Effectiveness of an Online Multicomponent Program FATIGUEWALK for Chronic Fatigue Syndrome: A Randomized Controlled Trial, 2023, Serrat et al.

Effectiveness of an Online Multicomponent Program FATIGUEWALK for Chronic Fatigue Syndrome: A Randomized Controlled Trial
Mayte Serrat, Jaime Navarrete, Sònia Ferrés, William Auer, Ramon Sanmartín-Sentañes, Rubén Nieto, Randy Neblett, Xavier Borràs, Juan V. Luciano, and Albert Feliu-Soler

Objectives
This study aimed to evaluate the effectiveness of an online multicomponent intervention called FATIGUEWALK (FaW) compared to treatment as usual (TAU) in patients with chronic fatigue syndrome/ myalgic encephalomyelitis (CFS/ME).

Methods
FaW included pain neuroscience education, therapeutic exercise, cognitive restructuring, and mindfulness training. A total of 428 patients with CFS/ME were randomized into two study arms: online FaW plus TAU versus TAU alone. A single-blinded randomized controlled trial was conducted. Validated patient-reported outcome measures of fatigue, pain, anxiety, depression, and physical function were collected at baseline and posttreatment, following the FaW intervention, which lasted 12 weeks.

Results
Statistically significant improvements (with small-to-moderate effect sizes) were observed in online FaW versus TAU alone with respect to multidimensional aspects of fatigue (Cohen’s d ranging from 0.25 to 0.73) and most secondary outcomes (pain and fatigue intensity, depressive and anxious symptomatology, functional impairment, kinesiophobia, physical functioning). The absolute risk reduction in FaW versus TAU was 19%, 95% confidence interval (CI) [12.19, 25.80] with number needed to treat = 6, 95% CI [3.9, 8.2]. Overall, similar clinical improvements were observed in sensitivity analyses including a subgroup of patients without comorbidity with fibromyalgia (n = 70).

Conclusions
This is the first study to assess the short-term effectiveness of an online multicomponent intervention added to TAU, compared to TAU alone, for the management of CFS/ME. Further trials, including active control groups with an equivalent treatment dose, and assessing the long-term effectiveness of the online FaW, are warranted.

Link | PDF (Health Psychology)

 

"All these factors, putatively contributed to the program’s success in delivering reporting positive outcomes."

 

I've done a lot of walking before and during ME, less during some periods, and more during others. I noticed no reduction of symptoms from walking. A reduction of symptoms, for whatever reason, did result in more walking. Could their results simply be subjects walking more when they felt better?

 

This FATIGUEWALK study is an offshoot (some of same authors) of the FIBROWALK study published 2022:

https://www.sciencedirect.com/science/article/pii/S0005796722001590?via=ihub

 

Well, no, it isn't. In fact there are dozens like this. It's basically the current paradigm, for all intents and purposes, as found in textbooks, presentations and fancy websites. There are people who have been making it their primary income to do this stuff for many years now. So it's old and tested, but also new and full of potential.

Basically, it's like a program that goes like this:

while(true) {

print("More research is needed");​

}

"Blinding"

Blinded data analysis is nice and all but everyone else was not just aware but actively participating in the process. Single-blinded is that patients are blinded to the intervention they are receiving, not possible here. Double-blinded is that clinicians involved in the intervention are also blinded, also not possible here. Independent data analysis is, in my opinion, expected as a basic requirement, so it's actually concerning that it's citing this as equivalent to blinding, suggesting that it's probably standard practice for researchers actively participating in their studies to do their own data analysis.

This is basically like claiming a chain of custody because the last person who handled the evidence was told there was a chain of evidence beforehand and it hasn't left their sight since.

And wow they actually called the paper a randomized controlled trial, even though it isn't even properly randomized since they have a selection process with a number of criteria, despite recognizing in the abstract that it isn't controlled. And this passed peer review, because peer review in evidence-based medicine is a sick joke.

 

And oddly, citing PACE for CBT, but not for GET. Even though GET is the main takeaway for PACE, and the main evidence for the Cochrane review. Literally all made-up.