Hypothalamic-Pituitary-Adrenal (HPA) Axis and Chronic Fatigue Syndrome in Older Adults: The Rehabilitation Perspectives, 2020, Ho-Yin Lai et al

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Open access peer-reviewed chapter
https://www.intechopen.com/books/ne...igue-syndrome-in-older-adults-the-rehabilitat

Hypothalamic-Pituitary-Adrenal (HPA) Axis and Chronic Fatigue Syndrome in Older Adults: The Rehabilitation Perspectives
By Frank Ho-Yin Lai, Maria Uscinska and Elaine Wai-hung Yan

Submitted: November 17th 2019
Reviewed: April 15th 2020
Published: June 24th 2020

DOI: 10.5772/intechopen.92570

Abstract

Chronic fatigue syndrome (CFS) is a long-term and debilitating condition that regards as a neurological disease.

Its symptoms include profound physical and mental fatigue (characteristically made worse by exertion), muscle and joint pain, disturbed sleep, and both concentration and memory problems.

CFS is a kind of human stress-related disorders that are characterized by alterations in hypothalamic-pituitary-adrenal (HPA) axis activity.

Investigation of abnormal activity of the HPA axis in various neurological and neuropsychiatric disorders can date back at least 60 years, and its relation to CFS had been reported in the early 1990s.

This chapter further disseminated updated evidence for disruption of HPA function in CFS, with the explanation on the relationship between cytokines and HPA activities.

Moreover, very limited literature had addressed the importance of rehabilitation to them.

This chapter addresses this gap by sharing a pilot rehabilitation outcome on a single-blinded randomized control trial with a parallel group experimental design in the application of activity scheduling (AS) program of occupational therapy for a group of community-dwelling older adults with CFS.

The primary objective is to study the outcome of physical functioning of individual participants.

The second objective is to study the outcome of AS on impact of caring role through assessing individual caregivers’ perceived burden in care.

The third objective is to study the time that needed in taking care; individuals’ perception of enjoyment and achievement in their participated activities will be evaluated.

There was a significant effect of AS on the physical functioning of participants as measured by Functional Independence Measure (FIM), as the primary outcome measure, in experimental group, with Wilk’s λ = 0.72, F (2,57) = 18.75, p < 0.001.

Moreover, in secondary outcome measures, there is a significant decrease in the impact of caring role as reflected by their perceived burden as measured by the Chinese Zarit Burden Interview (CZBI) in caring for experimental group, with Wilk’s λ = 0.72, F (2,97) = 18.75, p < 0.001.

Another study set out to examine the effect of time on caring activities for those recruited couples in AS group.

There was significant effect of AS on caring activities with Wilk’s λ = 0.71, F (2,97) = 12.47, p < 0.001.

With proper coaching and regular facilitation regarding AS, activity participation in older adults with CFS can be greatly enhanced.

Behavioral intervention, such as AS, can supplement therapeutic treatment or may lead to decline in CFS symptoms.
 
The benefits of perspectives only apply when the people providing the perspective know what they are talking about.

Otherwise this is basically a best of album made up of unfinished never-released songs by a cover band of a one-hit wonder.

Ugh, can't even read it all I have second-hand cringe.
 
Not only is this drivel, it's derivative drivel.
Frankly "stress" and "anxiety" used in clinical psychology are basically indistinguishable from the use of concepts like "toxins" in alternative medicine or thetans in scientology. It doesn't mean what it actually means but it's still the cause, explanation and cure for every ill. Whatever it needs to mean in the present circumstances is what it means, and that meaning may change if the circumstances change.

And as most people suffering from chronic illness report, this makes it impossible to actually get access to mental health services because they refuse the premise of what the need is in the first place. Everyone hates it, including the evangelists who are frustrated that their snake oil is correctly perceived as snake oil. It produces nothing. It's massively wasteful. But let's just keep doing it for a few decades, it might just "work", as long as you define work as something unsubstantial and immeasurable, especially as something not relevant to the actual needs of the patients, rather the wants of the practitioners.
 
inspite of all the blurb on HPA-axis and fMRI scans making it sound 'scientific'.........
This study provided insights on the importance of biopsychosocial approach in the evaluation and management for CFS.
The present study relied on self-report and completion of daily activity logs in reflecting individuals’ activity participation. This will limit the power of this study as social desirability bias and forgotten to complete the report would jeopardize the outcome of AS. A more standardized environment would much enhance the efficiency in building events for AS. Also, a well-cited experimental research in using neuroimaging to probe mechanisms of behavior change is needed [103].
 
Don't understand the results section: why do they focus on changes over time instead of between groups after treatment?

The primary outcome for the intervention group went from a score of 67.25 ± 4.35 to 102.63 ± 1.71. So I'm assuming that those 4.35 and 1.71 don't represent standard deviation otherwise the effects would be impossibly large. Perhaps they simply put the comma in the wrong place?
 
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