Patient education to encourage graded exercise in chronic fatigue syndrome

BMJ 2001; 322 doi: https://doi.org/10.1136/bmj.322.7301.1545 (Published 23 June 2001) Cite this as: BMJ 2001;322:1545

Trial has too many shortcomings

  1. Abhijit Chaudhuri, senior clinical lecturer in neurology (ac54p@udcf.gla.ac.uk)
  1. University Department of Neurology, Institute of Neurological Sciences, Southern General Hospital, Glasgow G51 4TF
  2. Department of Psychology, University of Manchester, Manchester M13 9PL
  3. Regional Infectious Unit, University Hospital Aintree, Liverpool L9 7AL
  4. Department of Medicine, University of Liverpool, Liverpool L69 3GA

    EDITOR—Powell et al's controlled trial of graded physical exercise in chronic fatigue syndrome has several shortcomings.1

    Firstly, the only tool that was used to assess the level of physical activity was entirely subjective. This was a single item (the third item) of the 11 item standardised SF-36 health survey questionnaire. Use of this single item alone as a valid measure of physical fitness is hardly acceptable in the absence of objective data.

    Secondly, in a randomised study one can only compare like with like. In this case, all patients in the intervention arms had a minimum of three telephone contacts during the first three months. Patients in the control group were abandoned to primary care after the randomisation. Why did the investigators not maintain the same number of telephone contacts with the control group? …

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