Marjon E A Wormgoor1,2, Sanne C Rodenburg3. 1. Division of Mental Health and Addiction, Vestfold Hospital Trust, Tønsberg, Norway. marwor@siv.no. 2. Division Physical Medicine and Rehabilitation, Vestfold Hospital Trust, Stavern, Norway. marwor@siv.no. 3. Department of Physiotherapy, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands.
Abstract
BACKGROUND: Due to the inconsistent use of diagnostic criteria in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), it is unsure whether physiotherapeutic management regarded effective in ME/CFS is appropriate for patients diagnosed with criteria that consider post-exertional malaise (PEM) as a hallmark feature. PURPOSE: To appraise current evidence of the effects of physiotherapy on symptoms and functioning in ME/CFS patients in view of the significance of PEM in the applied diagnostic criteria for inclusion. METHODS: A systematic review of randomized controlled trials published over the last two decades was conducted. Studies evaluating physiotherapeutic interventions for adult ME/CFS patients were included. The diagnostic criteria sets were classified into three groups according to the extent to which the importance of PEM was emphasized: chronic fatigue (CF; PEM not mentioned as a criterion), CFS (PEM included as an optional or minor criterion) or ME (PEM is a required symptom). The main results of included studies were synthesized in relation to the classification of the applied diagnostic criteria. In addition, special attention was given to the tolerability of the interventions. RESULTS: Eighteen RCTs were included in the systematic review: three RCTs with CF patients, 14 RCTs with CFS patients and one RCT covering ME patients with PEM. Intervention effects, if any, seemed to disappear with more narrow case definitions, increasing objectivity of the outcome measures and longer follow-up. CONCLUSION: Currently, there is no scientific evidence when it comes to effective physiotherapy for ME patients. Applying treatment that seems effective for CF or CFS patients may have adverse consequences for ME patients and should be avoided.
BACKGROUND: Due to the inconsistent use of diagnostic criteria in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), it is unsure whether physiotherapeutic management regarded effective in ME/CFS is appropriate for patients diagnosed with criteria that consider post-exertional malaise (PEM) as a hallmark feature. PURPOSE: To appraise current evidence of the effects of physiotherapy on symptoms and functioning in ME/CFS patients in view of the significance of PEM in the applied diagnostic criteria for inclusion. METHODS: A systematic review of randomized controlled trials published over the last two decades was conducted. Studies evaluating physiotherapeutic interventions for adult ME/CFS patients were included. The diagnostic criteria sets were classified into three groups according to the extent to which the importance of PEM was emphasized: chronic fatigue (CF; PEM not mentioned as a criterion), CFS (PEM included as an optional or minor criterion) or ME (PEM is a required symptom). The main results of included studies were synthesized in relation to the classification of the applied diagnostic criteria. In addition, special attention was given to the tolerability of the interventions. RESULTS: Eighteen RCTs were included in the systematic review: three RCTs with CF patients, 14 RCTs with CFS patients and one RCT covering ME patients with PEM. Intervention effects, if any, seemed to disappear with more narrow case definitions, increasing objectivity of the outcome measures and longer follow-up. CONCLUSION: Currently, there is no scientific evidence when it comes to effective physiotherapy for ME patients. Applying treatment that seems effective for CF or CFS patients may have adverse consequences for ME patients and should be avoided.
Authors: Andrew Keech; Carolina X Sandler; Ute Vollmer-Conna; Erin Cvejic; Andrew R Lloyd; Benjamin K Barry Journal: J Psychosom Res Date: 2015-09-02 Impact factor: 3.006
Authors: D C W M Vos-Vromans; R J E M Smeets; I P J Huijnen; A J A Köke; W M G C Hitters; L J M Rijnders; M Pont; B Winkens; J A Knottnerus Journal: J Intern Med Date: 2015-08-26 Impact factor: 8.989
Authors: Elisabet Guillamo; Joan R Barbany; Alicia Blazquez; Mari C Delicado; Josep L Ventura; Casimiro Javierre Journal: J Sports Med Phys Fitness Date: 2016-05 Impact factor: 1.637
Authors: Rainbow T H Ho; Jessie S M Chan; Chong-Wen Wang; Benson W M Lau; Kwok Fai So; Li Ping Yuen; Jonathan S T Sham; Cecilia L W Chan Journal: Ann Behav Med Date: 2012-10
Authors: Elin B Strand; Luis Nacul; Anne Marit Mengshoel; Ingrid B Helland; Patricia Grabowski; Angelika Krumina; Jose Alegre-Martin; Magdalena Efrim-Budisteanu; Slobodan Sekulic; Derek Pheby; Giorgos K Sakkas; Carmen Adella Sirbu; F Jerome Authier Journal: PLoS One Date: 2019-12-05 Impact factor: 3.240
Authors: Maximillian J Nelson; Jasvir S Bahl; Jonathan D Buckley; Rebecca L Thomson; Kade Davison Journal: Medicine (Baltimore) Date: 2019-10 Impact factor: 1.817
Authors: Md Al-Mustanjid; S M Hasan Mahmud; Farzana Akter; Md Shazzadur Rahman; Md Sajid Hossen; Md Habibur Rahman; Mohammad Ali Moni Journal: Inform Med Unlocked Date: 2022-07-06
Authors: Anouk W Vaes; Yvonne M J Goërtz; Maarten van Herck; Rosanne J H C G Beijers; Martijn van Beers; Chris Burtin; Daisy J A Janssen; Annemie M W J Schols; Martijn A Spruit Journal: Ann Med Date: 2022-12 Impact factor: 5.348