ME patients won’t be told to exercise

It’ll no longer be used as therapy

PATIENTS with chronic fatigue syndrome must no longer be told to start exercising to relieve symptoms, the health watchdog has ruled.

New medical guidelines said graded exercise therapy (GET) should not be recommended for those with myalgic encephalomyelitis (ME), also known as chronic fatigue syndrome.

The treatment involves starting an activity, such as swimming or walking, which is gradually increased.

But many patients wanted it banned as they say it is harmful. The National Institute for Health and Care Excellence (Nice) guidelines were published last night after a long-running row between campaigners and doctors.

They had been due to be published in August but were put on hold as Nice said a ‘number of professional groups are unwilling to support the guideline’.

Both the Royal College of Physicians and the Royal College of Paediatrics and Child Health said the therapies did help some patients.

But campaign group ME Action said evidence demonstrates graded exercise ‘harms most people with ME’.

Sian Leary, of the group, said not publishing in August had been ‘devastating to thousands of people with ME’ who had been ‘seriously harmed by graded exercise therapy’.

Nice has now pressed ahead with publication and no longer recommends GET, where a patient’s baseline level of activity is determined and they are given a programme to increase their exercise. ME is a longterm illness with a range of symptoms, the most common being extreme fatigue.

It affects 250,000 people in the UK. ME can affect anyone, including children, but is more common in women and tends to develop in people in their mid-20s to mid-40s. Until now treatments included cognitive behavioural therapy (CBT), GET and medication to control pain, nausea and sleeping problems.

The new guideline says there is no ‘one size fits all’ approach to managing ME symptoms.

It called for patients to be given a personalised treatment plan to improve activity levels, which is reviewed regularly and can be applied to any type of activity whether emotional, social or physical. Nice concluded CBT should only be offered to support people who live with ME to manage symptoms, improve functioning and reduce distress associated with having a chronic illness.

It also recommends reducing the time a person needs to have persistent symptoms before a diagnosis is made from four months to three.

Baroness Finlay, vice-chairman of the guideline committee, said: ‘Committee members involved in this guideline have worked particularly hard to ensure care becomes more empathetic and focused on the individual’s needs.’

Professor Chris Ponting, from the University of Edinburgh’s Institute of Genetics and Cancer, said the new guidelines ‘will improve awareness that graded exercise often makes ME symptoms worse’.

‘More focused on people’s needs’