Abstract: Does graded activity increase activity? A case study of chronic fatigue syndrome

J Behav Ther Exp Psychiatry 2002 Dec;33(3-4):203-15

Friedberg F.

Department of Psychiatry and Behavioral Science, Putnam Hall/South Campus, State University of New York at Stony Brook, PO Box 616, 11794-8790, Stony Brook, NY, USA

The reliance on self-report outcome measures in clinical trials of graded activity-oriented cognitive-behavior therapy in chronic fatigue syndrome (CFS) makes it difficult to draw definitive conclusions about actual behavioral change. The participant in this case study was a 52-year-old married male with CFS who was working full-time.

Outcome measures included a step counter to objectively measure physical activity as well as a daily diary measure of exercise activity and in vivo ratings of perceived energy, fatigue, and affect. The following psychometric instruments were also used: the CFS Symptom Inventory, the SF-36, the Beck Depression Inventory, and the Beck Anxiety Inventory. The 26-session graded activity intervention involved gradual increases in physical activity.

From baseline to treatment termination, the patient’s self-reported increase in walk time from 0 to 155min a week contrasted with a surprising 10.6% decrease in mean weekly step counts. The final follow-up assessment revealed a “much improved” global rating, substantial increases in patient-recorded walk time and weight lifting intensity, yet a relatively modest increment in weekly step counts. It appeared that improvement was associated with mood-enhancing, stress-reducing activities that were substituted for stress-exacerbating activities.

PMID: 12628637 [PubMed – in process]

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