PSYCHOLOGICAL PREDICTORS OF PHYSICAL EXERCISE IN HEALTHY AND CHRONIC FATIGUE POPULATION: A SELF - REGULATION PERSPECTIVE

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Effects of a self-regulation based physical activity program (the “4-STEPS”) for unexplained chronic fatigue : A randomized gontrolled trial

Publication . Marques, Marta Moreira; De Gucht, Véronique; Leal, Isabel Pereira; Maes, Stan

Background: This study aimed at assessing the effects of a self-regulation-based brief physical activity program for patients suffering from unexplained chronic fatigue, the “4- STEPS to control your fatigue program”. Method: A 12-week randomized controlled trial was conducted. Adult patients meeting the CDC criteria for idiopathic chronic fatigue were randomized to either the control condition (standard care) or the intervention condition (4-STEPS). The 4-STEPS was based on self-regulation principles and consisted of motivational interviewing and self-regulation skills training. All patients were assessed at baseline and post-treatment (12 weeks) for fatigue severity (primary outcome) and impact, physical activity (leisure time physical activity, number of daily steps and personal activity goal progress), health-related quality of life, somatic distress and psychological distress (depression and anxiety). Results Ninety-one patients (45 intervention and 46 control patients) received the allocated intervention. At post-treatment, statistical analysis revealed a significant difference for subjective experience of fatigue (4.73 points; g=0.51) in favour of the intervention group. Mixed design ANCOVAs showed a significant effect of the 4-STEPS on fatigue severity, leisure time physical activity, personal activity goal progress and healthrelated quality of life. No significant effects were found for number of daily steps and somatic and psychological distress. Conclusion: The 4-STEPS program has significant beneficial effects at post-treatment. This brief self-regulation-based intervention looks promising for the management of unexplained chronic fatigue.

2015Journal article

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Differential effects of behavioral interventions with a graded physical activity component in patients suffering from chronic fatigue (syndrome) : An updated systematic review and meta-analysis

Publication . Marques, Marta Moreira; De Gucht, Véronique; Gouveia, Maria João Pinheiro Morais; Leal, Isabel Pereira; Maes, Stan

An updated systematic review and meta-analysis was conducted to (1) evaluate the effects of behavioral and psychological interventions containing a graded physical activity component upon fatigue severity, physical functioning, physical activity and psychological distress, and to (2) examine potential moderator effects of trial characteristics (type of control, setting, provider, length of treatment, psychological component, flexibility in physical activity, and minimal face to face patient–provider contact). Pertinent content of selected studies was extracted and rated on a scale of methodological quality. Sixteen randomized controlled trials (N = 2004) were included in the meta-analyses. Significant small to medium effect sizes (Hedge's g = 0.25 to g = 0.66) were found for all outcomes at post-treatment (M = 5.2 months) and follow-up (M = 11.7 months), with the exception of physical activity at post-treatment (g = 0.11). The largest effects were found for fatigue severity (g = 0.61 to g = 0.66). Subgroup analyses revealed that minimal contact interventions had additional beneficial effects upon fatigue (g = 0.96) and depression (g = 0.85). Interventions provided by psychologistspsychotherapists and interventions conducted in secondary–tertiary settings also resulted in more beneficial effects on fatigue. We found some indication of publication bias. The small number of studies and variability between them are limitations of this study. Future research should explore additional moderating effects in order to improve the effectiveness of interventions.

2015Journal article

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