Trial Report Work Ability and Functioning Among Individuals with Persistent Indoor Environment-Related Symptoms or Chronic Fatigue:... 2026 Vuokko et al

[Andy]

Full title: Work Ability and Functioning Among Individuals with Persistent Indoor Environment-Related Symptoms or Chronic Fatigue: Nine-Month Follow-Up of a Web-Based Randomized Controlled Trial

Abstract​

Purpose​

Persistent physical symptoms (PPS) can significantly impair work ability and daily functioning, exacerbated by comorbid illness worry (IW). This randomized controlled trial (RCT) examined the effectiveness of guided internet-based treatment on work ability and daily functioning of working-aged individuals with PPS associated with indoor environment (IE) and/or chronic fatigue (CF) with disability. The intervention was based on acceptance and commitment therapy (ACT) combined with individual case formulation, compared to treatment as usual (TAU). IW’s role in moderating effects was explored.

Methods​

In this RCT (Clinicaltrials.gov NCT04532827), 103 individuals with PPS linked to IE, CF or both were assigned to a video-based case conceptualization and 10-week internet-based ACT with TAU (iACT + TAU; n = 50) or TAU alone (n = 53). Self-reported work ability and daily functioning were assessed from pre-intervention to 9-month follow-up, examining the potential moderating effect of baseline IW. Analyses used linear mixed models and Type III ANOVA.

Results​

Of the 103 participants, 62% completed the 9-month follow-up. Baseline demographics showed no significant differences between treatment groups. Significant positive interaction (treatment group and time) effects for work ability were found in the iACT + TAU group at post-measurement (β = 0.41, p = 0.041), 3-month (β = 0.58, p = 0.004), and 9-month (β = 0.47, p = 0.022) follow-ups. Daily functioning improved significantly at 3-month (β = 0.57, p = 0.007), particularly in the work domain (β = 0.67, p = 0.003). IW and PPS group did not moderate outcomes.

Conclusion​

Internet-based ACT with individual case formulation was associated with improved work ability for individuals with PPS associated with IE and CF, providing preliminary support for further examination as a potential frontline treatment.

Open access

 

[Andy]

"This study focuses on troublesome PPS manifested as prolonged tiredness and exhaustion, known as chronic fatigue (CF), and symptoms associated with indoor environments (IE).

The hallmark of CF is fatigue, post-exertional malaise and unrefreshing sleep, along with sleep disturbances, pain, neurological issues, and other multi-organ symptoms, with onset that can be sudden or gradual [6]. At its worst, CF can leave individuals bedridden, imposing substantial personal and societal burdens [7, 8]. Global prevalence estimates and diagnostic criteria for CF vary with self-reports suggesting 3.3% and clinical evaluations 0.8% [9]. Although several risk factors have been identified, no clear causal links for symptoms or tissue pathology have been established, suggesting a multifactorial nature to their occurrence [10]."

 

[Andy]

"Eligibility Criteria​

Individuals were eligible for this study if they (i) had PPS associated with IE or CF with significant daily life restrictions for at least six months but less than three years [6, 36], (ii) were aged 18 to 65, (iii) were actively working or studying, and iv) provided informed consent. Exclusion criteria included having a serious and/or acute medical condition that could explain the symptoms (e.g., severe psychiatric disorder, uncontrolled asthma or sleep apnea) or a need for further medical examinations based on symptoms. Both eligibility and exclusion criteria were determined through a questionnaire and a physician interview. See the protocol for detailed criteria [36]."

 

[Trish]

40% drop outs and all questionnaire based. The results look as I would expect for people unblinded subective - a bit better in the treatment group, but nothing startling, and many of the measures that had improved by 6 months follow up had started dropping back down again by 9 months.