(
@dave30th )
I have been looking through the dissertation to see if I could find some information on what
exactly the dutch division by Knoop & co in "low activity" and "high activity" (or in the case of RECOVer "fluctuating active activity pattern") entails beyond the vague descriptions, and how this division is determined exactly.
In the dissertation I found this, from: "Efficacy of guided self-instructions in the treatment of patients with
chronic fatigue syndrome: a randomised controlled trial", submitted version (which would be published as
a study on idiopatic chronic fatigue, determined by Fukuda).
Under the header "Assessment of predictors of treatment outcome" it says:
"The physical activity level was measured with an actometer, a motion-sensing device worn at the ankle that quantifies physical activity. The actometer was worn 12 consecutive days and nights. A general physical activity score that expressed the mean activity level over this period in the mean number of accelerations per 5-minute interval was calculated. Patients were classified in relative active and passive by comparing their activity pattern with reference scores. (18) On the basis of this typology they received a different type of treatment. For the analysis of the predictive value of the physical activity for treatment outcome the mean activity level was used."
18= Van der Werf SP, Prins JB, Vercoulen JHMM, van der Meer JWM, Bleijenberg G. Identifying physical
activity patterns in chronic fatigue syndrome using actigraphic assessment. J Psychosom Res 2000; 49: 373-
9.
When discussing the dutch method in the introduction of his dissertation, Knoop opens with: "In the protocol of Bleijenberg et al (26) the pattern of physical activity determines the type of interventions that are used after the regulation of the sleep-wake cycle. An actometer, a motion sensing device that can quantify physical activity, is used to assess the activity
pattern.(27) Two types of activity patterns are distinguished:"etc.
Reference 27 is again to Van der Werf et al., 2000, Reference 26, regarding the protocol for this approach, is to a book chapter Bleijenberg, Prins and Bazelmans wrote for the 2003 "Handbook of chronic fatigue syndrome".
It says:
A typically passive patient has an average daily activity score, recorded by an actometer around the ankle, below the norm score of CFS patients (=66) on 11 or 12 of a total of 12 days. (From Vander Werf et al. 2000)
(When discussing determining activity level through asking questions) :
"Although nearly all CFS claim that they hardly do anything anymore, the distinction between relatively active patients and those with a low activity pattern usually becomes much clearer.”
“The patient with a low activity pattern spends a great deal of time lying down, does not walk for long periods, and goes out infrequently.” (with short bit on how much support a patient receives b/c they do not live alone influences this)
When not determined by actometer but by anamnesis, one can distinguish between relatively active and passive patients, “identify the definitive activity type”, by their daily records:
“Relatively active patients still are able to do some paid work for several hours per day, do some domestic chores, and are socially active to some extent or engage in certain leisure activities or hobbies. By contrast, passive patients mainly spend a lot of time in bed, seldom leave the house, and undertake few to no household tasks. Relatively active CFS patients mostly have cognitions that entail making high demands on themselves, wanting to do (too) much, and refusing to accept the current situation. Low-active CFS patients primary exhibit anxious cognitions about the negative effect that activity may have on their symptoms.”
They also state that “passive or low-active patients” constitute “about 25% of all CFS patients.”
Sidenote: the aim of CBT according to this chapter is “full recovery”
