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Graded exercise benefits patients with chronic fatigue syndrome

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

Many patients with chronic fatigue syndrome have inaccurate illness beliefs that may perpetuate their condition. A study in this week's BMJ finds that providing patients with medical explanations for symptoms to encourage graded exercise can substantially improve their condition.

A total of 148 patients diagnosed with chronic fatigue syndrome were randomised into four groups. Patients in the control group received standardised medical care. Patients in three intervention groups received various degrees of treatment including explanations of symptoms that encouraged home based graded exercise. At one year, 69% of patients in the intervention groups had improved their physical functioning compared with 6% of patients in the control group. Similar improvements were seen in fatigue, sleep, disability and mood. Overall, the explanations of their symptoms convinced 94% of the patients to carry out graded activity.

This approach may be as effective as cognitive (mental) behaviour therapy, but is shorter and requires less therapist skill, conclude the authors.

Contact:

Richard Bentall, Professor of Experimental Clinical Psychology, University of Manchester, UK Email: bentall@psy.man.ac.uk

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