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
Studies show that light aerobic exercise, such as walking,
helps people who have
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.
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.
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.
Graded exercise is exercise that has planned
steps, or grades, for increasing the frequency, duration, or intensity of the
Continue to Why?
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.
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.
Avoiding all exercise will not help people with CFS
feel better. In fact, it can make them feel worse.
When your body gets no exercise, it becomes
weaker and less able to fight fatigue and illness.
Continue to How?
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:
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
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
Continue to Where?
Now that you've read this
information, you're ready to begin a graded exercise program.
Talk with your health professional
you have questions, take this information with you when you visit your
Return to topic:
Chronic Fatigue Syndrome
CitationsReid S, et al. (2008). Chronic fatigue syndrome,
search date September 2007. Online version of BMJ Clinical Evidence. Also available online:
http://www.clinicalevidence.com.U.S. Department of Health and Human Services (2008).
2008 Physical Activity Guidelines for Americans (ODPHP
Publication No. U0036). Washington, DC: U.S. Government Printing Office.
http://www.health.gov/paguidelines/pdf/paguide.pdf.Other Works ConsultedTogo F, et al. (2010). Sleep is not disrupted by exercise in patients with chronic fatigue syndromes. Medicine and Science in Sports and Exercise, 42(1): 16–22. White PD, et al. (2011). Comparison of adaptive pacing therapy, cognitive behaviour
therapy, graded exercise therapy, and specialist medical care
for chronic fatigue syndrome (PACE): A randomised trial. Lancet, 377(9768): 823–826.
April 22, 2011
Anne C. Poinier, MD - Internal Medicine & Nancy Greenwald, MD - Physical Medicine and Rehabilitation
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