Each year on May 12, we acknowledge International Awareness Day for Chronic Immunological and Neurological Diseases (CIND). A collective term for life-altering conditions like ME/CFS (Myalgic Encephalomyelitis/Chronic Fatigue Syndrome), Fibromyalgia, Multiple Chemical Sensitivity (MCS), Gulf War Illness, and Long COVID.
These conditions are often invisible but have very real impacts: fatigue that doesn’t improve with rest, chronic pain, brain fog, dizziness, and intolerance to physical and mental exertion. Many people living with CIND struggle to perform everyday tasks, let alone engage in traditional exercise.
Understanding Movement in the Context of CNID
In many chronic illnesses, exercise is a cornerstone of care. But in CIND, it’s more complicated. Some individuals, especially those with ME/CFS or Long COVID, experience post-exertional symptom exacerbation (PESE), where physical or cognitive effort leads to symptom flare-ups.
So, when we talk about exercise in this context, we don’t mean “just get moving.” We mean:
Pacing over pushing: Respecting energy limits and avoiding overexertion
Symptom-guided progressions: Letting the body lead the way
Rest as intervention: Strategic rest breaks are part of the plan
Function, not fitness: Prioritizing daily activity tolerance over training outcomes
What Does Safe Movement Look Like?
With the right support, some people with CIND can benefit from movement, but it must be gentle, flexible, and person-centred:
- Stretching and mobility: To reduce stiffness and support circulation
- Breathwork: To ease autonomic symptoms like dizziness or palpitations
- Light strength work (when tolerated): Using resistance bands or body weight in short bursts
- Seated or supine activity: Especially for those with orthostatic intolerance
- Energy conservation strategies: Teaching clients to “budget” their daily energy
Research in conditions like fibromyalgia shows that low-impact aerobic exercise (e.g., walking, aquatic therapy) can improve mood, pain levels, and sleep. But for each person, the right level of activity, and even the definition of “exercise” is different.
Our Role as Exercise Physiologists
We have a vital role to play in the lives of people with CIND:
- Listening first: Validating lived experience and symptom reports
- Adapting continuously: Adjusting plans daily or weekly based on feedback
- Working in a team: Collaborating with doctors, physios, OTs, and psychologists
- Advocating for safe movement: Educating the public and the profession about appropriate exercise strategies
Conclusion
People living with CIND face real challenges, even if you can’t always see them. With more awareness, more compassion, and more informed care, including thoughtful, personalized approaches to exercise, we can help create a world where no one feels invisible.
Written By Uplift EP, Luke O’Connor
References:
National Institute for Health and Care Excellence (NICE). Myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome: diagnosis and management. NICE guideline [NG206]. 2021, click here
World Health Organization. A clinical case definition of post COVID-19 condition by a Delphi consensus, 6 October 2021, click here
Häuser W, Klose P, Langhorst J, et al. Efficacy of different types of aerobic exercise in fibromyalgia syndrome: a systematic review and meta-analysis of randomised controlled trials. Arthritis Res Ther. 2010;12(3):R79, click here
Larun L, Brurberg KG, Odgaard-Jensen J, Price JR. Exercise therapy for chronic fatigue syndrome. Cochrane Database Syst Rev. 2019;10(10):CD003200, click here
