Randomised controlled trial of patient education to encourage graded exercise in chronic fatigue syndrome.

Powell, Pauline; Bentall, Richard P; Nye, Fred J; Edwards, Richard H T

doi:10.1136/bmj.322.7283.387

Cited by 259Fibromyalgia and Chronic Fatigue Syndrome ResearchLong-Term Effects of COVID-19Musculoskeletal pain and rehabilitation

Randomised controlled trial of patient education to encourage graded exercise in chronic fatigue syndrome.

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Powell, Pauline, Bentall, Richard P, Nye, Fred J, Edwards, Richard H T·2001·BMJ

DOI 10.1136/bmj.322.7283.387PMC PMC26565

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Abstract

Objective: To assess the efficacy of an educational intervention explaining symptoms to encourage graded exercise in patients with chronic fatigue syndrome. Design: Randomised controlled trial. Setting: Chronic fatigue clinic and infectious diseases outpatient clinic. Subjects: 148 consecutively referred patients fulfilling Oxford criteria for chronic fatigue syndrome. Interventions: Patients randomised to the control group received standardised medical care. Patients randomised to intervention received two individual treatment sessions and two telephone follow up calls, supported by a comprehensive educational pack, describing the role of disrupted physiological regulation in fatigue symptoms and encouraging home based graded exercise. The minimum intervention group had no further treatment, but the telephone intervention group received an additional seven follow up calls and the maximum intervention group an additional seven face to face sessions over four months. Main outcome measure: A score of 25 or an increase of 10 on the SF-36 physical functioning subscale (range 10 to 30) 12 months after randomisation. Results: 21 patients dropped out, mainly from the intervention groups. Intention to treat analysis showed 79 (69%) of patients in the intervention groups achieved a satisfactory outcome in physical functioning compared with two (6%) of controls, who received standardised medical care (P<0.0001). Similar improvements were observed in fatigue, sleep, disability, and mood. No significant differences were found between the three intervention groups. Conclusions: Treatment incorporating evidence based physiological explanations for symptoms was effective in encouraging self managed graded exercise. This resulted in substantial improvement compared with standardised medical care.

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In the second study, a pragmatic rehabilitation treatment yielded improvements in subjective sleep-problems compared to standard medical treatment at 1-year follow-up.
“In the second study, a pragmatic rehabilitation treatment yielded improvements in subjective sleep-problems compared to standard medical treatment at 1-year follow-up (Powell et al., 2001).”
From The relationship between improvement in insomnia severity and long-term outcomes in the treatment of chronic fatigue (2018) · cites this paper as Powell et al., 2001

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Authors: Powell, P., Bentall, R. P., Nye, F. J., & Edwards, R. H. T.
Affiliations: Aintree University Hospital (GB)
University of Liverpool (GB)
University of Manchester (GB)
Corresponding author: Bentall, Richard P
ORCID: Bentall, Richard P
Venue: BMJ
Publisher: BMJ
Published: 2001-02-17
Volume: 322
Issue: 7283
Pages: 387
ISSN: 0007-1447 (ISSN-L)
0959-8138
1468-5833
DOI: 10.1136/bmj.322.7283.387
PMC: PMC26565
OpenAlex: W2062547500
Cited by: 257
References: 29
Citations by year: 2026: 1 · 2025: 2 · 2024: 10 · 2023: 5 · 2022: 5 · 2021: 7 · 2020: 6 · 2019: 8 · 2018: 3 · 2017: 3 · 2016: 13 · 2015: 7 · 2014: 5 · 2013: 13 · 2012: 11
FWCI: 14.01
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.bmj.com/company/legal-information/terms-conditions/legal-information/tdm-licencepolicy (tdm)
Locations: BMJ (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
HighWire Press Open Archive (submittedVersion)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
Keywords: chronic fatigue syndrome, patient education, graded exercise, self-management, telephone follow-up, physical function, fatigue symptoms, disability, mood, sleep
MeSH terms: Adult, Exercise Therapy, Female, Humans, Male, Patient Education as Topic, Fatigue Syndrome, Chronic, Treatment Outcome

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Randomised controlled trial of patient education to encourage graded exercise in chronic fatigue syndrome.

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