Physiotherapist Catherine George talks about how people with ME/CFS, (who have broken energy systems), can approach movement and exercise safely with analeptic exercise.
Presentation for MECFS Canterbury, Rangiora, 14th March 2023
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This session explores:
✦ Why normal exercise doesn't work for people who experience post-exertional malaise.
✦ What is analeptic exercise?
✦ How does it work?
✦ Examples
Analeptic exercise is focused on improving functional strength and flexibility, rather than increasing fitness. It can be an appropriate movement programme for people with ME/CFS who are not able to tolerate exercise without triggering post-exertional malaise. There are options for those of us who are required to spend significant periods of time resting in bed.
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**About Catherine George:**
Over the last 20 years Catherine has worked in Australia, England and New Zealand as a physiotherapist with children, youth, and adults, to assess, treat and encourage self-management of breathing (respiratory) conditions. She has recently been supporting people with long Covid with breathing and safe exercise.
Qualifications include BPhty, Certificate of Proficiency in Breathing, Performance and Rehabilitation (AUT), Bradcliff method.
Catherine is a NZRP, MPNZ, Member of PNZ cardiorespiratory and mental health specialist interest groups and works closely with Canterbury Private Respiratory Specialists.
Contact details:
• www.thelungmechanic.co.nz
• [email protected]
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ADDITIONAL RESOURCES:
✦ Timestamped slide list further below
✦ Slide deck in pdf format https://drive.google.com/file/d/1P4EpRdQU30jzfnp2hsKCuXlpgJNcZmo4/view?usp=share_link
✦ Pacing self-management strategy
https://world.physio/sites/default/files/2021-06/WPTD2021-InfoSheet4-Pacing-Final-A4-v1a.pdf
✦ https://workwellfoundation.org/resources/
✦ Watch Catherine's previous presentation on 'Breathing - What it affects and how you can improve it' https://youtu.be/_6SRuD0at5U
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CONTENT /SLIDE LIST:
00:00 Intro
02:32 Plan
**Why normal exercise doesn’t work**
02:50 Post-Exertional Physiology in People with Post-Exertional Symptom Exacerbation (PESE)
03:52 Why working out doesn’t work out... (Aerobic vs Anaerobic Metabolism)
04:36 % of total energy vs timeline (Immediate vs Short Term vs Long term)
07:28 Relative Contributions of Metabolic Pathways vs Activity Duration
08:01 How do we rely more on shorter duration system / Short term energy system?
08:52 Oxygen debt & Interest Rates
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**How to build anaerobic Capacity**
10:21 Roller coaster vs activity avoider
11:00 How and why to do this... (functional and restorative)
11:59 Activity monitoring – Heart Rate under anaerobic threshold
15:49 Exertional scale
16:41 Post Exertional Malaise Timecourse
17:33 Energy Conservation (see slide deck or resources list for clearer view of info image)
19:02 Stay in your Energy Envelope!
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**Examples and discussion**
19:07 Analeptic Exercise Therapy – core concepts
19:17 Q. Is the heart rate threshold calculation safe to use in paediatrics or teens?
22:49 Stages of Analeptic Exercise
23:48 Functional goals – one size does not fit all!
25:17 Example: to get up the stairs
27:19 More examples: breathing
29:36 Q. Would you always have to do the exercises lying down?
32:52 Start where you are at
34:18 Example exercises (bottom and thigh muscle groups)
37:02 “General rule: only add in one thing at a time...”
38:26 “A massive grieving process...” The balance of mood/pleasure and exertion
42:53 More example exercises (thighs)
43:13 More example exercises (upright)
44:30 More example exercises (stretches)
45:45 More example exercises (more stretches)
**In closing:**
45:57 Summary – navigating the gap between what you want to do, and what you can do
46:59 Q. ‘All exercises are good providing you’re doing the exercise correctly’, true or false? (The right kind of exercise to train the anaerobic metabolism)
49:20 Still learning, educating the professionals
51:05 Outro, thanks