Workwell Foundation

Workwell Foundation was founded by Staci Stevens and is based in Ripon, California, US. It specialises in two-day cardiopulmonary exercise test (2-day CPET) for people with ME/CFS, Fibromyalgia and other fatiguing illnesses.

Notable people

• Staci Stevens: Founder
• Christopher Snell: Scientific Advisory Committee Chair
• Daniel Peterson: Medical Supervisor
• Mark VanNess: Scientific Advisory Committee Member
• Todd Davenport: Scientific Advisory Committee Member

Notable studies

• 2013, Discriminative validity of metabolic and workload measurements to identify individuals with Chronic Fatigue Syndrome
• 2011, Diagnostic accuracy of symptoms characterising chronic fatigue syndrome
• 2010, Post-exertional malaise in women with chronic fatigue syndrome
• 2010, Conceptual model for physical therapist management of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis
• 2005,Exercise capacity and immune function in male and female patients with Chronic Fatigue Syndrome (CFS)
• 2003, Subclassifying Chronic Fatigue Syndrome through Exercise Testing

Exercise recommendations for ME/CFS

Workwell Foundation recommends short periods (eg: 30 seconds) of analeptic exercise, with periods of rest which are 3-6 times longer than the period of exercise. The amount of exercise that the individual undertakes should be guided by VO2 max testing (or a safe heart rate threshold (generally 60% of maximum heart rate)), and the use of a heart rate monitor (both during exercise and to help with pacing) is recommended to ensure that the individual doesn't exceed their capacity. The Foundation also advises against aerobic exercise for people with ME/CFS.

This approach to exercise differs from graded exercise therapy (GET) in several important ways:

• There is no claim that the exercise program will cure the condition. The aim is to increase functional strength and flexibility, and to improve quality of life
• This program is based on a deep understanding of Post-exertional malaise (PEM), and the importance of staying within the energy envelope in order to not trigger PEM
• There is a recognition that any approach to exercise with people with ME/CFS must be carefully tailored to the individual. There is no one-size fits all
• This approach utilises objective measures such as VO2 max testing and heart rate monitoring to guide the level of activity suitable for the individual

COVID-19 rehabilitation information

• May 2020, Post Covid-19 Rehabilitation - Physios for ME, Workwell Foundation, and ME Association

Open letters

• 2018, The Workwell Foundation release an open letter to healthcare providers, detailing their concerns about GET.
• 2020, Opposition to Oxford Health NHS Foundation Trust: "Coping with Coronavirus: Fatigue" - joint letter with over 20 UK organisations, professionals and politicians

Talks and interviews

• Video: Post-exertional malaise: How to do more with less, Staci Stevens, Vancouver BC Canada, May 2015
• Video: A Realistic Approach to Exercise and Rehabilitation in ME/CFS, Mark VanNess, Bristol UK, Feb 2014
• Video: Cardio-Pulmonary Exercise Test (CPET), Workwell Foundation, Mar 2014

Online presence

• PubMed
• Twitter
• Facebook
• Website
• YouTube

Learn more

• Busted! Exercise study finds exercise production system is broken in Chronic Fatigue Syndrome, Cort Johnson, Jul 2013
• Functional outcomes of anaerobic rehabilitation in a patient with Chronic Fatigue Syndrome: Case report with 1-year follow up, Workwell Foundation, Dec 2015
• When working out doesn't work out, Workwell Foundation, Apr 2014
• A realistic approach to exercise for CFS patients, Workwell Foundation, Apr 2014

See also

• Two-day cardiopulmonary exercise test
• Post-exertional malaise
• Exercise
• Mark Vink

two-day cardiopulmonary exercise test (CPET) - A diagnostic test which involves testing an ME/CFS patient exercising on an exercise machine, while monitoring their respiration, especially oxygen consumption. This test is repeated the following day in order to confirm the patient's inability to replicate the first-day performance. This test is thought to be the most objective way to detect post-exertional malaise.

VO2 Max (VO2max) - the maximum amount of oxygen the body can utilize during a specified period of usually intense exercise (Volume of O2 Maximal)

heart rate (HR) - the number of times the heart beats within a certain time period, usually a minute

heart rate monitor (HRM) - A device that measures your heart rate (pulse rate). Heart rate monitors may come as a chest strap, wrist strap, smartwatch, or even as a mobile phone app. Heart rate monitors are often used by ME/CFS patients to pace their exertion, in order to avoid post-exertional malaise (PEM). For more information, see pacing with a heart rate monitor.

graded exercise therapy (GET) - A gradual increase in exercise or activity, according to a pre-defined plan. Focuses on overcoming the patient's alleged unhelpful illness beliefs that exertion can exacerbate symptoms, rather than on reversing physical deconditioning. Considered controversial, and possibly harmful, in the treatment or management of ME. One of the treatment arms of the controversial PACE trial.

post-exertional malaise (PEM) - A notable exacerbation of symptoms brought on by small physical or cognitive exertions. PEM may be referred to as a "crash" or "collapse" and can last for days or weeks. Symptoms can include cognitive impairments, muscle pain, trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, and others.

Chronic Fatigue and Immune Dysfunction Syndrome (CFIDS) - Chronic Fatigue and Immune Dysfunction Syndrome is another term for Chronic Fatigue Syndrome, but one which emphasizes the immunological aspects of the disease. Popular in the 1990s, this term has apparently fallen into disuse.