Operant Learning Versus Energy Conservation Activity Pacing Treatments in a Sample of Patients With Fibromyalgia Syndrome: A Pilot Randomized Controlled Trial

Racine, Mélanie; Jensen, Mark P.; Harth, Manfred; Morley‐Forster, Patricia; Nielson, Warren R.

doi:10.1016/j.jpain.2018.09.013

Cited by 18 publications

(17 citation statements)

References 95 publications

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“…In nine studies, the interventions were delivered solely in community settings such as general and specialist clinics [ 41 , 43 , 46 , 47 , 55 , 58 , 65 , 70 , 72 ], while a further nine comprised elements of home-based self-management combined with primary or outpatient care [ 53 , 54 , 61 , 62 , 64 , 71 , 73 – 75 ]. Two studies combined primary and secondary/specialist care [ 51 , 52 ], while 11 studies combined secondary/specialist care with outpatient care and laboratory-based assessment [ 14 , 38 , 42 , 49 , 50 , 57 , 59 , 60 , 63 , 67 , 68 ].…”

Section: Resultsmentioning

confidence: 99%

“…Several studies employed interventions that did show benefits but with smaller effect level, such as operant learning [ 55 ] (MD -10.6, 95% CI -22.5 to 1.3, SMD = 0.520) and different forms of physical activity, such as GET [ 49 ] (MD -11.5, 95% CI -17.6 to -5.4, SMD = 0.524) and self-regulation based physical activity [ 61 ] (MD -9.9, 95% CI -16.3 to -3.4, SMD = 0.513).…”

Section: Resultsmentioning

confidence: 99%

“…Tuina [47] and moxibustion [48]-all of which aim to stimulate or otherwise influence physiological processes (for example, increasing oxidation of the blood). Second, psychological or psycho-spiritual therapies such as cognitive behavioural therapy (CBT) [14,[49][50][51][52][53], behavioural self-regulation [54], operant learning [55] and Three Principles/Innate Health [56] which focus on influencing cognitive processes, building self-awareness and education. Third, physical interventions that require active physical input or participation from the individual, and which may or may not comprise a 'mind-body' component, such as Graded Exercise Therapy (GET) [57][58][59][60][61][62], Oriental Medicine Music Therapy [63], Tai Ji Quan [64] and yoga [65], and finally multi-modal interventions which comprise a either a mixture of the afore-mentioned activities or one or more activities plus pharmacological components [66][67][68][69][70].…”

Section: Study Characteristicsmentioning

confidence: 99%

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A mixed-methods systematic review of post-viral fatigue interventions: Are there lessons for long Covid?

et al. 2021

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Objectives Fatigue syndromes have been widely observed following post-viral infection and are being recognised because of Covid19. Interventions used to treat and manage fatigue have been widely researched and this study aims to synthesise the literature associated with fatigue interventions to investigate the outcomes that may be applicable to ‘long Covid’. Method The study was registered with PROSPERO (CRD42020214209) in October 2020 and five electronic databases were searched. Papers were screened, critically appraised and data extracted from studies that reported outcomes of fatigue interventions for post-viral syndromes. The narrative synthesis includes statistical analysis associated with effectiveness and then identifies the characteristics of the interventions, including identification of transferable learning for the treatment of fatigue in long Covid. An expert panel supported critical appraisal and data synthesis. Results Over 7,000 research papers revealed a diverse range of interventions and fatigue outcome measures. Forty papers were selected for data extraction after final screening. The effectiveness of all interventions was assessed according to mean differences (MD) in measured fatigue severity between each experimental group and a control following the intervention, as well as standardised mean differences as an overall measure of effect size. Analyses identified a range of effects–from most effective MD -39.0 [95% CI -51.8 to -26.2] to least effective MD 42.28 [95% CI 33.23 to 51.34]–across a range of interventions implemented with people suffering varying levels of fatigue severity. Interventions were multimodal with a range of supportive therapeutic methods and varied in intensity and requirements of the participants. Those in western medical systems tended to be based on self- management and education principles (i.e., group cognitive behavioural therapy (CBT). Conclusion Findings suggest that the research is highly focussed on a narrow participant demographic and relatively few methods are effective in managing fatigue symptoms. Selected literature reported complex interventions using self-rating fatigue scales that report effect. Synthesis suggests that long Covid fatigue management may be beneficial when a) physical and psychological support, is delivered in groups where people can plan their functional response to fatigue; and b) where strengthening rather than endurance is used to prevent deconditioning; and c) where fatigue is regarded in the context of an individual’s lifestyle and home-based activities are used.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

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A mixed-methods systematic review of post-viral fatigue interventions: Are there lessons for long Covid?

et al. 2021

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“…Pacing is associated with less pain interference and better psychological function, but there is marked variability in approach and response (Antcliff et al, 2019;Murphy and Kratz, 2014;Racine et al, 2018Racine et al, , 2020. There are two main theoretical models guiding pacing treatment: namely Operant Theory and Energy Conservation (Nielson et al, 2013;Racine et al, 2019). The former informs adaptive pacing behaviours that aim to limit the extent to which somatic symptoms control activity goals, whilst the latter alternatively encourages interventions which preserve activity, to help reduce pain and fatigue (Macfarlane et al, 2017).…”

Section: Changing Activitymentioning

confidence: 99%

Body Reprogramming: Reframing the Fibromyalgia narrative and providing an integrative therapeutic model

Davies

Hill

Fay³

et al. 2020

Health Psychology Open

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We propose a theory known as the Hyland model to help conceptualise Fibromyalgia within a complex adaptive control system. A fundamental assumption is that symptom generating mechanisms are causally connected, forming a network that has emergent properties. An illness narrative has been developed which has a ‘goodness of fit’ with the lived experience of those with Fibromyalgia. The theory guides management within the clinical setting and incorporates current evidence-based therapeutic strategies, within a multi-modal intervention described as ‘Body Reprogramming’. This intervention focuses on non-pharmacological and lifestyle-based considerations. The theoretical framework also helps explain why modest therapeutic effects are gained from current pharmacological options.

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“…In nine studies, the interventions were delivered solely in community settings such as general and specialist clinics [41,43,46,47,55,58,65,70,72], while a further nine comprised elements of home-based self-management combined with primary or outpatient care [53,54,61,62,64,71,[73][74][75]. Two studies combined primary and secondary/specialist care [51,52], while 11 studies combined secondary/specialist care with outpatient care and laboratory-based assessment [14,38,42,49,50,57,59,60,63,67,68].…”

Section: Study Characteristicsmentioning

confidence: 99%

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Operant Learning Versus Energy Conservation Activity Pacing Treatments in a Sample of Patients With Fibromyalgia Syndrome: A Pilot Randomized Controlled Trial

Cited by 18 publications

References 95 publications

A mixed-methods systematic review of post-viral fatigue interventions: Are there lessons for long Covid?

A mixed-methods systematic review of post-viral fatigue interventions: Are there lessons for long Covid?

Body Reprogramming: Reframing the Fibromyalgia narrative and providing an integrative therapeutic model

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