title: Multidisciplinary rehabilitation treatment versus cognitive behavioural therapy for patients with chronic fatigue syndrome: a randomized controlled trial. Protocol for the "four steps to control your fatigue (4-STEPS)" randomised controlled trial: a self-regulation based physical activity intervention for patients with unexplained chronic fatigue Focal Muscle Vibration and Progressive Modular Rebalancing with neurokinetic facilitations in post- stroke recovery of upper limb. Fatigue Exacerbation by Interval or Continuous Exercise in Chronic Fatigue Syndrome. Health-related quality of life in patients with chronic fatigue syndrome: group cognitive behavioural therapy and graded exercise versus usual treatment. A randomised controlled trial with 1 year of follow-up Does neuromuscular taping influence hand kinesiology? A pilot study on Down's Syndrome. Neuromuscular taping enhances hand function in patients with systemic sclerosis: a pilot study. Graduated exercise training and progressive resistance training in adolescents with chronic fatigue syndrome: a randomized controlled pilot study
abstract: OBJECTIVES The aim of this trial was to evaluate the difference in treatment effect , at 26 and 52 weeks after the start of treatment , between cognitive behavioural therapy ( CBT ) and multidisciplinary rehabilitation treatment ( MRT ) for patients with chronic fatigue syndrome ( CFS ) . DESIGN Multicentre , r and omized controlled trial of patients with CFS . Participants were r and omly assigned to MRT or CBT . SETTING Four rehabilitation centres in the Netherl and s. SUBJECTS A total of 122 patients participated in the trial . MAIN OUTCOME MEASURES Primary outcomes were fatigue measured by the fatigue subscale of the Checklist Individual Strength and health-related quality of life measured by the Short-Form 36 . Outcomes were assessed prior to treatment and at 26 and 52 weeks after treatment initiation . RESULTS A total of 114 participants completed the assessment at 26 weeks , and 112 completed the assessment at 52 weeks . MRT was significantly more effective than CBT in reducing fatigue at 52 weeks . The estimated difference in fatigue between the two treatments was -3.02 [ 95 % confidence interval ( CI ) -8.07 to 2.03 ; P = 0.24 ] at 26 weeks and -5.69 ( 95 % CI -10.62 to -0.76 ; P = 0.02 ) at 52 weeks . Patients showed an improvement in quality of life over time , but between-group differences were not significant . CONCLUSION This study provides evidence that MRT is more effective in reducing long-term fatigue severity than CBT in patients with CFS . Although implementation in comparable population s can be recommended based on clinical effectiveness , it is advisable to analyse the cost-effectiveness and replicate these findings in another multicentre trial Background Unexplained Chronic Fatigue is a medical condition characterized by the presence of persistent , severe and debilitating medically unexplained fatigue , leading to impaired functioning and lower quality of life . Research suggests that physical activity can contribute to the reduction of fatigue and other somatic symptoms and can thus significantly improve physical functioning and quality of life in these patients . Based on the self-regulation ( SR ) theory of behaviour change , we developed a brief physical activity program for patients suffering from unexplained chronic fatigue which focuses on the training of self-regulation skills , the " 4-STEPS to control your fatigue " program . Methods / Design This is a multi-centre , r and omised controlled trial ( RCT ) that will be carried out in local primary care centres and at the Portuguese Fibromyalgia and Chronic Fatigue Syndrome Patients Association . Patients aged between 18 and 65 and fulfilling operationalized criteria for Idiopathic Chronic Fatigue ( ICF ) and Chronic Fatigue Syndrome ( CFS ) will be recruited and r and omly allocated to st and ard care ( SC ) or st and ard care plus a self-regulation based physical activity program ( 4-STEPS ) . Patients will be assessed at baseline , after the intervention ( 3 months ) and at 12 months follow-up . The primary outcome is fatigue severity . Discussion The results of the RCT will provide information about the effectiveness of a brief self-regulation intervention for promoting physical activity in patients with unexplained chronic fatigue . If the program proves to be effective , it may be considered as an adjunctive treatment for these patients .Trial Registration IS RCT N : IS RCT BACKGROUND Stroke is one of the leading causes for disability worldwide . Exercise therapy is a key element of stroke rehabilitation but no evidence are present in literature . Moreover recently focal muscle vibrationis described as a useful therapeutic approach in the post stroke recovery . In this study the efficacy of the vibration therapy in association to progressive modular re balancing rehabilitative approach has been evaluated and compared to the conventional therapy alone and associated to the muscle vibration . METHODS A pilot r and omized controlled trial , using a pragmatic triple-blind , parallel-group study design in chronic stroke patients upper limb function . RESULTS Functional outcomes result ed increased in the group treated with vibration therapy and in particular in the group associated to progressive modular rebalancing approach . CONCLUSION The combining neurophysiologically-based rehabilitative technique and vibration therapy may improve functional recovery in chronic stroke patients PURPOSE The objective of this study is to determine whether the typical exacerbation of symptoms in patients with chronic fatigue syndrome ( CFS ) after a bout of exercise differs between high-intensity interval training ( HIIT ) or continuous ( CONT ) aerobic exercise of the same duration and mechanical work . METHODS Participants with specialist-diagnosed CFS performed two 20-min bouts of cycling in a r and omized crossover study . The bouts were either moderate-intensity continuous ( 70 % age-predicted HR maximum ) or high-intensity interval exercise , separated by at least 2 wk . Self-report question naires capturing fatigue , the related symptoms , and actigraphy were collected across 2 d before and 4 d after the exercise . Comparisons between exercise bouts were made using paired sample t-tests . RESULTS Fourteen moderately affected participants who were unable to work , but not bed bound , completed the study ( nine female , 32 ± 10 yr , 67 ± 11 kg ) . Mechanical work was matched successfully between the exercise bouts ( HIIT , 83,037 , vs CONT , 83,348 J , P = 0.84 ) . Mean HR ( HIIT , 76 % ± 5 % , vs CONT , 73 % ± 6 % age-predicted HR maximum , P < 0.05 ) and RPE ( 6 - 20 ) in the legs ( HIIT , 15.4 ± 1.4 , vs CONT , 13.2 ± 1.2 , P < 0.001 ) were higher for the interval compared with continuous exercise . Mean fatigue scores ( 0 - 10 ) were similar before each exercise challenge ( HIIT , 4.5 ± 1.8 , vs CONT , 4.1 ± 1.7 , P = 0.43 ) . Participants reported an increase in fatigue scores after both challenges ( mean difference : HIIT , 1.0 ± 1.3 , P < 0.01 ; CONT , 1.5 ± 0.7 , P < 0.001 ) , but these exacerbations in fatigue were not statistically or clinical ly different ( P = 0.20 ) . CONCLUSIONS High-intensity interval exercise did not exacerbate fatigue any more than continuous exercise of comparable workload . This finding supports evaluation of HIIT in grade d exercise therapy interventions for patients with CFS Chronic fatigue syndrome ( CFS ) produces physical and neurocognitive disability that significantly affects health-related quality of life ( HRQL ) .  Multidisciplinary treatment combining grade d exercise therapy ( GET ) cognitive behavioural therapy ( CBT ) and pharmacological treatment has shown only short-term improvements . To compare the effects on HRQL of ( 1 ) multidisciplinary treatment combining CBT , GET , and pharmacological treatment , and ( 2 ) usual treatment ( exercise counselling and pharmacological treatment ) at 12 months of follow-up . Prospect i ve , r and omized controlled trial with a follow-up of 12 months after the end of treatment . Patients consecutively diagnosed with CFS ( Fukuda criteria ) were r and omly assigned to intervention ( n = 60 ) or usual treatment ( n = 60 ) groups . HRQL was assessed at baseline and 12 months by the Medical Outcomes Study Short-Form question naire ( SF-36 ) . Secondary outcomes included functional capacity for activities of daily living measured by the Stanford Health Assessment Question naire ( HAQ ) and comorbidities . At baseline , the two groups were similar , except for lower SF-36 emotional role scores in the intervention group . At 12 months , the intervention did not improve HRQL scores , with worse SF-36 physical function and bodily pain scores in the intervention group . Multidisciplinary treatment was not superior to usual treatment at 12 months in terms of HRQL . The possible benefits of GET as part of multidisciplinary treatment for CFS should be assessed on an individual patient basis PURPOSE This paper is a first attempt analysis of h and and upper limb proprioception coordination induced by NeuroMuscular Taping ( NMT ) : application in a group of 5 participants with Down syndrome . MATERIAL S AND METHODS The participants underwent a drawing test with motion capture system acquisition before and after NMT application . Specific and descriptive parameters were computed and analysed in order to quantify the differences . RESULTS Results showed statistical differences between pre and post treatment sessions : the 5 participants with Down syndrome evidence d more reliance on proprioceptive signals in the post treatment session during the execution of the specific writing tasks . CONCLUSIONS Based on the hypothesis that modifications in proprioception should alter motor pathway mapping of the motor cortex , Neuromuscular taping may play a role in the treatment of dysgraphia and improving h and coordination following CNS impairment , even though a small treatment group was chosen for this pilot study the results lead to further discussion s concerning the role of different afferent signals in a pathological context H and functioning is often impaired in patients with Systemic sclerosis .  Neuromuscular Taping is a novel application of tape able to improve functioning . The aim of this study was to evaluate the possible role of this application in the h and functionality of patients with Systemic sclerosis . Women with a diagnosis of SSc has been recruited and evaluated using different scales before and immediately after NMT application and after one , three and six months . Fifty-three women has been evaluated and Cochin H and Functional Disability scale , H and Mobility in Sclerodermia , Modified Rodnan Skin Score and Dreiser Algo - Functional Index scores showed statistical significant differences during all the period ; moreover a reduction of pain and Raynaud Phenomenon 's and an improvement of finger flexion has been observed . Application of NMT in patients with Systemic sclerosis have showed beneficial effect and future studies are needed to confirm these results Objective : To investigate the differential effects of aerobic grade d exercise and progressive resistance training on exercise tolerance , fatigue and quality of life in adolescent patients with chronic fatigue syndrome ( CFS ) . Design : Single-blind , r and omized controlled pilot trial . Setting : A major metropolitan hospital in Melbourne , Australia . Subjects : Twenty-two adolescents aged 13—18 years diagnosed with CFS and admitted to the inpatient chronic fatigue rehabilitation programme . Intervention : Patients were r and omized to either grade d aerobic exercise training or a progressive resistance training programme , for five days/week for four weeks . The grade d aerobic training consisted of 20—40 minutes of stationary cycling and treadmill exercise . The progressive resistance training involved 16 exercises performed with single set , moderate load and high repetitions . Main measures : Exercise tolerance ( time to fatigue ) measured on a grade d sub-maximal treadmill test , metabolic equivalents and quality of life , along with muscular strength ( maximium push-ups ) and endurance ( sit-to-st and ) and question naires evaluating depressive symptoms and fatigue severity . Results : No intervention was significantly better than the other for any outcome . However , physical capacity and quality of life significantly improved in both groups , while fatigue severity and symptoms of depression improved only with aerobic training . Conclusions : Resistance and aerobic training result ed in similar changes to physical capacity , quality of life and fatigue severity . Generally , patients who completed resistance training or aerobic training experienced significant improvements in outcomes from baseline when they entered the programme . Whether these improvements can be attributed to the treatment is unknown
target: Rehabilitation programs that promote physiotherapy techniques such as exercise , mobilization , and body awareness ( e.g. , MRT and GET ) are the most effective in reducing medium and long-term fatigue severity in CFS patients
background: OBJECTIVE The objectives of this work were to fill the gap in the scientific literature and to evaluate the results of physical therapy treatments  in individuals affected by chronic fatigue syndrome , considering only studies that employed a r and omized controlled trial .