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http://www.medscape.com/viewarticle/838452
Continue HEREReducing fear of exercise through cognitive behavioral therapy or graded exercise helps patients with chronic fatigue syndrome (CFS), according to a planned secondary analysis of a 2011 trial.
However, the trial itself — the adaptive Pacing, graded Activity and Cognitive Behaviour Therapy; a randomized Evaluation (PACE) trial — is controversial, and the new findings only highlight the complexity and confusion surrounding the condition's name and diagnostic criteria.
In the new analysis, Trudie Chalder, PhD, from the Academic Department of Psychological Medicine, King’s College London, Weston Education Centre, London, United Kingdom, and colleagues find that relieving patients' fear that exercise would make symptoms worse was a key mediator of the effect of both graded exercise therapy (GET) and cognitive behavior therapy (CBT). The findings were published online January 13 inLancet Psychiatry.
"Our results suggest that fearful beliefs can be changed by directly challenging such beliefs (as in CBT) or by simple behaviour change with a graded approach to the avoided activity (as in GET)," the authors write.
"Clinically, the results suggest that therapists delivering CBT could encourage more physical activities such as walking, which might enhance the effect of CBT and could be more acceptable to patients," Dr Chalder said in a journal news
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