A multiconvergent approach to the rehabilitation of patients with chronic fatigue syndrome: a comparative study

ObjectivesThis study investigated the efficacy of a rehabilitation technique for the treatment of chronic fatigue syndrome that was developed by a physiotherapist. Data collected retrospectively from a pilot study indicated that patients benefited from this multiconvergent approach, so further assessments were warranted.DesignTreatment efficacy was assessed by comparing the primary and secondary outcome measures of patients attending multiconvergent therapy (MCT) with those of patients attending relaxation therapy and a group of non-intervention controls.SettingThe active treatment took place at a clinic within the physiotherapy outpatient unit. Relaxation therapy and all assessments were conducted at the psychology unit.ParticipantsThirty-five participants, fitting the Centers for Disease Control and Prevention criteria for chronic fatigue syndrome, were recruited from two outpatient clinics and an existing patient panel.InterventionPatients were assigned to either MCT (n = 12) or relaxation therapy (n = 14). Nine participants who received general medical care were used as a comparison group.Main outcome measuresThe Karnofsky performance scale was used as the primary outcome measure of function. Secondary outcome measures assessing overall improvement in patient condition, fatigue and disability levels were also administered.ResultsA significant percentage of the patients attending the MCT sessions showed improvement in the primary outcome score used to measure the success of the treatment (MCT = 83%, relaxation = 21%, controls = 0; P < 0.001). A significant percentage of this group also reported improvement in their overall condition (MCT = 92%, relaxation = 64%, controls = 22%; P < 0.001), lower fatigue levels (MCT = 83%, relaxation = 57%, controls = 11%; P < 0.001) and lower levels of disability (MCT = 75%, relaxation = 43%, controls = 11%; P = 0.032) immediately post-therapy. In addition, these improvements were maintained at 6-month follow-up.ConclusionsOutcomes from this small preliminary study were encouraging. The multiconvergent approach produced significant improvements for standardised primary and secondary outcome measures. Further research is required to examine the efficacy of this approach over time, and its effectiveness on a larger scale within the primary healthcare setting using additional therapists trained in the technique.