Healthy living

Therapy and gradual exercise work best for chronic fatigue

Therapy and gradual exercise works best for ME/CFS Clinical trial compared four types of treatment

Six out of ten patients with Chronic Fatigue Syndrome or Myalgic Encephalomyelitis find their symptoms improve after two types of treatment, according to a trial carried out in the UK.

Around a quarter of a million people in the UK suffer from ME, also known as chronic fatigue syndrome (CFS). The debilitating symptoms usually include severe fatigue, tiredness, muscle pain and aching joints. The cause is unknown.

The study - known as the PACE trial - compared the effectiveness of four separate treatments: cognitive behavioural therapy (CBT), graded exercise therapy (GET), adaptive pacing therapy (APT) and specialised medical care.

The trial included 640 patients diagnosed with CFS/ME from six specialist clinics in Scotland and England.

The trial, funded by the Medical Research Council, found that CBT - where patients are taught how their thoughts and actions can have an affect on symptoms - and GET - where exercise is gradually increased to suit a patient - benefited the patients most.

Specialised medical care - where patients were given advice about how to manage their condition, as well as medication for specific symptoms such as insomnia and pain - and APT - where a patient matches their activity to the amount of energy they have - were found to be less effective.

The success of the treatments was measured by improvements in levels of fatigue after exertion, levels of physical activity, overall health and ability to lead a normal life.

The trial was carried out by a team of experts from Queen Mary, University London, King’s College London and the University of Edinburgh.

Professor Peter White, from Barts and The London School of Medicine and Dentistry, Queen Mary, said: “We have found that both CBT and GET can safely help a significant number of patients.

"While there is still room for improvement, this is a real step forward in informing patients with CFS/ME which treatments can help to improve their health and ability to lead a more normal life.”

The findings of the PACE trial are published in the journal Lancet.

This article was published on Fri 18 February 2011

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