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Influence of graded exercise therapy on anxiety levels and health-related quality of life in CFS

Bob

Senior Member
Messages
16,455
Location
England (south coast)
New small Serbian study (n=26) of GET for CFS.

In a nutshell, there was no significant improvement in physical function. I haven't read the full paper but from the abstract it looks like there was no control group, which means the study doesn't provide robust data.


Influence of graded exercise therapy on anxiety levels and health-related quality of life in chronic fatigue syndrome.
Klasnja A, Grujic N, Popadic Gacesa J, Barak O, Tomic S, Brkic S.
The Journal of Sports Medicine and Physical Fitness 2014 April;54(2):210-5
http://www.minervamedica.it/en/journals/sports-med-physical-fitness/article.php?cod=R40Y2014N02A0210
 
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determined

Senior Member
Messages
306
Location
USA: Deep South
I'd have to look more carefully at the experimental design, but it seems logical to assume that those who are ABLE to partake of GET are going to be more likely to respond positively. My experience over decades with CFS is that one has to get better first and only then can the graded exercise follow....and once that happens, more rapid improvement is possible.
 

Dolphin

Senior Member
Messages
17,567
http://www.apa.org/pi/about/publica...ce-settings/assessment/tools/trait-state.aspx
The State-Trait Anxiety Inventory (STAI)
Construct: Adult anxiety
Description of Measure: The State-Trait Anxiety Inventory (STAI) is a commonly used measure of trait and state anxiety (Spielberger, Gorsuch, Lushene, Vagg, & Jacobs, 1983). It can be used in clinical settings to diagnose anxiety and to distinguish it from depressive syndromes. It also is often used in research as an indicator of caregiver distress

Form Y, its most popular version, has 20 items for assessing trait anxiety and 20 for state anxiety. State anxiety items include: “I am tense; I am worried” and “I feel calm; I feel secure.” Trait anxiety items include: “I worry too much over something that really doesn’t matter” and “I am content; I am a steady person.” All items are rated on a 4-point scale (e.g., from “Almost Never” to “Almost Always”). Higher scores indicate greater anxiety. The STAI is appropriate for those who have at least a sixth-grade reading level.

I found the 20 questions listed as question 11 in this file:
http://www.biomedcentral.com/content/supplementary/1472-6874-11-22-s1.doc
(they may be elsewhere on the internet also)
 

Dolphin

Senior Member
Messages
17,567
Results weren't that good. These were 26 women of average age 36 who seem to have healthy BMIs (average weight / average h squared = 21.9)
Klasnja Table 2 cropped.jpg

If they were recovered, one would expect SF-36 PF scores of 90-100.
 

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Dolphin

Senior Member
Messages
17,567
The exercise was done in person rather than at home:
Klasnja exercise cropped.jpg


This is quite a lot of attention. Combine this with the commitment and would think there's a possibility for some placebo effects/people saying they're better than they are.

These were patients where the "mean number of months with fatigue was 17, ranging from 12 to 22 months". So one might think that such early-stage individuals might even improve a little naturally over time.

So results not exciting.
 
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Dolphin

Senior Member
Messages
17,567
Aside:
Quoting the PACE Trial and the Edmonds et al. Cochrane Review, they said:
"It has been shown that patients who underwent physical activity therapy had a significant decrease of pain and were able to carry out their daily routines with ease, unlike a controlled group which did not undergo this therapy."

This is overstating the previous evidence.
 
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Dolphin

Senior Member
Messages
17,567
Quite a lot of the paper is about how the STAI (anxiety) results correlated with the SF-36 subscale scores. The implication is that because the STAI scores went up, as they're correlated with the SF-36 scores, this means people's functioning was helped. But we've a better way of checking this: just look at the results of the SF-36 subscales, which generally didn't go up. The authors seem to be trying to spin the small positives they achieved father than they should.
 
Messages
15,786
Results weren't that good. These were 26 women of average age 36 who seem to have healthy BMIs (average weight / average h squared = 21.9)
View attachment 8081
If they were recovered, one would expect SF-36 PF scores of 90-100.
It's interesting that only Vitality (which focuses on "fatigue") improved, but nothing else. This is another nice example of the brainwashing effect, I think - patients are told they shouldn't feel fatigued, and a minor significant improvement shows up on the questionnaire regarding fatigue. Yet physical functioning, physical limitations, pain, etc, don't improve.
 

A.B.

Senior Member
Messages
3,780
CBT is effective for every problem known to man, as long as we measure said problem according to opinion and the CBT is focused on changing that opinion in the desired direction

Then again these people think perception (and not reality) is what matters, so they might not even see anything wrong with this. I wonder what they would do if, instead of getting paid, they were told that not being able to pay their bills is only a problem due to their poor attitude :rofl: