SIIT and CMT

Here are some tips from my friend Steven Csorba (check out his art!) about exercises that might be of special interest to CMTers and others whose neuropathy and fatigue may be caused or exacerbated by abnormal motility, fusion, and fission of mitochondria.

🥘 A nutritionist has suggested that intermittent fasting and “paleo” or “keto” influenced diets might be helpful too if you have problems with the health or movement of your mitochondria, the powerhouse of your cells. This is speculative, not an established treatment for CMT, so talk to your doctor before making big changes to how you eat.

Steven says, “By far the best thing to do to build mitochondria from an exercise perspective is something called Sub-maximal Intensity Interval Training (SIIT).

Not to be confused with Special High Intensity Training you may have received in your workplace, SIIT is just about moving for 5-10 minutes every hour (doing it on the hour helps) throughout the day during the 5-8 hour window when you’re active.

That means you’ll do a total of maybe 25-80 minutes of exercise.

The exercise can be anything: moderate strength training, jumping jacks, a quick trip on a bike, jump rope, pushups, or a quick hike up and down some stairs.

Look at it this way, as an Equinox article on SIIT (archived copy) put it:

Sub-maximal intensity interval training (SIIT) is a fancy label for regular movement in daily life. One way to think of it is that SIIT is really just less sitting.

With SIIT, the key is to avoid pushing too hard and going on to muscle failure. So if the most you can do with maximum effort is 10 of something, only do 5-7 every hour and never more.

Repeat Training is a similar approach you can use as well. It is based on the same principle of “never pushing to failure” — i.e. never go longer than 6-10 seconds. But here’s how Repeat Training is different:

• Power-based movements like heavy kettle bell swings, hard stationary bike sprints, swimming all out, and stair sprints.
• Only 6-10 seconds all out – then stop and rest before the lactic acid kicks in. You should never feel the burn. 
• One time period 15-45 minutes long. The first 6-10 seconds of any movement should feel like the last 6-10 seconds of movement in terms of effort.
  • E.g., do jumping jacks for 10 seconds and rest 50 seconds.
  • Repeat this interval until those 10 seconds start to feel harder than the first set. That’s when you’re done. “Every ten second interval should feel the same.”
• Requires a solid foundation in fitness first.
• Can be done 3-5 days a week since you’re never sore the next day.

A caution (added October 2026, updated October 10, 2026): This exercise plan is a friend’s personal suggestion, not a tested treatment for CMT. A 2023 review found only six small randomized trials of exercise in CMT, most at high risk of bias; the strongest evidence was for ankle-strengthening exercise in children with CMT1A.¹ The intensity and movements need to be adapted to your own strength, balance, fatigue, and heart and lung health, and all-out intervals aren’t right for everyone. If you have foot drop, weak ankles, or balance problems, be careful with all-out efforts like stair sprints, jumping jacks, jump rope, or heavy kettlebell swings, which can lead to falls and injuries. Seated or supported options like a stationary bike are safer choices, and it’s worth checking with your physiotherapist before starting.

Notes

1. Conde et al., “Effectiveness of Exercise Therapy.” ↩︎

Sources

• Conde, Rodrigo Melo, Iara Senem, Marcia dos Santos, Flávia de Lima Osório, and Wilson Marques Júnior. “Effectiveness of Exercise Therapy for Individuals Diagnosed with Charcot-Marie-Tooth Disease: A Systematic Review of Randomized Clinical Trials.” Journal of the Peripheral Nervous System 28, no. 2 (2023): 169–178. https://doi.org/10.1111/jns.12548.