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Research Project
PSYCHOLOGICAL PREDICTORS OF PHYSICAL EXERCISE IN HEALTHY AND CHRONIC FATIGUE POPULATION: A SELF - REGULATION PERSPECTIVE
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Publications
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.
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.
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Funding agency
Fundação para a Ciência e a Tecnologia
Funding programme
PIDDAC
Funding Award Number
SFRH/BD/47579/2008