Gunstige resultaten van een revalidatieprogramma met cognitieve gedragstherapie en gedoseerde fysieke activiteit bij patiënten met het chronische-vermoeidheidssyndroom

To determine whether a specific course of interdisciplinary rehabilitation might lead to clinically significant changes in fatigue, experienced disability and physical function in patients with the chronic-fatigue syndrome (CFS).

Design

Prospective and uncontrolled.

Method

‘Het Roessingh’, a rehabilitation centre in Enschede, the Netherlands, has developed an interdisciplinary clinical rehabilitation programme for patients with CFS in cooperation with the ‘Nijmeegs Kenniscentrum Chronische Vermoeidheid’ Chronic-Fatigue Knowledge Centre in Nijmegen, the Netherlands. In this programme, physical, mental and social activities are gradually increased on the basis of cognitive behavioural principles and graded activity. Of the 127 successive persons who enrolled for the therapy during the period from August 2000 to December 2004, 99 fulfilled the inclusion criteria; they had a median duration of symptoms of 6 years. The results of treatment were evaluated by a measurement with the ‘Checklist individuele spankracht’ Checklist individual muscle tone before and after treatment and the scores on the ‘Patiëntspecifieke beperkingen’ Patient-specific disability and the Short form-36. The measured data were complete in 74 patients.

Results

Before rehabilitation, the levels of fatigue, disability and distress were high. After treatment, the studied population showed significant improvement in fatigue, experienced disability and physical function. The magnitude of the improvement was generally ‘average’. At the end of treatment, 70 of the patients were clinically less fatigued, 68 experienced less disability and 55 functioned better physically. In 34 the level of fatigue was normalised after treatment, but 9.5 of the patients was more fatigue.

Conclusion

The rehabilitation programme offered for CFS led to significant improvements in function and fatigue.

Ned Tijdschr Geneeskd. 2006;150:2088-94