Long-Term Effect of a Tablet-Based [CBT] Group Intervention on Step Count, Fatigue, Self-Efficacy, and [QoL] in Older Adults With Arthritis 2024 Fiske

Andy

Andy

Retired committee member
Full title: Long-Term Effect of a Tablet-Based Cognitive Behavioral Group Intervention on Step Count, Fatigue, Self-Efficacy, and Quality of Life in Older Adults With Arthritis: A Pilot Study

Abstract

PURPOSE:
To evaluate the long-term effect of a tablet-based, cognitive-behavioral group intervention (Tab-G) to improve daily walking for older adults with arthritis.

METHOD:
Using an experimental pretest/posttest repeated measure design, long-term effects on step count, fatigue, self-efficacy, and quality of life (QOL) were investigated.

RESULTS:
Results of repeated measures analysis of variance showed significant improvement in step counts (F[1, 37] = 4.18, p = 0.048), fatigue (F[1, 36] = 9.971, p = 0.003), self-efficacy (F[1,28] = 4.645, p = 0.04), and QOL (F[1, 29] = 6.147, p = 0.019) in the Tab-G group compared to the control group. There were significant time effects across four time points (baseline and Weeks 4, 8, and 10) in fatigue (F[3, 108] = 5.43, p = 0.002), self-efficacy (F[3, 84] = 5.433, p = 0.002), and QOL (F[3, 87] = 3.673, p = 0.015), but not in step counts (F[3, 111] = 0.611, p = 0.609).

CONCLUSION:
Findings demonstrate positive long-term effects on fatigue in older adults with arthritis. [Journal of Gerontological Nursing, 50(5), 35–42.]

Open access, https://journals.healio.com/doi/10.3928/00989134-20240416-06#d679500e1
 
Glancing through that table, the thing that stands out to me is that the intervention group started with much higher step count (7300 versus 5100) and lower fatigue than the control group. The intervention group cut their step count by 600 in the first 4 week and kept it at that lower level. Perhaps that's why their fatigue decreased more than the controls.
 
About what would be expected of any random alternative medicine program coaching people to think positively, then asking the participants how they think. You could get better results out of getting people who drink their own pee for health reasons, if you wanted to. Assessment of fatigue and most PROMs remains terrible, fluctuates a lot and would need a highly significant effect size. A race to the bottom is one where everyone loses. All they're doing is trying to squeeze out the barest minimum signal, then argue the conclusions they started with.

I don't know if we could have better results by pointing out how literally all of this type of research is flawed to the point of being useless, because it's really not limited to ME research, the failure is spreading everywhere like rot. It explicitly seeks to influence reported outcomes. But of course that's basically... evidence-based medicine. All of it. A methodology that barely works when all strict criteria are met, trying to reduce biases as much as possible, is even more worthless when the opposite is happening, when trying to bias the outcome is essentially the whole process.

A "tablet-based" has that "we tried with a funny hat before, here we're trying with the same funny hat, but worn backwards" feel to it. Honestly this is no different than old witchcraft. Do you summon a demon better by saying the ritual prayer backwards with your dominant hand on your hip? Or in a monotone while hop-scotching? Neither, but once the process has been reduced to which of two useless things is better, or no worse than the other, the whole process itself becomes irrelevant. It's like arguing that 0=0, and 0 being non-inferior to zero, means that it's positive. Nonsense.

They're taking all the things that people shouldn't do here, misrepresenting correlation as causation, arguing things that happen after must be the first cause, bias everywhere, nothing objective, a process that explicitly seeks to misreport outcomes, and so on, and rolled them into one giant disaster. Evidence-based medicine in a nutshell, a process worse than no process at all.

Pragmatic trials should probably be banned. At least behavioral ones, and even then, they should meet a significant threshold of validity and certainly should not be performed in such a mindless serial process where roughly the same thing is tried 100x over. It created a parasitic industry that produces nothing and impairs everything.
 
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oldtimer said:
I haven't got the will to read it so I've probably missed the point but a quick glance provided this interesting revelation:
"Simple walking is easy to learn and requires minimal professional guidance ..."
Click to expand...
So simple that even a toddler can do it. Are you not smarter than a toddler?!

And they genuinely seem shocked that we get offended at being treated like we're too stupid to figure stuff like this.

I kind of glossed over the "requires minimal professional guidance" and it's even worse when you take it all in. What kind of professional guidance is required to learn simple walking? As if people can't figure this out without being told how.

Usually the meme is "Simpsons did it", but this time it comes courtesy of Family guy:

 
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