How therapy and exercise 'may help some with CFS'

Conclusion This study has tried to pick apart how cognitive behavioural therapy (CBT) and graduated exercise therapy (GET) affected fatigue and physical function in the PACE randomised controlled trial (RCT). Its findings suggest this could partly be a result of CBT and GET reducing fear avoidance beliefs, such as the fear that exercise would make symptoms worse. But these treatments were less effective in cases where fear avoidance beliefs remained. The researchers also identified other factors (mediators) that seemed to be playing a role, such as GET increasing the maximum distance an individual could walk in the six-minute walk test. This study benefits from being a pre-planned analysis of an RCT, as well as the fact the treatments, mediators and outcomes occurred one after the other. The latter means it is possible the treatments are influencing the mediators, which are then influencing outcomes. The study only measured some potential mediators, and the authors note they could not rule out the possibility unmeasured factors are influencing the results. They did adjust for a range of confounders to try to reduce this chance, however. Another potential limitation was the main analysis excluded participants with missing data. This is appropriate if those with missing data are missing at random, but if particular types of people – such as those for whom the treatments are not working as well – are more likely to be missing data, this can bias the results. The resear...
Source: NHS News Feed - Category: Consumer Health News Tags: Lifestyle/exercise Medical practice Mental health Neurology Source Type: news