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Randomised controlled trial of patient education to encourage graded exercise in chronic fatigue syndrome.
Open accessAbstract
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 (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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Metadata
- 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
- 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 › Clinical Neurology › Long-Term Effects of COVID-19
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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