Measurement of fatiguedetermining minimally important clinical differences

Schwartz, Anna L.; Meek, Paula; Nail, Lillian M.; Fargo, Jamison D.; Lundquist, Margaret; Donofrio, Melissa; Grainger, Merilyn; Throckmorton, Terry; Mateo, M.Á. Abad

doi:10.1016/s0895-4356(01)00469-3

Cited by 88 publications

(32 citation statements)

References 20 publications

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“…Consequently, symptoms of fatigue should not be very frequent, as notably observed with half of the donors reporting a level of fatigue before donation of three or less on the VAS. Moreover, blood donation did not induce clinically significant fatigue [34] in our study and the minor difference detected reflected rather a regression toward the mean due to a natural fluctuation of fatigue. Therefore, treatment effect on fatigue was possibly absent merely because no symptom was perceived before intervention.…”

Section: Discussionmentioning

confidence: 50%

Clinical evaluation of iron treatment efficiency among non-anemic but iron-deficient female blood donors: a randomized controlled trial

Waldvogel

Pedrazzini

Vaucher

et al. 2012

BMC Med

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BackgroundIron deficiency without anemia is related to adverse symptoms that can be relieved by supplementation. Since a blood donation can induce such an iron deficiency, we investigated the clinical impact of iron treatment after a blood donation.MethodsOne week after donation, we randomly assigned 154 female donors with iron deficiency without anemia, aged below 50 years, to a four-week oral treatment of ferrous sulfate versus a placebo. The main outcome was the change in the level of fatigue before and after the intervention. Aerobic capacity, mood disorder, quality of life, compliance and adverse events were also evaluated. Hemoglobin and ferritin were used as biological markers.ResultsThe effect of the treatment from baseline to four weeks of iron treatment was an increase in hemoglobin and ferritin levels to 5.2 g/L (P < 0.01) and 14.8 ng/mL (P < 0.01), respectively. No significant clinical effect was observed for fatigue (-0.15 points, 95% confidence interval -0.9 points to 0.6 points, P = 0.697) or for other outcomes. Compliance and interruption for side effects was similar in both groups. Additionally, blood donation did not induce overt symptoms of fatigue in spite of the significant biological changes it produces.ConclusionsThese data are valuable as they enable us to conclude that donors with iron deficiency without anemia after a blood donation would not clinically benefit from iron supplementation.Trial RegistrationClinicalTrials.gov: NCT00981877

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Section: Discussionmentioning

confidence: 50%

Clinical evaluation of iron treatment efficiency among non-anemic but iron-deficient female blood donors: a randomized controlled trial

Waldvogel

Pedrazzini

Vaucher

et al. 2012

BMC Med

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“…The magnitudes of increase in vigor scores (by an average of 20% for the low and moderate exercise conditions) and decrease in fatigue scores (by 65% in the low-intensity condition) from baseline to week 6 were large and clinically meaningful [37], but unrelated to changes in aerobic fitness. The absence of a strong relationship between changes in aerobic fitness and changes in feelings of energy and fatigue is consistent with prior exercise training experiments with CFS patients [17, 38] and a growing body of evidence showing that symptoms of fatigue are mediated by central nervous system mechanisms [39].…”

Section: Discussionmentioning

confidence: 99%

A Randomized Controlled Trial of the Effect of Aerobic Exercise Training on Feelings of Energy and Fatigue in Sedentary Young Adults with Persistent Fatigue

Puetz

Flowers

O’Connor

2008

Psychother Psychosom

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Background: There is growing evidence that chronic exercise is a promising intervention for combating feelings of low energy and fatigue. Although groups with well-defined medical conditions (for example cancer and heart disease) or unexplained fatigue syndromes consistently have reported improved feelings of energy and fatigue after chronic exercise, relatively few exercise training studies have been conducted with people who report persistent fatigue yet neither have a medical condition nor reach diagnostic criteria for an unexplained fatigue syndrome. The purpose of this investigation was to use a randomized controlled design to examine the effects of 6 weeks of chronic exercise training on feelings of energy and fatigue in sedentary, healthy young adults reporting persistent fatigue. Methods: Thirty-six healthy, young adults who reported persistent feelings of fatigue were randomly assigned to a moderate-intensity exercise, low-intensity exercise or no treatment control group. Participants in each condition then visited the exercise laboratory on 18 occasions over a 6-week period. Exercise laboratory visits occurred 3 days per week. Vigor and fatigue mood state scores were obtained at the beginning of the third exercise session each week for 6 weeks. Aerobic fitness was measured before and after intervention. Results: The effect of 6 weeks of exercise training on feelings of fatigue was dependent on exercise intensity; however, the effect on feelings of energy was similar for both the low- and moderate-intensity conditions. The changes in feelings of energy and fatigue were independent of changes in aerobic fitness. Conclusions: Six weeks of low and moderate exercise training performed by sedentary adults without a well-defined medical condition or an unexplained fatigue syndrome but reporting persistent feelings of fatigue resulted in similarly beneficial effects on feelings of energy. The effects for symptoms of fatigue were moderated by exercise intensity, and the more favorable outcome was realized with low-intensity exercise. Changes in feelings of energy and fatigue following exercise training were unrelated to changes in aerobic fitness.

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“…For weight and body composition outcomes, we considered 3 kg to indicate a clinically important change in body weight (which equals approximately 5% of the average baseline body weight of participants), 5 cm to indicate a clinically important change in girth (arm and thigh), 5 kg/cm 2 to indicate a clinically important change in body mass index, 5 kg to indicate a clinically important change in fat mass, and 5 cm 2 to indicate a clinically important change in leg muscle area. For psychological outcomes, we considered 10 points to indicate a clinically important change in the sub scales of the SF-36 quality of life questionnaire [12, 22]. We based these a priori estimates on a combination of clinical experience and interpretations in the individual included studies” [12].…”

Section: Methodsmentioning

confidence: 99%

Effectiveness of Progressive Resistive Exercise (PRE) in the context of HIV: systematic review and meta-analysis using the Cochrane Collaboration protocol

O’Brien

Tynan²,

Nixon

et al. 2017

BMC Infect Dis

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BackgroundHIV is increasingly considered a chronic illness. More individuals are living longer and aging with the health-related consequences associated with HIV and multi-morbidity. Exercise is a self-management approach that can promote health for people aging with HIV. We examined the safety and effectiveness of progressive resistive exercise (PRE) interventions on immunological, virological, cardiorespiratory, strength, weight, body composition, and psychological outcomes in adults living with HIV.MethodsWe conducted a systematic review using the Cochrane Collaboration protocol. Searching databases up to April 2013, we included randomized controlled trials that compared PRE with no exercise or another intervention performed at least three times per week for at least four weeks with adults living with HIV. Two reviewers independently determined study eligibility. We extracted data from included studies and assessed risk of bias using the Cochrane Collaboration risk of bias tool. Meta-analyses were conducted using random effects models with Review Manager (RevMan) computer software.ResultsTwenty studies met inclusion criteria (n = 764 participants at study completion); the majority of participants were men (77%) taking antiretroviral therapy (14/20 included studies). Exercise interventions included PRE alone (8 studies) or a combination of resistive and aerobic exercise (12 studies) ranging from 6 to 52 weeks in duration. Thirty-four meta-analyses were performed. Results demonstrated statistically significant improvements in cardiorespiratory status (maximum oxygen consumption, exercise time), strength (chest press, knee flexion), weight, and body composition (arm and thigh girth, leg muscle area) among exercisers versus non-exercisers. We found no significant differences in change in CD4 count and viral load. We were unable to perform meta-analyses for psychological outcomes however results from individual studies demonstrated improvements in health-related quality of life with exercisers compared with non-exercisers.ConclusionsPerforming progressive resistive exercise (PRE) or a combination of resistive and aerobic exercise at least three times per week for at least six weeks is safe and can lead to improvements in cardiorespiratory fitness, strength, weight, and body composition for adults with HIV. Exercise may be considered a safe and beneficial for enhancing the health of medically stable adults aging with HIV.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-017-2342-8) contains supplementary material, which is available to authorized users.

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Measurement of fatiguedetermining minimally important clinical differences

Cited by 88 publications

References 20 publications

Clinical evaluation of iron treatment efficiency among non-anemic but iron-deficient female blood donors: a randomized controlled trial

Clinical evaluation of iron treatment efficiency among non-anemic but iron-deficient female blood donors: a randomized controlled trial

A Randomized Controlled Trial of the Effect of Aerobic Exercise Training on Feelings of Energy and Fatigue in Sedentary Young Adults with Persistent Fatigue

Effectiveness of Progressive Resistive Exercise (PRE) in the context of HIV: systematic review and meta-analysis using the Cochrane Collaboration protocol

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