Limited evidence was found for the psychometric properties and clinical usability of these instruments .
However , the CFS-activities and participation question naire ( APQ ) is a disease-specific instrument with moderate content and construct validity .
PURPOSE To summarize measurement instruments used to evaluate activity limitations and participation restrictions in patients with chronic fatigue syndrome ( CFS ) and review the psychometric properties of these instruments .
Chronic fatigue syndrome causes activity limitations and participation restrictions in one or more areas of life .
Cognitive behavioural therapy in chronic fatigue syndrome: a randomised controlled trial of an outpatient group programme.
OBJECTIVES To test the hypothesis that group cognitive behavioural therapy ( CBT ) will produce an effective and cost-effective management strategy for patients in primary care with chronic fatigue syndrome/myalgic encephalopathy ( CFS/ME ) . DESIGN A double-blind , r and omised controlled trial was adopted with three arms . Outcomes were assessed at baseline and 6 and 12 months after first assessment and results were analysed on an intention-to-treat basis . SETTING A health psychology department for the management of chronic illness in a general hospital in Bristol , UK . PARTICIPANTS Adults with a diagnosis of CFS/ME referred by their GP . INTERVENTIONS The three interventions were group CBT incorporating grade d activity scheduling , education and support group ( EAS ) and st and ard medical care ( SMC ) . OUTCOME MEASURES The primary outcome measure was the Short Form with 36 Items ( SF-36 ) physical and mental health summary scales . Other outcome measures included the Chalder fatigue scale , Hospital Anxiety and Depression Scale , General Health Question naire , physical function ( shuttles walked , walking speed and perceived fatigue ) , health utilities index and cognitive function ( mood , recall and reaction times ) . RESULTS A total of 153 patients were recruited to the trial and 52 were r and omised to receive CBT , 50 to EAS and 51 to SMC . Twelve patients failed to attend for the 12-month follow-up and 19 patients attended one follow-up , but not both . The sample was found to be representative of the patient group and the characteristics of the three groups were similar at baseline . Three outcome measures , SF-36 mental health score , Chalder fatigue scale and walking speed , showed statistically significant differences between the groups . Patients in the CBT group had significantly higher mental health scores [ difference + 4.35 , 95 % confidence interval ( CI ) + 0.72 to + 7.97 , p = 0.019 ] , less fatigue ( difference -2.61 , 95 % CI -4.92 to -0.30 , p = 0.027 ) and were able to walk faster ( difference + 2.83 shuttles , 95 % CI + 1.12 to + 5.53 , p = 0.0013 ) than patients in the SMC group . CBT patients also walked faster and were less fatigued than those r and omised to EAS ( walking speed : difference + 1.77 , 95 % CI + 0.025 to + 3.51 , p = 0.047 ; fatigue : difference -3.16 , 95 % CI -5.59 to -0.74 , p = 0.011 ) . Overall , no other statistically significant difference across the groups was found , although for many measures a trend towards an improved outcome with CBT was seen . Except for walking speed , which , on average , increased by + 0.87 shuttles ( 95 % CI + 0.09 to + 1.65 , p = 0.029 ) between the 6- and 12-month follow-ups , the scores were similar at 6 and 12 months . At baseline , 30 % of patients had an SF-36 physical score within the normal range and 52 % had an SF-36 mental health score in the normal range . At 12 months , the physical score was in the normal range for 46 % of the CBT group , 26 % of the EAS group and 44 % of SMC patients . For mental health score the percentages were CBT 74 % , EAS 67 % and SMC 70 % . Of the CBT group , 32 % showed at least a 15 % increase in physical function and 64 % achieved a similar improvement in their mental health . For the EAS and SMC groups , this improvement in physical and mental health was achieved for 40 and 60 % ( EAS ) and 49 and 53 % ( SMC ) , respectively . The cost-effectiveness of the intervention proved very difficult to assess and did not yield reliable conclusions . CONCLUSIONS Group CBT did not achieve the expected change in the primary outcome measure as a significant number did not achieve scores within the normal range post-intervention . The treatment did not return a significant number of subjects to within the normal range on this domain ; however , significant improvements were evident in some areas . Group CBT was effective in treating symptoms of fatigue , mood and physical fitness in CFS/ME . It was found to be as effective as trials using individual therapy in these domains . However , it did not bring about improvement in cognitive function or quality of life . There was also evidence of improvement in the EAS group , which indicates that there is limited value in the non-specific effects of therapy . Further research is needed to develop better outcome measures , assessment s of the broader costs of the illness and a clearer picture of the characteristics best fitted to this type of intervention
Limited evidence was found for the psychometric properties and clinical usability of these instruments .
However , the CFS-activities and participation question naire ( APQ ) is a disease-specific instrument with moderate content and construct validity .
PURPOSE To summarize measurement instruments used to evaluate activity limitations and participation restrictions in patients with chronic fatigue syndrome ( CFS ) and review the psychometric properties of these instruments .
Chronic fatigue syndrome causes activity limitations and participation restrictions in one or more areas of life .