chronic fatigue syndrome

Inside the Bounce Program! A Chronic Fatigue Syndrome case study

Fatigue management can be a hard space to navigate… As a case manager, an exercise physiologist, and of course – as the person experiencing the fatigue! 


Luckily, we are well seasoned in the fatigue management space, having worked with clients in this space for 6+ years (very successfully, might we add). Last year, we launched the Bounce program. A structured, fixed-fee program that bundles up all the strategies that we KNOW work in this space – and people are loving it. 


What’s all the fuss about, you say? What better way to explain than to put yourself in the shoes of someone who has done it. 


Josie’s* Story 


The Covid 19 pandemic had an impact on many working professionals, but some of those most significantly hit were medical professionals. Being at the forefront of the pandemic, our doctors and nurses had to show up to work and put the care of others above the care for themselves.  The health care system struggled to keep up with rising numbers of Covid cases. Can you imagine being in a health management position over this time?


Josie was working as a nursing director at the time of the pandemic. After a year and a half of immense stress and pressure, her symptoms of fatigue had progressed to the point that completing a full day of work was near impossible. Josie was diagnosed with chronic fatigue syndrome (CFS) in August of 2021, and eventually, she was forced to stop working altogether. 


When Josie met our exercise physiologist, Renee, in 2022 she desperately wanted to get back to some sort of “normal”. Her goals were simple – but substantial; 


  • She wanted to walk around her neighborhood a couple of times per week,
  • She wanted to be able to do a full grocery shop without being exhausted for days, 
  • She wanted the energy to play with her new grandson.


Between Josie and her goals were a few key barriers that needed to be addressed. At the time of meeting Renee, Josie didn’t understand how to manage her activity, and as a result she was stuck in a cycle of booming and busting. Her sleep patterns were non-existent and daytime naps had become her reprieve! On top of this, she was experiencing on-going joint pain. 


It’s no wonder that she didn’t know where to start! And this is exactly where the Bounce program comes into play.  


Bouncing Back 


Meeting an “exercise” physiologist can be nerve racking for someone struggling with fatigue, but the Bounce program is about much more than exercise. Over 12 weeks, Renee guided Josie through the three phases of the Bounce program.


  1. As always, the start of the program involved a lot of education. Renee made Josie aware of her boom and bust patterns and taught her about pacing. Using a diary and heart rate variability (HRV) tracking, they broke down Josie’s day-to-day routine together and discovered which tasks affected her most. For Josie, they found that cognitive tasks were particularly challenging, so they worked on spacing these out, giving her the permission to rest in between.


  1. After the routine-based foundations had been implemented, additional strategies were added to target barriers and get Josie closer to her goals. This started with a personalised wind-down routine before bed, including stretching for joint pain. It also included breathing exercises on days where Josie’s HRV readings suggested that she was in a state of “fight or flight”. 


  1. As Josie’s HRV, sleep and symptoms improved, Renee was able to add more challenging tasks. Josie was able to include structured walking, cognitive training and near the end of the program, small amounts of strength training in her week too!


The Outcomes



After 12-weeks, Josie was walking daily, babysitting her new grandson with confidence, and able to complete her grocery shopping without the struggle she used to experience. Tick, tick, and tick! ✅


On top of that, Josie was able to sit down and read again, something she hadn’t even considered previously due to cognitive fatigue. Her stretching routine was well and truly ingrained and her joint pain under control as a result. 


This program, like many Bounce programs, had more of a well-being focus for the client, meaning a return to work wasn’t the end goal, however, despite this, Josie was ready to partake in a gradual return to work by the end of the program! Renee facilitated this by handing the case over to a vocational consultant and away they went. 


Do you have customers who are struggling with fatigue?
Are they ready to take that next step in their recovery?


*name changed for privacy

Author: Tessa Nielsen
Editor: Yolanda van Vugt
Clinical Exercise Physiologist and Content Creator at Specialised

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