E King1, M Beynon2, T Chalder3, M Sharpe4, P D White2. 1. Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UK. 2. Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine, Queen Mary University, London, UK. 3. Academic Department of Psychological Medicine, King's College London, Weston Education Centre, London, UK. Electronic address: Trudie.chalder@kcl.ac.uk. 4. Psychological Medicine Research, Department of Psychiatry, University of Oxford, Oxford, UK.
Abstract
OBJECTIVES: To classify patients with chronic fatigue syndrome (CFS) by pattern of physical activity and determine the clinical associations of each type. METHODS:579 out of 641 participants with CFS from the PACE (Pacing, graded Activity, Cognitive behavioural therapy: a randomised Evaluation) trial wore an Actiwatch (accelerometer) for between 3 and 7 days before any trial treatments, which provided a measure of physical activity. Participants' activity was categorised into one of four patterns (pervasively inactive, pervasively active, boom and bust, or indeterminate) primarily using a priori definitions of activity. Clinical associations were sought with each group using an exploratory logistic regression with the indeterminate activity group being the reference group. RESULTS: 124 (21%) of the participants were classified as pervasively inactive, 65 (11%) as pervasively active, 172 (30%) showed a 'boom and bust' pattern of activity, and 218 (38%) had an indeterminate pattern. Pervasively inactive patients were more physically disabled, those in the pervasively active group were more anxious, and those in the boom and bust group had more sleep disturbance. CONCLUSION: We were able to classify patients with CFS into groups by their daytime activity pattern. The different patterns of activity were associated with important clinical variables, suggesting that they might be helpful in determining prognosis and targeting treatments. These associations need replication. Crown
RCT Entities:
OBJECTIVES: To classify patients with chronic fatigue syndrome (CFS) by pattern of physical activity and determine the clinical associations of each type. METHODS: 579 out of 641 participants with CFS from the PACE (Pacing, graded Activity, Cognitive behavioural therapy: a randomised Evaluation) trial wore an Actiwatch (accelerometer) for between 3 and 7 days before any trial treatments, which provided a measure of physical activity. Participants' activity was categorised into one of four patterns (pervasively inactive, pervasively active, boom and bust, or indeterminate) primarily using a priori definitions of activity. Clinical associations were sought with each group using an exploratory logistic regression with the indeterminate activity group being the reference group. RESULTS: 124 (21%) of the participants were classified as pervasively inactive, 65 (11%) as pervasively active, 172 (30%) showed a 'boom and bust' pattern of activity, and 218 (38%) had an indeterminate pattern. Pervasively inactive patients were more physically disabled, those in the pervasively active group were more anxious, and those in the boom and bust group had more sleep disturbance. CONCLUSION: We were able to classify patients with CFS into groups by their daytime activity pattern. The different patterns of activity were associated with important clinical variables, suggesting that they might be helpful in determining prognosis and targeting treatments. These associations need replication. Crown
Authors: Sari Harenwall; Suzanne Heywood-Everett; Rebecca Henderson; Sherri Godsell; Sarah Jordan; Angela Moore; Ursula Philpot; Kirsty Shepherd; Joanne Smith; Amy Rachel Bland Journal: J Prim Care Community Health Date: 2021 Jan-Dec