deleder2k
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Differential effects of behavioral interventions with a graded physical activity component in patients suffering from Chronic Fatigue (Syndrome): An updated systematic review and meta-analysis
http://www.sciencedirect.com/science/article/pii/S0272735815000896
Highlights
•Interventions including physical activity have beneficial effects on chronic fatigue.
•The number of trials is modest and there is heterogeneity between them.
•Type of setting and provider of treatment moderate fatigue severity effect sizes.
•Minimal direct contact interventions are promising.
And the criterias:
Not sure whether this belongs in the ME research forum or in the other forum (with respect to the non existent criteria used)
- M.M. Marquesa, b, c, , ,
- V. De Guchta,
- M.J. Gouveiab,
- I. Lealb,
- S. Maesa
http://www.sciencedirect.com/science/article/pii/S0272735815000896
Highlights
•Interventions including physical activity have beneficial effects on chronic fatigue.
•The number of trials is modest and there is heterogeneity between them.
•Type of setting and provider of treatment moderate fatigue severity effect sizes.
•Minimal direct contact interventions are promising.
Abstract
An updated systematic review and meta-analysis was conducted to (1) evaluate the effects of behavioral and psychological interventions containing a graded physical activity component upon fatigue severity, physical functioning, physical activity and psychological distress, and to (2) examine potential moderator effects of trial characteristics (type of control, setting, provider, length of treatment, psychological component, flexibility in physical activity, and minimal face to face patient-provider contact). Pertinent content of selected studies was extracted and rated on a scale of methodological quality. Sixteen randomized controlled trials (N = 2004) were included in the meta-analyses. Significant small to medium effect sizes (Hedge’s g= 0.25 to g= 0.66) were found for all outcomes at post-treatment (M = 5.2 months) and follow-up (M = 11.7 months), with the exception of physical activity at post-treatment (g= 0.11). The largest effects were found for fatigue severity (g= 0.61 to g= 0.66). Subgroup analyses revealed that minimal contact interventions had additional beneficial effects upon fatigue (g= 0.96) and depression (g= 0.85). Interventions provided by psychologists-psychotherapists and interventions conducted in secondary-tertiary settings also resulted in more beneficial effects on fatigue. We found some indication of publication bias. The small number of studies and variability between them are limitations of this study. Future research should explore additional moderating effects in order to improve the effectiveness of interventions.
And the criterias:
Eligibility criteria
Types of participants
Studies were included if they were conducted in adult patients presenting (Idiopathic) Chronic Fatigue or Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME).
Types of interventions
Studies had to include an arm of a behavioral and/or psychological intervention with a graded physical activity/exercise component, targeting chronic fatigue management.
Types of comparisons
Studies had to include a control condition, consisting of usual care, waiting list control, or another type of intervention (e.g. relaxation).
Types of outcomes
Studies had to present statistical data allowing the calculation of effect sizes (in the published study or provided by the author(s) upon request), on at least one of the following outcomes - fatigue severity, functional impairment/physical functioning, physical activity and/or physical capacity, and psychological distress (depression and/or anxiety), measured at baseline (pre-treatment), at post-treatment and/or at follow-up.
Types of studies
Studies were included if they were randomized controlled trials (RCTs) published in peer review journals in English.
There were no restrictions with respect to the type of diagnostic criteria used, setting, format and source of delivery of the intervention, as well as with respect to the length of the intervention and follow-up measurement point(s).
Conclusion
This meta-analysis of behavioral and psychological interventions targeting graded activity suggests that these interventions have sustained beneficial effects on chronic fatigue management, in particular on fatigue severity reduction for which a medium effect was found. The finding that minimal contact interventions have similar and in some cases higher effects on fatigue severity and depression compared to more intensive interventions is important as these interventions can be more easily implemented in standard health care, can be useful for patients presenting difficulties in regularly attending health care facilities (Burgess et al., 2012), and can be suitable for patients who do not need more intensive forms of treatment (Tummers et al., 2012). All trials included in this meta-analysis had an initial face to face contact with patients, which may have led to increased motivation of patients to engage in a behavior change process (Burgess et al., 2012). Most of these minimal interventions also included patient (self-help) manuals and allowed flexible physical activity/exercise levels that take into consideration the patients’ own resources, which can add to chronic fatigue management. Notwithstanding the beneficial effects of the behavioral and psychological interventions included in this meta-analysis and the valuable indications about targets and format of future interventions, more research is needed to identify optimal features of interventions for chronic fatigue management.
Not sure whether this belongs in the ME research forum or in the other forum (with respect to the non existent criteria used)