How does cognitive behaviour therapy reduce fatigue in patients with chronic fatigue syndrome? The role of physical activity

Abstract

The effect of CBT on fatigue in CFS is not mediated by a persistent increase in physical activity.

Bias, misleading information and lack of respect for alternative views have distorted perceptions of myalgic encephalomyelitis/chronic fatigue syndrome and its treatment

“…The latter is particularly important given Dutch research found no significant increase in activity after treatment in three of their trials (Wiborg et al, 2010).…”

Authors’ response to commentary by Twisk

“…With regard to successful behavioral interventions in CFS, we agree that outcomes are rarely confirmed with more objective measures, such as actigraphy (which does not improve with the treatment) [3] or the 6-min walk test which sometimes shows increased fitness [4] and sometimes not.…”

Cognitive-behavior therapy: why is it so vilified in the chronic fatigue syndrome community?

“…Of the three successful CBT trials that utilized more objective actigraphy-based physical activity outcomes, [17] none found improvements in actigraphy from pre-to post-treatment or between intervention and control groups. One plausible interpretation of this finding is that 'recovered' individuals may have replaced illness-exacerbating activities with illness-moderating behaviors, resulting in no net increase in total activity levels.…”