Physiotherapy

Physiotherapy is a healthcare profession concerned with improving physical ability, function and movement in a wide range of conditions.

How does Physiotherapy help people with CFS/ME?

The objective of physiotherapy is to provide support, advice and management strategies for people with CFS/ME.  Physiotherapy focuses upon physical health, strength and fitness. It also integrates other factors such as sleep, emotional well-being and goal setting.  Physiotherapy aims to help people make changes that will positively affect their physical health and look at ways of maintaining these changes.

Physiotherapy is planned individually and may include:

1. Using structured and guided Graded Exercise Therapy (GET)

Graded Exercise Therapy is a structured, mutually agreed and monitored programme, that plans gradual increments of exercise or physical activity. It can help establish regular patterns of activity or gentle exercise that can improve energy levels, physical fitness and strength, as well as help sleep.  Stretches may be used as part of a graded exercise programme, particularly in the beginning.  The programme involves establishing a baseline of physical activity (most often walking) that can be coped with even on a bad day,  and then increasing the duration, but not the intensity, until 30 minutes of exercise is undertaken a day.  Once this is achieved, then the intensity of the exercise is gradually increased.  Incremental increases are dependent on symptoms and are negotiated with the patient regularly.   Physiotherapists specialising in CFS/ME can help individuals to start or return to physical activity or exercise.

GET has been shown in research trials to help people improve both fatigue and function in CFS/ME and is one of the two most effective treatments currently known.

2.  Understanding the condition

Physiotherapists can help individuals understand their condition, by using the biopsychosocial model – this means that is takes physical, psychological and social factors into account when assessing and planning treatment.  An understanding of the condition and the effects exercise have on the body can often make a significant difference in helping people to improve physical function and quality of life.

3.  Managing symptoms

Physiotherapists can provide advice on how to manage symptoms, such as fatigue and pain.

4.  Goal setting

Physiotherapists can help to set personal activity/exercise goals and identify the different steps towards achieving them.  Examples of physical goals are being able to live more independently, getting back to walking, or to return to an enjoyable hobby.  Goals provide the focus for therapy and can be used to help monitor progress.

5.  Encouraging balance in daily life

Physiotherapy can help encourage daily structure and routine.  Physiotherapists use tools such as activity diaries to help individuals identify patterns of activity.

6.  Relaxation/Breathing exercises

Physiotherapists can help with strategies such as relaxation and breathing control to manage symptoms and help maximise restorative rest.  These techniques can help improve sleep and other symptoms.

7.  Sleep advice and monitoring

Sleep disturbance is a common problem for people with CFS/ME. Physiotherapists can help advise on sleep pattern and quality.

8.  Planning a graded return to work

Physiotherapists can help with a graded return to work by helping to plan a programme looking at the physical components.

9.  Managing stress/anxiety

Having a regular routine including physical activity, relaxation and meaningful goals can help to reduce stress or feelings of anxiety or worry.

The Physiotherapy team:

Our Physiotherapy team consists of experienced, senior physiotherapists who specialise in CFS/ME. The team is involved in offering clinical education, teaching and support to other therapists nationwide. We are also involved in research; incuding the PACE research trial (LINK).  The physiotherapy team works closely with other members of the CFS/ME team, including doctors, clinical psychologists and occupational therapists to provide an integrated approach to recovery.  Referrals can be made between disciplines and multi-disciplinary team (MDT) members.

Contact details:

In order to attend for physiotherapy, you will need a referral from your general practitioner and will need to be assessed in the CFS/ME clinic by one of our specialist doctors.  At this time, if physiotherapy is agreed to be useful, you will be referred to the service for an assessment.

Physiotherapy Dept
Rehabilitation Unit
Kenton and Lucas Wing
St Bartholomew’s Hospital
London EC1A 7BE
Tel: 0207 601 8240
Fax: 0207 601 8242

Patient Information Leaflet - Physiotherapy and CFS/ME