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Description
A Physiotherapist's Guide to Understanding and Managing ME/CFSMyalgic encephalomyelitis, also known as Chronic Fatigue Syndrome, is a deeply complex and multi system condition which has historically suffered from a lack of awareness within physiotherapy education and practice. Similarities in presentation between this condition and Long Covid make this comprehensive and evidence based guide for physiotherapists even more timely and important. This guide includes an in depth explanation and history of ME CFS
Myalgic encephalomyelitis, also known as Chronic Fatigue Syndrome, is a deeply complex and multi-system condition which has historically suffered from a lack of awareness within physiotherapy education and practice. Similarities in presentation between this condition and Long Covid make this comprehensive and evidence-based guide for physiotherapists even more timely and important. This guide includes an in-depth explanation and history of ME/CFS whilst also describing symptoms, varying degrees of severity, and how to manage ME/CFS in children. It also provides detailed management advice and discussion on how the information can directly inform physiotherapy practice, supplemented with patient case studies.
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4.7 ★★★★★
Based on 17 reviews
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Product Reviews
★★★★★ 5
Excellent tug toy!
Size: Large Triple, Size: Large Triple
My dog had this set of 3 interlocking rings for 7 years and they finally broke. I was so happy to be able to get a replacement set that is just as durable as the original! Just ask our Gretzky to, “get your rings” and she knows exactly what to find. She can tug these for an hour and not lose interest. She loves them. They are the perfect size for her to grab comfortably and for her human playmate to hold onto the other ring in opposition. Gretzky is half Boxer, about 85lbs and all muscle. For her first set to withstand years of tugging without breaking was surprising but they’re made well and as long as you don’t allow your dog to just sit and chew them, they’ll give you years of tugging playtime!
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Reviewed in the United States on June 7, 2026
★★★★★ 5
Simple! Easy! All We Needed!!
Size: Large Triple
These were the only durable rubber like rings that were both the same material; not too thick (not heavy) so my 1 year old Pit, Dixie, was able to latch on to one ring while we grabbed the third ring, leaving enough space so she won't accidentally bite us when grabbing the rings to play. They were also the only ones that came interlocked and cannot be taken apart. She is also a big chewer, which means she can gnaw on these without tearing them apart. The rubber is thick enough to play, but thin enough to twist and flex with her. So far, they are sturdy. She was immediately so excited! Simple and easy!
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Reviewed in the United States on May 8, 2026
★★★★★ 5
Great durable dog toy!!
Size: Large Triple
We have a medium-sized dog (45 lb mixed Aussie/Hound) who is a pretty aggressive chewer. He also loves playing tug-of-war with his canine and human siblings using these rings. This is easily his favorite toy. We bought one a little over a year ago that he plays with daily. If finally broke this December just in time to buy a replacement for Christmas!
The prior one finally broke when the middle ring came apart at one of the thinner rubber points. He still plays with the intact outer rings as well as his new toy.
I wanted to dock this 1/2 star for a few reasons: 1) it is not completely invincible, although I would argue a toy that lasts over a year with pretty constant play for an $11 price tag is a great value. 2) the one we received is not yellow/black. It is blue/green. I was personally thrilled it was blue/green because it ended up being an exact replacement of the one we had previously. However the description does not say "colors vary" and it was hard for me to tell when ordering if I was ordering the correct replacement toy. A clearer description would be appreciated. 3) This is a great toy for one dog, but our other dobbie/cattle dog mix has no interest in them. So not all dogs will love this toy (obviously).
4.5 stars isn't an option so I'm giving this 5 stars because it's just about as close to a perfect dog toy as one can buy (at least for our dog).
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Reviewed in the United States on December 31, 2016
★★★★★ 4
Great toy, as long as dog is NOT ALLOWED to chew on it
Size: Large Triple
Let me start by saying that I like this dog toy. My big dog LOVES tugging with it. As long as you keep away when the dog is in a chewing mood, it lasts a long time (my 1st one lasted a year), however, it WILL NOT last if the dog chews on it, as I found out with this one. A friends dog chewed on it while she was behind a snow mound (mostly out of our sight) when it was only a week old. One end ring was barely holding together when we discovered her chewing it. Fortunately it was an end ring, so I still have 2 connected rings for tugging with.
It is a great tug toy! But it is also a TERRIBLE chew toy, so make sure to take it away when your dog starts to chew on it and it will give you long service.
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Reviewed in the United States on February 14, 2021
★★★★★ 5
Fabulous toy!!
Size: Large Triple
My GSD is always up for a good game of tug-o-war. I purchased these in large and I think I love them as much as my dog. They are super strong and hold up to his 100lb self pulling on one end and my “blah blah-lb” self pulling on the other. (Ha! You thought I would say how much I weigh) I even bought another pair for our cabin so we have some to play with at both places. He isn't a sit and chew on things kind of dog. He gets plenty of playtime and bully sticks for chewing. Not to mention that I wouldn't let him use them as a chew toy anyway. There are toys for play and toys for chew. Therefore, I cant say anything on how they hold up for chewers. So if you let your dog just sit and chew on it instead of giving them something designed for strong chewers, then no it might not hold up to that. All I can say is my German Shepherd is 100lbs with sharp teeth and stronger than me now and honestly he is probably stronger than I have ever been in my life, and they hold up to the pulling and tugging of both of us. Thats what they're designed for and they serve their purpose excellently.
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Reviewed in the United States on January 22, 2026