Graded exercise for chronic fatigue syndrome

Introduction

You may be thinking, "How can I exercise when I'm so tired I can barely get through the day?" You can do it, as long as you start out very slowly and are careful not to overexert yourself. Most important, it will make you feel better.

Studies show that light aerobic exercise, such as walking, helps people with chronic fatigue syndrome (CFS) feel more energetic and less tired.¹ Maybe you have avoided exercise because you're afraid it will make you feel worse, but the opposite is true. Total rest leaves your body in worse shape. It can also hurt your self-image by making you feel as if you can't do anything for yourself.

What is graded exercise?
Why do I need a graded exercise program?
How can I start an exercise program?
Where to go from here

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What is graded exercise?

Graded exercise is exercise that starts out slowly and increases in very small steps. It means you have a plan for your exercise and you stay with it, even when you're having a good day and feel like doing more. Increasing your exercise very slowly lets your body make the changes it needs to cope with activity and exercise. People with chronic fatigue syndrome often have an exercise program designed for them by a health expert called a physiologist who can create a tailor-made plan and carefully watch the person's progress.

For example, you might start by walking, bicycling or swimming as little as 5 minutes every other day for 2 weeks. If you feel strong enough at the end of 2 weeks, you might add 2 to 5 minutes to your exercise for another 2 weeks, and so on.

Test Your Knowledge

1. When your doctor talks to you about "graded" exercise, he or she means exercise during which you are supervised and given a grade based on how well you do.
1. True
   

   The answer is incorrect

   Graded exercise is exercise that has planned steps, or grades, for increasing the frequency, duration, or intensity of the exercise.

   
2. False
   

   The answer is correct

   Graded exercise is exercise that has planned steps, or grades, for increasing the frequency, duration, or intensity of the exercise.

   

Continue to Why do I need a graded exercise program?
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Why do I need a graded exercise program?

If you have chronic fatigue syndrome, you may have days when you feel pretty good and days when you can barely get out of bed. On your good days, you may decide you can do twice as much, but that may cause a relapse of your symptoms. Those relapses may make you afraid to exercise at all. But if you avoid exercising altogether, your body grows weaker and less able to fight off fatigue as well as illness. People with CFS often feel like they have no control over their bodies, as if they cannot do anything for themselves. By starting a carefully controlled exercise plan, you can begin taking back control.

In combination with good sleep habits and careful scheduling of activities, a gentle, graded exercise program can help you feel better. You must start with very brief activities and gradually increase the frequency, duration, and intensity of exercise as you feel able. This kind of exercise plan can be extremely helpful in relieving and controlling symptoms of chronic fatigue syndrome.

Test Your Knowledge

1. Avoiding all exercise will not help people with CFS feel better. In fact, it can make them feel worse.
1. True
   

   The answer is correct

   When your body gets no exercise, it becomes weaker and less able to fight fatigue and illness.

   
2. False
   

   The answer is incorrect

   When your body gets no exercise, it becomes weaker and less able to fight fatigue and illness.

   

Continue to How can I start an exercise program?
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How can I start an exercise program?

You should work with your doctor to draw up a specific plan for your needs and abilities, but there are things you can do on your own.

Walking is an excellent form of aerobic exercise for people with chronic fatigue syndrome. Other gentle exercises, such as riding a bicycle or stationary bike or swimming, are also good. You need to find a balance so that you are exercising enough to benefit from it but not exercising so much that you become overtired. Here are some things to consider:

• Adopt a positive attitude toward exercise. Try to put aside your doubts and your worries that it will cause a relapse.
• Start very slowly. If you have not been very active lately, it is a bad idea to jump into a vigorous exercise program. Start with just a few minutes of very gentle exercise, such as stretching. When you are comfortable with stretching exercises, add very short periods of a mild aerobic activity such as walking or swimming.
• Increase very gradually. After you know that your body can tolerate this level of exercise over the course of several sessions, increase the length of your exercise session by only 1 minute. Rest frequently, and gradually increase your exercise intensity a little bit at a time until you can exercise for 20 to 30 minutes without becoming overtired. Try to exercise 3 to 4 times a week.
• Don't push yourself too hard. You can easily become overtired, which will defeat the purpose of exercise.
• Don't exercise within 2 hours of bedtime. Exercising just before you go to bed may make it harder to fall asleep.
• Take a few days off when you need to. There may be periods of time when stress or other physical activities make exercise too difficult. When this happens, take a little time off, and then try to get back into your exercise routine as soon as possible.
• Keep track of your exercise on a calendar or use this progress chart.

Test Your Knowledge

1. If you are having a good day and feel more energetic, it's okay to push yourself a little harder than your exercise plan calls for.
1. True
   

   The answer is incorrect

   People with CFS should closely follow their planned exercise program. Increasing your exercise very slowly lets your body make the changes that it needs to cope with activity and exercise. Pushing yourself harder when you're having a good day might cause a relapse of severe fatigue.

   
2. False
   

   The answer is correct

   People with CFS should closely follow their planned exercise program. Increasing your exercise very slowly lets your body make the changes that it needs to cope with activity and exercise. Pushing yourself harder when you're having a good day might cause a relapse of severe fatigue.

   

Continue to Where to go from here
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Where to go from here

Now that you've read this information, you're ready to begin a graded exercise program.

Talk with your health professional

If you have questions, take this information with you when you visit your doctor.

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