title: Conceptual model for physical therapist management of chronic fatigue syndrome/myalgic encephalomyelitis.
abstract: Fatigue is one of the most common reasons why people consult health care providers. Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is one cause of clinically debilitating fatigue. The underdiagnosis of CFS/ME, along with the spectrum of symptoms that represent multiple reasons for entry into physical therapy settings, places physical therapists in a unique position to identify this health condition and direct its appropriate management. The diagnosis and clinical correlates of CFS/ME are becoming better understood, although the optimal clinical management of this condition remains controversial. The 4 aims of this perspective article are: (1) to summarize the diagnosis of CFS/ME with the goal of promoting the optimal recognition of this condition by physical therapists; (2) to discuss aerobic system and cognitive deficits that may lead to the clinical presentation of CFS/ME; (3) to review the evidence for graded exercise with the goal of addressing limitations in body structures and functions, activity, and participation in people with CFS/ME; and (4) to present a conceptual model for the clinical management of CFS/ME by physical therapists.
authors.affiliation: Department of Physical Therapy, Thomas J Long School of Pharmacy and Health Sciences, University of the Pacific, 3601 Pacific Ave, Stockton, CA 95211, USA. tdavenport@pacific.edu
authors.forename: Todd E
authors.initials: TE
authors.lastname: Davenport
authors.forename: Staci R
authors.initials: SR
authors.lastname: Stevens
authors.forename: Mark J
authors.initials: MJ
authors.lastname: VanNess
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Snell
authors.forename: Tamara
authors.initials: T
authors.lastname: Little
mesh_terms: D003072:Cognition Disorders / Q000503:physiopathology; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D017079:Exercise Tolerance / Q000502:physiology; D015673:Fatigue Syndrome, Chronic / Q000175:diagnosis / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D010101:Oxygen Consumption / Q000502:physiology