue syndrome in metropolitan, urban, and rural Georgia.Population Health Metrics. 2007;5(1):5.
2.   National Institute for Health and Care Excellence (2017) available at: https://www.nhs.uk/conditions/chronic-fatigue-syndrome-cfs/treatment/
3.   Larun L, Brurberg KG, Odgaard‐Jensen J, Price JR. Exercise therapy for chronic fatigue syndrome.Cochrane Database of Systematic Reviews. 2017;4:CD003200.
4.   Moss-Morris R, Sharon C, Tobin R, Baldi JC. A randomized controlled graded exercise trial for chronic fatigue syndrome: outcomes and mechanisms of change.Journal of Health Psychology. 2005;10(2):245-59.