Research highlights:

• Heart rate biofeedback and graded exercise training improve fatigue as core symptom of CFS.
• Heart rate biofeedback improves quality of life and depression in patients with CFS.
• Graded exercise training reduces physical fatigue and betters physical functioning in patients with CFS.

Research abstract:

OBJECTIVE

Chronic fatigue syndrome (CFS) is characterised by persistent fatigue, exhaustion, and several physical complaints. Research has shown cognitive behavioural therapy (CBT) and graded exercise training (GET) to be the most effective treatments. In a first step we aimed to assess the efficacy of heart rate variability biofeedback therapy (HRV-BF) as a treatment method comprising cognitive and behavioural strategies and GET in the pilot trial. In a second step we aimed to compare both interventions with regard to specific parameters.

METHODS

The study was conducted in an outpatient treatment setting. A total of 28 women with CFS (50.3 ± 9.3 years) were randomly assigned to receive either eight sessions of HRV-BF or GET. The primary outcome was fatigue severity. Secondary outcomes were mental and physical quality of life and depression. Data were collected before and after the intervention as well as at a 5-month follow-up.

RESULTS

General fatigue improved significantly after both HRV-BF and GET. Specific cognitive components of fatigue, mental quality of life, and depression improved significantly after HRV-BF only. Physical quality of life improved significantly after GET. There were significant differences between groups regarding mental quality of life and depression favouring HRV-BF.

CONCLUSION

Both interventions reduce fatigue. HRV-BF seems to have additional effects on components of mental health, including depression, whereas GET seems to emphasise components of physical health. These data offer implications for further research on combining HRV-BF and GET in patients with CFS.

Heart rate variability biofeedback therapy and graded exercise training in management of chronic fatigue syndrome: An exploratory pilot study, by Petra Windthorst, Nazar Mazurak1, Marvin Kuske, Arno Hipp, Katrin E. Giele, Paul Enck, Andreas Nieß, Stephan Zipfel, Martin Teufel in the Journal of Psychosomatic Research, February 2017, Vol 93, Pages 6–13 [published online December 2016]

TRIAL REGISTRATION

The described trial has been registered at the International Clinical Trials Registry Platform following the number DRKS00005445.