Tuesday, February 2, 2010

Self-Pacing in chronic fatigue may provide modest symptom, daily functioning improvements

Written by Anthony Hardie, 91outcomes

(91outcomes.blogspot.com) -- A new Belgian scientific study suggests that patients with Chronic Fatigue Syndrome/Myalgic Encepholopathy (CFS/ME) may feel slightly better by pacing their daily activities.

The study by J. Nijs of the Vrije Universiteit Brussel in Brussles, Belgium and colleagues found that 3 weeks of pacing self-management was accompanied by a modest improvement in symptom severity and daily functioning.

The authors of the study, Can pacing self-management alter physical behavior and symptom severity in chronic fatigue syndrome? A case series, suggest that the next step should be to conduct a larger-scale, randomized controlled clinical trial to examine the effectiveness of pacing self-management for people with CFS.

Chronic Fatigue Syndrome is one of three presumptive conditions for VA service-connection for veterans with Persian Gulf service in August 1990 or later.

The study’s abstract, published in the Journal of Rehabilitation Research and Development, is as follows:

Given the lack of evidence in support of pacing self-management for patients with chronic fatigue syndrome (CFS), we examined whether physical behavior and health status of patients with CFS would improve in response to a pacing self-management program. \

We performed an observational study of pacing self-management in seven CFS patients using a single-case study design. Stages A1 and A2 (7-day assessment periods) of the A1-B-A2 design corresponded to the baseline and posttreatment measurements of physical behavior (real-time activity monitoring) and health status (self-reported measures), respectively. Stage B (3 weeks of treatment) consisted of three individual treatment sessions of pacing self-management.

When comparing pre- versus posttreatment data, we found that the patients' ability to perform daily activities and the severity of their symptom complexes were improved (p = 0.043). Concentration difficulties, mood swings, muscle weakness, and intolerance to bright light improved as well. A statistically significant decrease in the mean time spent doing light activity (<3 metabolic equivalents) was observed, but a change in the way physical activity was spread throughout the day was not.

We found that 3 weeks of pacing self-management was accompanied by a modest improvement in symptom severity and daily functioning.

The outcome of the present study calls for a randomized controlled clinical trial to examine the effectiveness of pacing self-management for people with CFS.

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