P. Powell et al., Randomised controlled trial of patient education to encourage graded exercise in chronic fatigue syndrome, BR MED J, 322(7283), 2001, pp. 387-390
Citations number
23
Categorie Soggetti
General & Internal Medicine","Medical Research General Topics
Objective To assess the efficacy of an educational intervention explaining
symptoms to encourage graded exercise in patients with chronic fatigue synd
rome
Design Randomised controlled trial.
Setting Chromic fatigue clinic and infectious diseases outpatient clinic.
Subjects 148 consecutively referred patients fulfilling Oxford criteria for
chronic fatigue syndrome.
Interventions Patients randomised to the control group received standardise
d medical care. Patients randomised to intervention received two individual
treatment sessions and two telephone follow up calls, supported by a compr
ehensive educational pack, describing the role of disrupted physiological r
egulation in fatigue symptoms and encouraging home based graded exercise. T
he minimum intervention group had no further treatment, but the telephone i
ntervention group received am additional seven follow up calls and the maxi
mum intervention group an additional seven face to face sessions over four
months.
Main outcome measure A score of greater than or equal to 25 or an increase
of greater than or equal to 10 on the SF-36 physical functioning subscale (
range 10 to 30) 12 months after randomisation.
Results 21 patients dropped out, mainly from the intervention groups. Inten
tion to treat analysis showed 79 (69%) of patients in the intervention grou
ps achieved a satisfactory outcome in physical functioning compared with tw
o (6%) of controls, who received standardised medical care (P < 0.0001). Si
milar improvements were observed in fatigue, sleep, disability, and mood. N
o significant differences were found between the three intervention groups.
Conclusions Treatment incorporating evidence based physiological explanatio
ns for symptoms was effective in encouraging self managed graded exercise.
This resulted in substantial improvement compared with standardised medical
care.