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Health-related quality of life in patients with chronic fatigue syndrome. Group cognitive behavioral therapy and graded exercise versus usual treatment: A randomized controlled trial with 1 year of follow-up – Source: Clinical rheumatology, Jan 15, 2011

  [ 16 votes ]   [ 2 Comments ]
By M Nunez, et al. • • January 15, 2011

Chronic fatigue syndrome (CFS) produces physical and neurocognitive disability that significantly affects health-related quality of life (HRQL). Multidisciplinary treatment combining graded exercise therapy (GET) cognitive behavioral therapy (CBT) and pharmacological treatment has shown only short-term improvements.

To compare the effects on HRQL of:

(1) Multidisciplinary treatment combining CBT, GET, and pharmacological treatment, and

(2) Usual treatment (exercise counseling and pharmacological treatment) at 12 months of follow-up.

Prospective, randomized controlled trial with a follow-up of 12 months after the end of treatment.

Patients consecutively diagnosed with CFS (Fukuda criteria) were randomly assigned to intervention (n?=?60) or usual treatment (n?=?60) groups.

HRQL was assessed at baseline and 12 months by the Medical Outcomes Study Short-Form questionnaire (SF-36). Secondary outcomes included functional capacity for activities of daily living measured by the Stanford Health Assessment Questionnaire (HAQ) and comorbidities.

At baseline, the two groups were similar, except for lower SF-36 emotional role scores in the intervention group.

At 12 months, the intervention did not improve HRQL scores, with worse SF-36 physical function and bodily pain scores in the intervention group.

Multidisciplinary treatment was not superior to usual treatment at 12 months in terms of HRQL.

The possible benefits of GET as part of multidisciplinary treatment for CFS should be assessed on an individual patient basis.

Source: Clinical rheumatology, Jan 15, 2011. PMID: 21234629, by  Núñez M, Fernández-Solà J, Nuñez E, Fernández-Huerta JM, Godás-Sieso T, Gomez-Gil E. Rheumatology Service, Functional Readaptation Unit, Hospital Clinic, Barcelona, Spain, [Email:]

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Article Comments Post a Comment

CDC needs to read this
Posted by: Sandy10m
Jan 22, 2011
The CDC needs to read this report and STOP giving limited research money to studies that keep looking at these useless modalities. We CFS/ME/FM sufferers know that this stuff doesn't work. Let's spend the research money on actual research that's looking for the cause and the cure!
Reply Reply

Quotes from this study
Posted by: franktwisk
Mar 2, 2011
At 12 months, there were significantly lower SF-36 physical function and bodily pain dimension scores compared to baseline (p=0.004 and p= 0.021, respectively). Patients reported more impairment due to pain and weakness in the HAQ (p=0.012 and p= 0.002, respectively). No changes in the global health status and pain intensity measured by VAS were detected. There was also a significant increase in comorbidities between baseline and 12 months (p<0.001) (Table 2). Although some studies cautiously conclude that exercise therapy is a promising treatment for CFS, the results of our study tend to support the somewhat controversial findings of Twisk and Maes that the combination of CBT and GET is ineffective and not evidence-based and may in fact be harmful in some patients, a view supported by various surveys carried out by patient advocate groups.
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