Research abstract:
OBJECTIVE:
The objective of this study was to evaluate the effectiveness of an activity pacing self-management (APSM) intervention in improving performance of daily life activities in women with chronic fatigue syndrome (CFS).
METHOD:
A total of 33 women with CFS (age 41.1 ± 11.2 yr) were randomly allocated to APSM (experimental group; n = 16) or relaxation (control group; n = 17). Main outcome measures included the Canadian Occupational Performance Measure (COPM; primary) and Checklist Individual Strength (CIS).
RESULTS:
COPM scores changed significantly over time in both groups (p = .03). The change in Satisfaction scores showed a significant difference in favor only of APSM (effect size = 0.74 [0.11, 1.4]). CIS scores decreased significantly in the experimental group only (p < .01).
CONCLUSION:
APSM was found to be feasible and effective in optimizing participation in desired daily life activities in women with CFS. Replication in a larger sample with long-term follow-up is required.
Activity pacing self-management in chronic fatigue syndrome: a randomized controlled trial, by Daphne Kos; Inge van Eupen; Jill Meirte; Deborah Van Cauwenbergh; Greta Moorkens; Mira Meeus; Jo Nijs in American Journal of Occupational Therapy, 2015 Sep, Vol. 69, 6905290020p1-6905290020p11
Trial proposal describes the management approaches:
Pacing
The pacing self-management program focussed on teaching the patient to estimate their current physical capabilities prior to commencing an activity. In order to appropriately pace activities (daily activities and exercise bouts), CFS patients were learned to estimate their current physical capabilities prior to commencing an activity, keeping in mind the regular fluctuating nature of their symptoms.
The activity duration used within the program was less than that reported by the patient so to account for typical overestimations made by the patient. Each activity block was interspersed with breaks, with the length of this break equating to the duration of the activity.
3 one-on-one sessions weekly for 3 consecutive weeks
Other Names: activity self-management; activity management; adaptive pacing
Relaxation therapy
Relaxation therapy comprised of education about the role of stress in CFS biology, and the opportunities stress management provides to handle this issue. Patients were then taught how to apply stress management techniques like Jacobson relaxation skills, Schultz relaxation skills, visualization, etc.
3 one-on-one sessions weekly for 3 consecutive weeks
Other Names: stress management; Jacobson relaxation; visualisation; Schultz relaxation
