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The Posture Theory and Chronic Fatigue

The 1982 Research Project (Measuring the fitness levels of volunteers with persistant fatigue and assessing the benefits of exercise)
 

The Posture Theory and Chronic Fatigue

The first indication that I had that posture had anything to do with my own health problems was when I was working as a public service clerk.

I was transferred to the cash controllers office where part of my duties was to sit at a desk and count the daily take of coins into piles of twenty of their particular denomination.

I noticed that after a couple of hours of starting work at 9 a.m. that I would get a vague ache in the left side of my back at the level of my left kidney, and if I continued with that work for another hour I would also start getting the ache in the region of my right kidney.

A few months later I had some tests and was found to have a stone in my left kidney.

About a year later, when I was engaged in my usual pastime of gymnastics, I performed a handspring heels over head leap and when my feet landed on the floor with my back arched I felt a ripping sensation in my upper abdomen. I waited a few moments to see if blood would come pouring from my belly, up through my throat , and out of my mouth, but nothing happened so I resumed my activities as an instructor without any further problems.

However in the next month or so, I started to notice that I would get a nagging ache in my belly about an hour after commencing my days work as a clerk. I also noted that these aches were associated with leaning toward the desk to read or write, and that the longer I did that work for the worse the pain got. Hence the pain was worse on the busiest days of the week.

Within a year or two the abdominal pain was becoming more of a problem and I was beginning to feel faint, or dizzy or breathless as well, each time I leaned toward a desk.

I was also getting fatigue, and one night in the gym I performed an exercise called a round off back somersault and when I landed on my feet I felt dizzy and it appeared as if a thousand stars were shooting in all directions before my eyes, so I stood still and staid bent over. I then waited for a few moments expecting to lose consciousness and collapse, but I recovered without ill effect and continued with my activities, although in a more subdued manner.

The problems were therefore beginning to have a serious effect on my occupation and my lifestyle.

Unfortunately the problems were a mystery to my doctor, and the medication that he was prescribing was not helping, as my health continued to deteriorate regardless.

At about that time I read that an organisation called The South Australian Institute For Fitness Research and Training was conducting fitness training programmes under medical supervision for various ailments. I therefore thought that I could attend such a course as treatment and that research doctors might be able to enlighten me about the nature of my ailments.

At the initial medical assessment I was required to ride an ergometric cycle while attached to electrodes which recorded pulse rate over wheel pressure and could measure aerobic capacity with scientific reliability. The result was a fitness level of zero, compared to a friend of mine who measured 900, and an Olympic athletes measurement of 1200. Another person I met was a forty year old overweight asthmatic with a measurement of 600.

At the same session my body fat was measured with calipers, and I was told that I was all skin and muscle, with virtually no body fat, and that I had the muscle, fat ratio of an athlete, probably due to ten years of sport and gymnastics.

I trained at the Fitness Institute for three months and achieved a level of 350 kpms, and increased the programme to four times a week and three months later was still at 350 kpm's so I concluded that I had some sort of physical impairment which was limiting my fitness capacity regardless of the amount of exercise I did. I trained more often again for another 3 months and then injured my knee cartilage while playing social volleyball with the other programme participants. My leg remained injured due to diagnosis and post operative problems for 3 years.

During all of that time I was inquiring about my health and studying it and writing about my conclusions, and submitting my essays to The Australasian Nurses Journal. After several articles had been published I met and befriended the editor, Edna Davis, who continued to publish my articles about once every three months. Five years later I was able to conclude that most of my ailments were aggravated by leaning forward, including the fatigue, and in 1980 I wrote a three page essay called The Matter Of Framework, which I have since called The Posture Theory.

Some time later I became aware that Sir Mark Oliphant was living in a nursing home in North Adelaide and I knew that he was regarded as one of Australia's most respected scientists for his involvement in the Manhattan Project which developed the atom bomb, so I phoned him and arranged a meeting with the objective of asking him his opinion about the theory. At our first meeting he said that he thought the idea was interesting, but that he was not qualified to comment on medical matters with any authority. However he told me that he would discuss it with some of his colleagues who were among the country's top medical researchers and let me know their opinion. When I met him again two weeks later he advised me that his medical colleagues also regarded the theory as interesting but that it was not possible to say anything other than that because that whole area of medicine (the range of undetectable an unmeasurable ailments) was a Pandora's box of mysteries.

One day, while walking along a city street I met a friend of mine, Clive Thelning, who was blind, and who I had befriended some years earlier when I was studying group psychology at The South Australian Institute of Technology, and I asked him what he was doing. He had completed the Certificate Course, and went on to do a Psychology Degree, and was working as a psychologist. I told him about my essay and he said that he knew Tony Sedgewick who was the head of The Fitness Institute where I trained, so he suggested that I approach him with the view to arranging some research on the subject.

At a subsequent meeting with Tony Sedgwick I outlined a potentially useful training and research programme for reliably and scientifically assessing the aerobic capacity of people with persistent fatigue, and asked him to discuss it with his research staff to see if they were interested.

At a further meeting he advised me that his staff were fully committed to other projects and invited me to run the programme.

I told him that my health problems would impede my capacity to do such a project properly, and added that I thought I was not able to do scientific studies unless I had medical qualifications, and that I didn't know how it would be funded. He then advised me that he had some medically qualified contacts and that I could approach them with the view to forming a committee to satisfy all the requirements of administering such a course, and he gave me the name of a politician who I could approach for funding.

A committee was formed and a very small government research grant was obtained so the programme was established.

I then approached a journalist named Diane Beer who wrote several articles for the Adelaide newspaper called the "News" inviting people with persistent fatigue to attend the course.

After three years 80 people had been assessed as having aerobic capacities of 100 to 1200 kpms with variable responses to training from those who did not participate, to those who trained but did not gain much in fitness, to one who trained for nine months and participated in a small marathon (about 6 miles).

My own health problems stopped me from continuing the recording and reporting of the statistics in programme, but there was also conflicting data which I couldn't account for. i.e. I expected all fatigued participants to have low aerobic capacity, but some had normal or high levels, and I didn't understand how that could be so at the time of making my initial report. However, about 5 years later I drew the conclusion that those fatigued people who had low aerobic capacity possibly had a fitness disorder (a disorder of exercise metabolism), and those with a high aerobic capacity must have had a sleep disorder. (In the English language the word fatigue has two meanings: more commonly it means physical exhaustion, but that same word is also used to describe tiredness, therefore, if you recruit people with fatigue into a training programme, then you are likely to get two totally different types of volunteer, those who become readily exhausted by exertion, and those who are always drowsy - you would also find some overlap and confusion of both symptoms in the same individual).

Another five years went by when I was diagnosed with cancer and given two months to live with no hope of a cure. The cancer had spread to most of my lymph glands, and was in my blood and bone marrow.

I did not think that I would be able to study and cure cancer in two months, so I decided to occupy my remaining time by writing about posture and health, and if sitting at a desk aggravated my health problems it wouldn't matter because I would soon be dead anyway.

The task did aggravate my health problems and caused some damage as I wrote one sentence, or one paragraph, or one essay at a time. After about 6 years I discovered that standing and typing on a computer screen positioned at eye height caused much less problems than sitting and leaning forward to write at a desk.

The book continued to increase in size at about 150 pages per year and 8 years later in the year 2000 when my cancer was cured by a stem cell transplant, I completed it as the 1000 page 11th edition.

Over the years several editors have commented critically on my writing style as being an unusual collection of sentences, paragraphs, and illustrations, but I have noticed the advantage of spending a lot of time thinking, and a small amount of time writing. The following research project results were submitted to several medical journals in 1983 but were not accepted, with one editor advising me apologetically, that it would need to be submitted in the appropriate medical format before being publishable. I have decided to present the results in rough form on this web page 24 years later in April 2007. M.B.

The Research Project

South Australian Institute For Fitness Research And Training (1982 - 1983)

Study co-ordinator: M.A.Banfield

The objectives: To determine the physical fitness levels of patients with persistent fatigue, and whether or not it was possible to design a fitness programme which was acceptable to such patients, and then to determine the effect of such training on fitness levels. The objective was also to compare the fitness level of patients with persistent fatigue with that of healthy individuals.

 

The factor which motivated me to run this project was the research literature which indicated that most, if not all previous programmes were unsuccessful in retaining participants for long enough to get meaningful results. The general view was that "such patients could not or would not train".

I had participated in such a course for nine months five years earlier, and was therefore confident that I could design a programme which would be acceptable to other people with similar problems.

During that time part of the training involved walking or jogging around a 400 metre oval. In general terms I would be jogging 50 yards behind the tailenders as the front runners were overtaking me. The other participants were simply trying to improve their fitness, or were exercising as a treatment for obesity, asthma, arthritis, or heart disease. On one occasion, as two fifty year old men were out lapping me, one turned to the other and said loudly enough for me to hear "that is typical of the youth of today: they are unfit because they are too lazy to exercise". Those men did not know that I had been a gymnastics instructor for five years, and they both seemed to me to be training to treat smoking induced lung or heart problems.

I had to take those things into consideration because many people would drop out of a course due to the humiliation of coming last, and the ridicule associated with it.

I also considered that most training courses had instructors enthusiastically encouraging participants to constantly improve their training levels from week to week, and that such an approach would prompt fatigued patients to exceed their limits and start experiencing the types of distressing symptoms which would make them drop out of the course immediately.

Therefore I established the following protocols for the course.

Firstly, people with persistent fatigue would need to train in an entirely separate group, so that they all had a reasonable understanding of each others ailment.

The participants were to be informed that their objective was to train at their own pace of walking or jogging, and that they were to improve their pace according to the way they felt, and not because they were required to, and that the programme was not a contest or a race, but an exercise of staying in training for as long as possible, or for as long as their health continued to improve.

The participants were advised that the cause of the fatigue was not known, and that those who were running faster were to recognise the possible difficulties of those going slow and not be critical or judgmental about it, and the slower walkers or joggers were advised to ignore any negative comments from other members of the group, or outsiders, and to continue training at their own pace regardless.

Test Results

The Aerobic Capacity (physical fitness level) of volunteers with persistent fatigue

Did Not Train

 

These volunteers were tested at the outset, and some did not attend training at all, or complete the training sessions for at least 3 months.

Volunteers tested at outset but did not complete 3 months training and were not retested

______ These volunteers did not train but were called in to be tested again after 3 months and 6 months.

Trained

These volunteers participated in the exercise programme. They were tested at the outset, and after 3 months and then 6 months of training.

__ The aerobic capacity of a male athlete

. . . . . The aerobic capacity of an average fit male 850, and the average fit female 550

__________ Nine volunteers completed 3 months training, and five of those continued to complete 6 months or more.

- - - - - - - - - The aerobic capacity of the author who was tested and trained five years earlier.

 

 

Female volunteers

__________ The aerobic capacity of female volunteers who trained

- - - - - - - - - The aerobic capacity of an average fit female.

Male volunteers

_________The aerobic capacity of male volunteers who trained

- - - - - - - - The aerobic capacity of an average fit male.

X = volunteers who were tested at the outset but did not complete 3 months training.

At the outset the general view in the research literature was that:

There was no scientific evidence of a physical or measurable basis for persistent fatigue.

That patients who complained about persistent fatigue were complaining excessively about normal fatigue.

That such patients were reluctant to exercise because:

1. of a fear of exercise

2. they were too lazy to train

3. they had no desire or motivation to get well.

The Data from this Fitness Training programme indicated that:

80 people applied for the course and were tested as far as my recollections can determine, but data was not recorded for the last groups. Of the initial 3 groups data was compiled for 26 participants. Of those the measurements were adjusted according to age, body weight, and gender, and 15 were below average, 8 were average, and 2 were above average aerobic capacity. Although only 9 completed 3 months training, and only five completed 6 months training, that is not unusual for any group of patients. Groups of patients with asthma, obesity, or arthritis etc, had similar drop out rates.

The fact that 1 woman and 4 men with abnormally low aerobic capacity continued to train for at least 2 hours per night, twice per week, for at least 6 months is evidence that the former views were invalid. i.e. Patients with severe fatigue were motivated to regain their health, they were not afraid of exercise. and they were prepared to train in an attempt to achieve their objective.

It is interesting to note that of the nine people who trained, and continued for at least 3 months, only one started with above average fitness, and the other eight started out low, or very low, indicating that those with the most severe fatigue were the ones with the highest motivation to regain their former health.

The conclusion from the study was that there are a group of patients with persistent fatigue who have a measurable physical condition that responds favorably, to some extent, from an appropriately designed exercise programme. M.B.

Prog