Free Online Training
There is now a free online training resource about ME that provides 1 hour of CPD, which is open to any health professional. You can find the training here.
The Physios for ME team have completed this course and would really recommend it for any physiotherapist or health care professional, whether they are already involved with people with ME or are starting their knowledge base from scratch. We found the real-life clinical scenarios really put the theory into context, and it highlighted the importance of understanding the impact of co-morbidities.
Remember, even if you are not based in a specialist service, you may come across people with ME in any area of physiotherapy, for reasons beyond ME itself, so it’s important for every physiotherapist to expand their knowledge. In these times of post-Covid fatigue, there is also plenty of overlap in the management approaches for these patients.
The course has been written by Dr Nina Muirhead, who has personal experience of ME. We caught up with Dr Muirhead to find out more about the course.
Why did you create this course?
"UK education on ME/CFS to date has been lacking and potentially harmful. Despite being a common, chronic, multisystem disease, ME/CFS is not well recognised by doctors and many patients are experiencing delays in diagnosis or lack of belief from medical professionals.
"Biomedical research is more aligned with the patient experience of this disease, particularly in relation to post exertional exacerbation of symptoms, however this has not yet reached the mainstream clinical narrative.
"We are moving away from outdated theories of psychosocial factors perpetuating the illness, such as fear avoidance of exercise, personality type and patients getting trapped in vicious cycles of fatigue. Graded exercise is the mainstay of illness rehabilitation, so it is a huge paradigm shift for healthcare professionals to adjust to the fact that exercise can harm ME/CFS patients.
"The patient experience that in ME/CFS exercise capacity can be reduced by exercising is confirmed by biomedical research. Exercise can result in systemic, cytokine, hypoxic and neuroinflammatory abnormalities and reduce VO2max, reduce power and reduce the lactate threshold. In practice exercise levels demonstrated on day 1 (e.g. 5 minutes of walking) may be over-exertion on day 2, resulting in post exertional malaise and increased disease severity.
Some young, fit and previously athletic patients find that with ME/CFS normal activities of daily living are enough to trigger post exertional malaise."
How did you write the course?
"Writing the module was patient driven and evidence based. It was a collaborative effort with many international clinicians, scientists, charity representatives and patients contributing to the case examples, clinical explanations and peer review.
"This is a case-based module using a wide range of patient examples across typical ages, ethnic subtypes and presenting symptomatology to reflect the heterogenous nature of the disease and its presentation."
What has the uptake been like so far?
"This module has been downloaded over a thousand times in fifty different countries. Around a fifth of those completing the pre and post course questionnaires are physiotherapists or allied health professionals.
"I would like to encourage more physiotherapists to try the course, it is free to access and completion of the course provides a certificate in continued professional development."
Do you have plans to expand on the module, or create any more?
"This module will be updated at around 6 months and/or with publication of the new NICE guidelines. We would like to encourage you to complete the 2-minute pre and post course questionnaires as they are a great way to give your feedback so we can improve the course. All feedback is welcome, we would like to generate more user-friendly teaching materials on this topic."
We’d encourage every physiotherapist to take this course. As it is made up of ten case studies you could split the course into small chunks, or complete the whole thing within an hour.
As Nina states on the course information page: “This module is just the start. There will be some who take time picking through the evidence and I welcome your opinion and future collaboration. For others it may be an extra CPD point. For the patients who are recognised, believed and diagnosed because you have taken the time to do this learning module – it could be life changing.”