The effect of homework compliance on treatment outcomes for participants with myalgic encephalomyelitis/chronic fatigue syndrome.

Abstract

Purpose This study examined the relationship between level of treatment engagement through completion of homework and treatment outcomes within non-pharmacological interventions for participants with ME/CFS. Methods A sample of 82 participants with ME/CFS was randomly assigned to one of four non-pharmacological interventions. Each intervention involved 13 sessions over the course of six months. Change scores were computed for self-report measures taken at baseline and 12-month follow-up. Homework compliance was calculated as the percentage of completed assignments across the total number of sessions and grouped into three categories: minimum (0–25%), moderate (25.1–75%), or maximum (75.1–100%). Results Findings revealed that after controlling for treatment condition, those who completed a maximum amount of homework had greater improvement on a number of self-report outcome measures involving role, social and mental health functioning. There were no differential improvements in physical and fatigue functioning based on level of homework compliance. Implications Findings from this study suggest homework compliance can have a positive influence on some aspects of physical, social, and mental health functioning in participants with ME/CFS. It should be emphasized that these interventions do not cure this illness. The lack of significant changes in physical functioning and fatigue levels suggests a need for more multidisciplinary treatment approaches that can elicit improvement in these areas.

Feasibility of a cognitive strategy training intervention for people with Parkinson’s disease

“…All participants maintained high levels of effort and enjoyment during treatment sessions, and most of them had high homework adherence (4 of the 7 participants’ homework completion rates were ≥ 93%). Rehabilitation participation and homework adherence are positively associated with functional outcomes [58, 59], so our results are reassuring and suggest that non-demented people with PD can engage in the intervention in a way that should benefit them if it is truly effective. Executive dysfunction and depressive symptoms, both of which are common in people PD, have been negatively associated with rehabilitation participation in stroke [60].…”

Functional Magnetic Resonance Imaging Neurofeedback-guided Motor Imagery Training and Motor Training for Parkinson’s Disease: Randomized Trial

“…An acceptable attrition rate, based on similar complex interventions, would be 25% (Stack et al, 2012 ). Because of the relatively unique nature of our homework design there were no benchmarking figures, but we would assume protocol adherence of at least 75% to be required for successful transfer of learnt skills into everyday settings based on existing literature (Hlavaty et al, 2011 ). Adverse events were defined as any subjective complaints of physical or mental deterioration or any physical or psychological impairment requiring medical intervention.…”

A prolonged pandemic impacts the mental health of orthopaedic patients

“…22,23 However, increased fatigue levels are known to decrease adherence to physiotherapy and can undermine the efficacy of conservative management. 24,25 Hence, severe fatigue has a multifaceted impact on the outcomes of orthopaedic conditions.…”

“…22,23 However, increased fatigue levels are known to decrease adherence to physiotherapy and can undermine the efficacy of conservative management. 24,25 Hence, severe fatigue has a multifaceted impact on the outcomes of orthopaedic conditions. The combination of increased fatigue and postponement of surgeries will likely complicate the management of elective orthopaedic conditions and have detrimental effects on their outcomes.…”