The impact of energy modulation on physical functioning and fatigue severity among patients with ME/CFS

Patient Educ Couns. 2009 Nov;77(2):237-41. doi: 10.1016/j.pec.2009.02.015. Epub 2009 Apr 8.


Objective: The energy envelope postulates that patients with Myalgic Encephalomyelitis/chronic fatigue syndrome (ME/CFS) will improve functioning when maintaining expended energy levels at the same level as available energy level.

Methods: Estimated weekly Energy Quotients were established by dividing expended energy level by perceived energy level and multiplying by 100. Two groups of patients were identified following participation in a non-pharmacologic intervention trial. Some were able to keep expended energy close to available energy and others were not successful at this task.

Results: Those who were able to stay within their energy envelope had significant improvements in physical functioning and fatigue severity.

Conclusion: Findings suggest that helping patients with ME/CFS maintain appropriate energy expenditures in coordination with available energy reserves can help improve functioning over time.

Practice implications: Health care professionals that treat patients with ME/CFS might incorporate strategies that help patients self-monitor and self-regulate energy expenditures.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Activities of Daily Living
  • Adaptation, Psychological
  • Adult
  • Analysis of Variance
  • Chi-Square Distribution
  • Cognitive Behavioral Therapy
  • Energy Metabolism*
  • Fatigue Syndrome, Chronic / physiopathology
  • Fatigue Syndrome, Chronic / rehabilitation*
  • Female
  • Humans
  • Interview, Psychological
  • Male
  • Relaxation Therapy
  • Severity of Illness Index
  • Surveys and Questionnaires