Treatment expectations influence the outcome of multidisciplinary rehabilitation treatment in patients with CFS

Vos-Vromans, D.C.W.M.; Huijnen, Ivan P.J.; Rijnders, L.J.M.; Winkens, Björn; Knottnerus, J. André; Smeets, Rob

doi:10.1016/j.jpsychores.2016.02.004

Cited by 13 publications

(8 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, the current clinical report shows few effects of multimodal rehabilitation in patients with ME/CFS, which is in line with studies by Vos-Vromans et al (28). In addition, the current study did not assess Personal Factors, which have been shown to be important in the outcomes of ME/CFS rehabilitation (29).…”

Section: Study Limitationssupporting

confidence: 88%

Preliminary ICF core set for patients with myalgic encephalomyelitis/chronic fatigue syndrome in rehabilitation medicine

Bilevičiūtė-Ljungar

Schult²,

Borg³

et al. 2020

J Rehabil Med

View full text Add to dashboard Cite

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a disabling condition with no diagnostic or prognostic markers. The patient group is heterogeneous, and impairments in functioning and disability vary between patients. The International Classification of Functioning, Disability and Health (ICF) is a wellestablished method to assess patient's functioning and disability. This study sets out a preliminary ICF Core Set for ME/CFS in rehabilitation medicine. However, this requires improvement, and approval by research society and clinicians working with ME/CFS. The introduction of post-exertional malaise as a new category in the ICF should also be considered. Objective: To create and evaluate a preliminary ICF Core Set for myalgic encephalomyelitis/chronic fatigue syndrome using a team-based approach. Design: Observational study. Subjects/patients: A total of 100 consecutive patients (mean age 45 years (standard deviation (SD) 9 years)) were assessed by a rehabilitation team and included in the study. Methods: A preliminary International Classification of Functioning, Disability and Health (ICF) Core Set was created, based on literature studies, and on discussion forums between the team and the researchers. Patients were assessed by a rehabilitation medicine team regarding impairments in body function, activity limitations, and restrictions in participation. Results: Clinical assessments of the component Body Functions found impairments in energy, fatigue, physical endurance, fatigability, sleep and pain in 82-100% of patients. At least half of the patients had impairments in higher cognitive functions, attention, and emotions, as well as sound and light hypersensitivity, general hyper-reactivity and thermoregulatory functions. For the component Activity/Participation, the most frequent limitations and restrictions were in doing housework (93%), assisting others (92%), acquisition of goods and services (90%), remunerative employment (87%), handling stressful situations (83%), preparing food (83%), recreation and leisure (82%), informal socializing (78%) and carrying out daily activities (77%). The most frequent degrees of impairments/limitations/ restrictions assessed were light and moderate, except for remunerative employment, for which restrictions were severe. Conclusion: Using unconventional methods, this study sets out a preliminary ICF Core Set list for patients with myalgic encephalomyelitis/chronic fatigue syndrome. Further studies are required to improve and test this Core Set in myalgic encephalomyelitis/chro nic fatigue syndrome populations.

show abstract

Section: Study Limitationssupporting

confidence: 88%

Preliminary ICF core set for patients with myalgic encephalomyelitis/chronic fatigue syndrome in rehabilitation medicine

Bilevičiūtė-Ljungar

Schult²,

Borg³

et al. 2020

J Rehabil Med

View full text Add to dashboard Cite

show abstract

“…It is possible that improvements after self-help were seen because patients’ expectations about treatment led to them feeling better before treatment started. Previous research has shown that expectations can influence treatment outcomes of people who have CFS (Heins et al, 2013; Vos Vromans et al, 2016). However, as we did not measure treatment expectations in this study, these conclusions cannot be drawn from our data.…”

Section: Discussionmentioning

confidence: 99%

Guided Self-Help for Patients with Chronic Fatigue Syndrome Prior to Starting Cognitive Behavioural Therapy: a Cohort Study

Ali

Goldsmith

Burgess

et al. 2017

Behav. Cogn. Psychother.

View full text Add to dashboard Cite

show abstract

“…CBT, GET and rituximab, the use of subjective outcomes (only) involves an important risk of bias, e.g. due to researcher allegiance [36], the Hawthorne effect [37], placebo effects [38] and buy-in effects [39], especially when subjective measures are combined with different cut-off scores for meeting the diagnosis CFS [21] and improvement or recovery [40].…”

Section: Assessment Of Symptoms Based On Questionnaires and Subjectivmentioning

confidence: 99%

An Accurate Diagnosis of Myalgic Encephalomyelitis and Chronic Fatigue Syndrome requires strict Clinical Case definitions and Objective Test Methods

Twisk¹

2017

J Med Diagn Meth

View full text Add to dashboard Cite

Myalgic Encephalomyelitis (ME) and Chronic Fatigue Syndrome (CFS) are subject to controversy. Although ME and CFS are often considered to be to be synonymous, the case criteria for ME and CFS define two distinct diseases with partial overlap. ME, recognized as a new clinical entity in the 1950's, is characterized by distinctive muscular, neurological and autonomic symptoms. In contrast the core feature of CFS, introduced in 1988 and redefined in 1994, is chronic fatigue. Some researchers consider CFS to be equivalent to (incapacitating) chronic fatigue (CF). After the introduction of CFS, other criteria for ME, ME/CFS, CFS and CF were introduced and used in research studies, creating obfuscation and controversy. The use of various diagnostic criteria has hampered effective research into ME and CFS.Next to the various diagnostic criteria, the assessment of symptoms is almost always based on questionnaires and subjective measures, e.g. physical functioning. Due to their nature subjective measures are incomparable over time and between patients. Moreover subjective measures introduce a significant risk of bias, for example due to researcher allegiance, the Hawthorne effect, and buy-in effects. Despite the fact that ME and CFS (subtypes) lack a clear etiological explanation (yet), the symptoms can and should be assessed by objective test measures, since subjective measures are ambiguous, incomparable and introduce the risk of bias. Objective test measures can also confirm the seriousness of both ME and CFS.To resolve the diagnostic issues in research studies and clinical practice, a clear distinction between ME and CFS (not ME), based on the original criteria, is crucial.Although the use of objective test methods is more expensive and time-consuming and severe cases cannot be subjected to these tests, considering the (scientific) confusion originating from the use of subjective measures it is essential to assess the symptoms of patients objectively both in clinical practice and research settings.

show abstract

Treatment expectations influence the outcome of multidisciplinary rehabilitation treatment in patients with CFS

Cited by 13 publications

References 28 publications

Preliminary ICF core set for patients with myalgic encephalomyelitis/chronic fatigue syndrome in rehabilitation medicine

Preliminary ICF core set for patients with myalgic encephalomyelitis/chronic fatigue syndrome in rehabilitation medicine

Guided Self-Help for Patients with Chronic Fatigue Syndrome Prior to Starting Cognitive Behavioural Therapy: a Cohort Study

An Accurate Diagnosis of Myalgic Encephalomyelitis and Chronic Fatigue Syndrome requires strict Clinical Case definitions and Objective Test Methods

Contact Info

Product

Resources

About