Disability evaluation in chronic fatigue syndrome: associations between exercise capacity and activity limitations/participation restrictions Identifying physical activity patterns in chronic fatigue syndrome using actigraphic assessment. Functional status in patients with chronic fatigue syndrome, other fatiguing illnesses, and healthy individuals. Health-related quality of life in patients with chronic fatigue syndrome: group cognitive behavioural therapy and graded exercise versus usual treatment. A randomised controlled trial with 1 year of follow-up Psychometric characteristics of the short form 36 health survey and functional assessment of chronic illness Therapy-Fatigue subscale for patients with ankylosing spondylitis Psychometric testing of fatigue instruments for use with cancer patients. Measuring disability in patients with chronic fatigue syndrome: reliability and validity of the Work and Social Adjustment Scale. Measurement of fatigue. determining minimally important clinical differences. Exercise and cognitive performance in chronic fatigue syndrome. Exercise performance and chronic pain in chronic fatigue syndrome: the role of pain catastrophizing. How relevant are exercise capacity measures for evaluating treatment effects in chronic fatigue syndrome? Results from a prospective, multidisciplinary outcome study Kinesiophobia in chronic fatigue syndrome: assessment and associations with disability. The Development and Testing of an Instrument for Perceived Self-efficacy for Fatigue Self-management Can exercise limits prevent post-exertional malaise in chronic fatigue syndrome? An uncontrolled clinical trial Fatigue and quality of life of women with multiple sclerosis: a randomized controlled clinical trial. Generic and specific measurement of health-related quality of life in a clinical trial of respiratory rehabilitation. Fatigue, as measured using the Modified Fatigue Impact Scale, is a predictor of processing speed improvement induced by exercise in patients with multiple sclerosis: data from a randomized controlled trial
Objective : In an attempt to examine whether impairments in cardiorespiratory fitness are associated with daily functioning in patients with chronic fatigue syndrome ( CFS ) , this study addresses the correlations between exercise capacity and activity limitations /participation restrictions . Design : Prospect i ve observational study . Setting : An outpatient tertiary care , chronic fatigue clinic at the Vrije Universiteit Brussel ( VUB ) , Belgium . Subjects : Seventy-seven patients fulfilling the 1994 Centers for Disease Control and Prevention ( CDC ) case definition for CFS . Interventions : All patients filled in the Chronic Fatigue Syndrome Activities and Participation Question naire ( CFS-APQ ) and performed a maximal exercise stress test on a bicycle ergometer . Heart rate was monitored continuously by use of an electrocardiograph .  Metabolic and ventilatory parameters were measured through spirometry .  Results : A statistically significant correlation between the score obtained with the CFS-APQ and the body weight-adjusted peak oxygen uptake ( Spearman rho = -0.32 ; p = 0.005 ) , functional aerobic impairment ( rho = 0.33 ; p = 0.004 ) , workload/body weight ( rho = -0.30 ; p = 0.009 ) , exercise duration ( rho = -0.30 ; p = 0.008 ) , and the percentage of target heart rate achieved ( rho = -0.33 ; p = 0.004 ) was observed . The correlations between the remaining exercise capacity parameters and the scores obtained with the CFS-APQ all indicated a trend towards association ( 0.01<p<0.05 ) . Conclusions : These results suggest a moderate association between exercise capacity and activity limitations /participation restrictions in patients with CFS . The observed correlations lack strength to predict activity limitations / participation restriction based on exercise capacity parameters . Disability evaluation in CFS should therefore encompass both exercise capacity testing and measurements at the activity/participation dimension OBJECTIVE Changes in physical activity are thought to play an important role in maintaining symptoms in chronic fatigue syndrome ( CFS ) . The aim of this study was to describe intraindividual physical activity patterns in more detail and to identify pervasively passive patients . METHODS With help of a movement-sensing device , physical activity levels were registered continuously over a 12-day period in 277 CFS patients . Within this registration period , the 10 largest activity peaks were computed . The intensity and duration of these activity peaks and their subsequent rest periods were described and compared to those of 47 healthy controls . In addition , the patients ' 12 daily activity scores were used to identify patients who were characterised by low levels of physical activity throughout the registration period . RESULTS The CFS sample had less intense and shorter activity peaks , while the average rest periods that followed these peaks lasted longer . Approximately one-fourth of the CFS sample differed distinctly from the control group and was labelled as pervasively passive . CONCLUSION The measurements and classification of actual physical activity levels were found to reduce heterogeneity in the CFS population and therefore could provide the opportunity to optimise behavioural intervention protocol s for CFS BACKGROUND Chronic fatigue syndrome ( CFS ) is a condition that may be associated with substantial disability . The Medical Outcomes Study Short-Form General Health Survey ( SF-36 ) is an instrument that has been widely used in outpatient population s to determine functional status . Our objectives were to describe the usefulness of the SF-36 in CFS patients and to determine if subscale scores could distinguish patients with CFS from subjects with unexplained chronic fatigue ( CF ) , major depression ( MD ) , or acute infectious mononucleosis ( AIM ) , and from healthy control subjects ( HC ) . An additional goal was to ascertain if subscale scores correlated with the signs and symptoms of CFS or the presence of psychiatric disorders and fibromyalgia . DESIGN Prospect ively collected case series . SETTING Patients with CFS and CF were seen in a university-based referral clinic and had undergone a complete medical and psychiatric evaluation . Other study subjects were recruited from the community to participate in research studies . PARTICIPANTS The study included 185 patients with CFS , 246 with CF , 111 with AIM , and 25 with MD . There were 99 HC subjects . MEASURES The  SF-36 and a structured psychiatric interview  were used . The SF-36 contains 8 subscales : physical , emotional , social , and role functioning , body pain , mental health , vitality , and general health- and a structured psychiatric interview .  RESULTS Performance characteristics ( internal reliability coefficients , convergent validity ) of the SF-36 were excellent . A strikingly consistent pattern was found for the physical functioning , role functioning , social functioning , general health , and body pain subscales , with the lowest scores in CFS patients , intermediate scores in AIM patients , and the highest scores in the HC subjects . The CFS patients had significantly lower scores than patients with CF alone on the physical functioning ( P < or = 0.01 ) , role functioning ( P < or = 0.01 ) , and body pain ( P < or = 0.001 ) subscales . The emotional functioning and mental health scores were worst among those with MD . The presence of fibromyalgia , being unemployed , and increasing fatigue severity all were associated with additional functional limitations across multiple functional domains , with increasing fatigue appearing to have the greatest effect . CONCLUSIONS The SF-36 is useful in assessing functional status in patients with fatiguing illnesses . Patients with CFS and CF have marked impairment of their functional status . The severity and pattern of impairment as documented by the SF-36 distinguishes patients with CFS and CF from those with MD and AIM , and from HC , but does not discriminate between CF and CFS Chronic fatigue syndrome ( CFS ) produces physical and neurocognitive disability that significantly affects health-related quality of life ( HRQL ) .  Multidisciplinary treatment combining grade d exercise therapy ( GET ) cognitive behavioural therapy ( CBT ) and pharmacological treatment has shown only short-term improvements . To compare the effects on HRQL of ( 1 ) multidisciplinary treatment combining CBT , GET , and pharmacological treatment , and ( 2 ) usual treatment ( exercise counselling and pharmacological treatment ) at 12 months of follow-up . Prospect i ve , r and omized controlled trial with a follow-up of 12 months after the end of treatment . Patients consecutively diagnosed with CFS ( Fukuda criteria ) were r and omly assigned to intervention ( n = 60 ) or usual treatment ( n = 60 ) groups . HRQL was assessed at baseline and 12 months by the Medical Outcomes Study Short-Form question naire ( SF-36 ) . Secondary outcomes included functional capacity for activities of daily living measured by the Stanford Health Assessment Question naire ( HAQ ) and comorbidities . At baseline , the two groups were similar , except for lower SF-36 emotional role scores in the intervention group . At 12 months , the intervention did not improve HRQL scores , with worse SF-36 physical function and bodily pain scores in the intervention group . Multidisciplinary treatment was not superior to usual treatment at 12 months in terms of HRQL . The possible benefits of GET as part of multidisciplinary treatment for CFS should be assessed on an individual patient basis Background We evaluated the psychometric characteristics of the Short Form 36 ( SF-36 ) Health Survey and the Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue subscale in patients with ankylosing spondylitis ( AS ) . Methods We analyzed clinical and patient-reported outcome ( PRO ) data collected during 12-week , double-blind , placebo-controlled periods of two r and omized controlled trials comparing adalimumab and placebo for the treatment of active AS . The Bath Ankylosing Spondylitis Disease Activity Index , Bath Ankylosing Spondylitis Functional Index , and other clinical measures were collected during the clinical trial . We evaluated internal consistency/reliability , construct validity , and responsiveness to change for the SF-36 and FACIT-Fatigue . Results The SF-36 ( Cronbach alpha , 0.74 - 0.92 ) and FACIT-Fatigue ( Cronbach alpha , 0.82 - 0.86 ) both had good internal consistency/reliability . At baseline , SF-36 and FACIT-Fatigue scores correlated significantly with Ankylosing Spondylitis Quality of Life scores ( r = -0.36 to -0.66 and r = -0.70 , respectively ; all p < 0.0001 ) . SF-36 scores varied by indicators of clinical severity , with greater impairment observed for more severe degrees of clinical activity ( all p < 0.0001 ) . FACIT-Fatigue scores correlated significantly with SF-36 scores ( r = 0.42 to 0.74 ; all p < 0.0001 ) and varied by clinical severity ( p < 0.05 to p < 0.0001 ) . Conclusions The SF-36 is a reliable , valid , and responsive measure of health-related quality of life and the FACIT-Fatigue is a brief and psychometrically sound measure of the effects of fatigue on patients with AS . These PROs may be useful in evaluating effectiveness of new treatments for AS.Trial Registration Clinical Trials.gov : NCT00085644 and BACKGROUND Cancer treatment-related fatigue ( CRF ) is a common side effect of cancer treatment . A problem identified in most review s of CRF is lack of sound approaches to measurement that are congruent with the conceptualization of CRF as a self-perceived state . The diversity of instruments available to measure fatigue and the lack of comprehensive testing of several promising instruments with cancer patients undergoing treatment provided the rationale for this study . The purpose of this article is to report the results of psychometric testing of several fatigue instruments in patients undergoing cancer treatment . OBJECTIVES The aims of this study were to determine the reliability , validity , and responsiveness of each instrument and to determine the ability of each instrument to capture CRF . METHODS Existing fatigue instruments with published psychometric information that indicated suitability for further testing were selected and included the Profile of Mood States Short Form fatigue subscale ( F_POMS-sf ) ,  Multidimensional Assessment of Fatigue ( MAF ) ,  Lee Fatigue Scale ( LFS ) , and the  Multidimensional Fatigue Inventory ( MFI ) . Data were collected at a university-based clinical cancer center and a freest and ing comprehensive cancer center . Subjects completed all study instruments , which were presented in r and om order , at a time when CRF was expected to be high and again when it was expected to be low . A subset of subjects completed the instruments within 48 hours of one of the data collection points when CRF was expected to be relatively unchanged to provide stability data . RESULTS Reliability estimates using Cronbach 's alpha indicated that all instruments examined had good internal consistency . Test-retest correlations showed good stability for total scores on all the instruments , but some subscales of the LFS and MFI had marginal stability . Factor analysis of all instruments indicated that only the LFS and the F_POMS-sf fully supported their construct validity . All of the instruments showed responsiveness to changes in CRF related to treatment . CONCLUSIONS The results of the study provide research ers and clinicians with detailed comparisons of the performance of established fatigue measures in cancer patients undergoing treatment to use when selecting measures of CRF BACKGROUND Disability is a defining feature of chronic conditions , and it is an increasingly used measure of therapy effectiveness . The  Work and Social Adjustment Scale ( WSAS )  is a simple and clear measure of disability . Although the scale is widely used , no study has yet investigated its psychometric properties in patients with chronic fatigue syndrome ( CFS ) . METHODS Data from two sample s of patients were used , one from a multicenter r and omized controlled clinical trial of treatments for CFS ( n = 639 ) and the other from a clinic that specializes in CFS ( n=384 ) . All patients completed the WSAS as well as other measures . RESULTS Internal consistency and the Spearman-Brown split-half coefficient values indicated that the scale is reliable . CFS patients who had comorbid diagnoses of depression , anxiety or fibromyalgia had higher WSAS scores . High levels of disability were associated with high number of physical symptoms , severe fatigue , depression , anxiety , poor sleep quality and poor physical fitness , with correlation coefficients ranging between 0.41 and 0.11 . Lower scores on the WSAS were modestly associated with better physical functioning as well as higher levels of physical capacity as assessed by a walking test . Sensitivity to change was evaluated in a subgroup of patients who had undergone a course of cognitive behavioral therapy .  Disability significantly decreased after therapy and remained stable at follow-ups . CONCLUSION The WSAS is a reliable and valid assessment tool for disability in patients with CFS The purpose was to determine the minimally important clinical difference ( MICD ) in fatigue as measured by the Profile of Mood States , Schwartz Cancer Fatigue Scale ( SCFS ) , General Fatigue Scale , and a 10-point single-item fatigue measure . The MICD is the smallest amount of change in a symptom ( e.g. , fatigue ) measure that signifies an important change in that symptom . Subjects rated the degree of change in their fatigue over 2 days on a Global Rating Scale . 103 patients were enrolled on this multisite prospect i ve repeated measures design . MICD was determined following established procedures at two time points . Statistically significant changes were observed for moderate and large changes in fatigue , but not for small changes . The scales were sensitive to increases in fatigue over time . The MICD , presented as mean change , for each scale and per item on each scale is : POMS = 5.6 , per item = 1.1 , SCFS = 5.0 , per item = 0.8 , GFS = 9.7 , per item = 1.0 , and the single item measure of fatigue was 2.4 points . This information may be useful in interpreting scale scores and planning studies using these measures PURPOSE To determine the effect of submaximal steady-state exercise on cognitive performance in patients with chronic fatigue syndrome ( CFS ) alone , CFS with comorbid fibromyalgia FM ( CFS + FM ) , and sedentary healthy controls ( CON ) . METHODS Twenty CFS-only patients , 19 CFS + FM , and 26 CON completed a battery of cognitive tests design ed to assess speed of information processing , variability , and efficiency .  Tests were performed at baseline , immediately before , and twice following 25 min of either cycle ergometry set at 40 % of peak oxygen capacity or quiet rest . RESULTS There were no group differences in average percentage of peak oxygen consumption during exercise ( CFS = 45 % ; CFS + FM = 47 % ; Control = 43 % : P = 0.2 ) . There were no significant effects of acute exercise on cognitive performance for any group . At baseline , one-way ANOVA indicated that CFS patients displayed deficits in speed of processing , performance variability , and task efficiency during several cognitive tests compared with healthy controls . However , the CFS + FM patients were not different than controls . Repeated measures ANOVA indicated that across all tests ( pre- and postexercise ) CFS , but not CFS + FM , were significantly less consistent ( F2,59 = 3.7 , P = 0.03 ) and less efficient ( F2,59 = 4.6 , P = 0.01 ) than controls . CONCLUSION CFS patients without comorbid FM exhibit subtle cognitive deficits in terms of speed , consistency , and efficiency that are not improved or exacerbated by light exercise . Importantly , our data suggest that CFS + FM patients do not exhibit cognitive deficits either pre- or postexercise . These results highlight the importance of disease heterogeneity in studies determining acute exercise and cognitive function in CFS OBJECTIVES This study aim ed to examine the associations between bodily pain , pain catastrophizing , depression , activity limitations /participation restrictions , employment status , and exercise performance in female patients with chronic fatigue syndrome ( CFS ) who experience widespread pain . DESIGN Cross-sectional observational study . SETTING A university-based clinic . PATIENTS Thirty-six female CFS patients who experienced widespread pain . OUTCOME MEASURES Patients filled in the  Medical Outcomes Short-Form 36 Health Status Survey ,  the  Chronic Fatigue Syndrome Activities and Participation Question naire , the Beck Depression Inventory , and the Pain Catastrophizing Scale , and underwent a maximal exercise stress test with continuous monitoring of electrocardiographic and ventilatory parameters . RESULTS Pain catastrophizing was related to bodily pain ( r = -0.70 ) , depression ( r = 0.55 ) , activity limitations /participation restrictions ( r = 0.68 ) , various aspects of quality of life ( r varied between -0.51 and -0.64 ) , and exercise capacity ( r varied between -0.41 and -0.61 ) . Based on hierarchical multiple regression analysis , pain catastrophizing accounted for 41 % of the variance in bodily pain in female CFS patients who experience chronic widespread musculoskeletal pain . Among the three subscale scores of the Pain Catastrophizing Scale , helplessness and rumination rather than magnification were strongly related to bodily pain . Neither pain catastrophizing nor depression was related to employment status . CONCLUSIONS These data provide evidence favoring a significant association between pain catastrophizing , bodily pain , exercise performance , and self-reported disability in female patients with CFS who experience widespread pain . Further prospect i ve longitudinal study ing of these variables is required Objective : To evaluate the outcome of a multidisciplinary treatment programme for patients with chronic fatigue syndrome , including health-related quality of life ( HRQoL ) and psychosocial variables , and exercise capacity measures . Design : A six-month prospect i ve outcome study . Setting : University outpatient rehabilitation clinic ; group setting . Subjects : One hundred and sixteen women fulfilling chronic fatigue syndrome criteria . Interventions : Cognitive behaviourally and grade d exercise-based strategies ; emphasis on adaptive lifestyle changes . Measures : Short Form General Health Survey ( SF-36 ) ; Symptom Checklist ( SCL-90 ) ; Causal Attribution List ( CAL ) ; Self-Efficacy Scale ( SE ) ; maximum progressive bicycle ergometer test with respiratory gas analysis ; and isokinetic leg strength test  , before and after treatment . Results : The total group significantly improved on nearly all reported HRQoL/ psychosocial variables . Changes in exercise capacity measures were rather modest and did not correlate or only weakly correlated with HRQoL/psychosocial variables . Subgroup analyses indicated that less fit patients improved significantly more on exercise capacity measures than their more fit counterparts . Patients who were fitter at baseline scored better on pretreatment HRQoL/psychosocial variables , but both subgroups improved similarly on these variables . Conclusions : Health-related quality of life and psychosocial functioning in patients with chronic fatigue syndrome improves after a six-month cognitive behaviourally and grade d exercise-based multidisciplinary treatment programme . Increase in exercise capacity measures is not a necessary condition for reported improvements , except for less fit patients OBJECTIVES To investigate aspects of the validity of the total scores of the Tampa Scale for Kinesiophobia ( TSK ) , Dutch Version , which was modified to make it an appropriate question naire for the assessment of kinesiophobia ( fear of movement ) in chronic fatigue syndrome ( CFS ) patients ( the Dutch TSK-CFS ) , and , using this assessment tool , to examine the associations between kinesiophobia , exercise capacity , and activity limitations and participation restrictions in patients with CFS . DESIGN Prospect i ve observational studies . SETTING An outpatient fatigue clinic . PARTICIPANTS In the first study , 40 patients fulfilling the 1994 US Centers for Disease Control and Prevention ( CDC ) criteria for CFS were enrolled . The sample of the second study consisted of 51 CDC-defined patients with CSF . INTERVENTIONS Not applicable . Main outcome measures Study 1 : Subjects completed a set of question naires ; the Utrechtse Coping List ( UCL ) , the Dutch TSK-CFS , and the Dutch Baecke Question naire of Habitual Physical Activity . Study 2 : All patients completed 2 question naires (  Chronic Fatigue Syndrome Activities and Participation Question naire [ CFS-APQ ] , Dutch TSK-CFS ) and performed a maximal exercise stress test on a bicycle ergometer . The heart rate was monitored continuously by use of an electrocardiograph .  Metabolic and ventilatory parameters were measured through spirometry . RESULTS Study 1 : The Cronbach alpha coefficient for the individual item scores on the TSK-CFS was .80 . The total scores on the Dutch TSK-CFS showed a statistically significant correlation with both the avoidance/abide subscale of the UCL ( Spearman rho=.35 , P=.029 ) and the total score of the Baecke Question naire ( rho=-.45 , P=.004 ) . Study 2 : The total scores on the Dutch TSK-CFS showed a statistically significant correlation with the total scores on the CFS-APQ ( rho=.39 , P=.004 ) . No statistically significant associations were observed between the exercise capacity parameters and the total scores on the Dutch TSK-CFS . CONCLUSIONS These results provide evidence for the internal consistency and the convergent and congruent validity of the scores obtained by use of the Dutch TSK-CFS . Kinesiophobia appears to be associated with activity limitations /participation restrictions but not with exercise capacity in patients with CFS Background : Persons with chronic illness commonly report fatigue . Measurement of perceived self-efficacy for fatigue self-management ( PSEFSM )  is essential if fatigue is to be monitored and enhanced to improve physical functional status . Objective : The objective of the study was to describe the development and testing of the PSEFSM instrument . Methods : The PSEFSM instrument was incorporated into 2 r and omized controlled trials for secondary analysis ( N = 298 ) : 63 persons with lung cancer and 235 persons with other cancer diagnoses undergoing a course of chemotherapy .  Results : Evidence for construct validity and generalizability was supported through hypotheses testing of the mediation pathway from fatigue to physical functional status through PSEFSM , with results indicating support for partial mediation . Structural modeling indicated a good model fit that further supported the construct validity of the PSEFSM instrument . Conclusions : The instrument provides a reliable and valid measure of PSEFSM that could be used in research to facilitate the development of interventions to increase perceived self-efficacy to achieve optimal symptom self-management . Implication s for Practice : The PSEFSM instrument is brief and easy to complete , which results in a low response burden for persons who are already fatigued , providing for regular use in transdisciplinary research and practice setting s. This is important because the use of this instrument can impact how we partner with our patients to better underst and how to manage this troublesome symptom , fatigue Objective : It was hypothesized that the use of exercise limits prevents symptom increases and worsening of their health status following a walking exercise in people with chronic fatigue syndrome . Design : An uncontrolled clinical trial ( semi-experimental design ) . Setting : Outpatient clinic of a university department . Subjects : Twenty-four patients with chronic fatigue syndrome . Interventions : Subjects undertook a walking test with the two concurrent exercise limits . Each subject walked at an intensity where the maximum heart rate was determined by heart rate corresponding to the respiratory exchange ratio = 1.0 derived from a previous submaximal exercise test and for a duration calculated from how long each patient felt they were able to walk . Main outcome measures : The Short Form 36 Health Survey or SF-36 , the Chronic Fatigue Syndrome Symptom List , and the Chronic Fatigue Syndrome — Activities and Participation Question naire were filled in prior to , immediately after and 24 hours after exercise . Results : The fatigue increase observed immediately post-exercise ( P= 0.006 ) returned to pre-exercise levels 24 hours post-exercise . The increase in pain observed immediately post-exercise was retained at 24 hours post-exercise ( P=0.03 ) . Fourteen of the 24 subjects experienced a clinical ly meaningful change in bodily pain ( change of SF-36 bodily pain score ≥10 ) ; 6 indicated that the exercise bout had slightly worsened their health status , and 2 had a clinical ly meaningful decrease in vitality ( change of SF-36 vitality score ≥20 ) . There was no change in activity limitations /participation restrictions . Conclusion : It was shown that the use of exercise limits ( limiting both the intensity and duration of exercise ) prevents important health status changes following a walking exercise in people with chronic fatigue syndrome , but was unable to prevent short-term symptom increases AIM The aim of this study was to determine the effects of aquatic exercise on fatigue and the quality of life in women with multiple sclerosis ( MS ) . METHODS This r and omized controlled clinical trial was carried out in a multiple sclerosis clinic in Iran , where 37 outpatient women with MS were r and omized into an exercise group ( N.=18 ) and a control group ( N.=19 ) . In the exercise group , aquatic exercise was performed for 45 minutes , 3 times per week for 8 weeks . The control group did not receive any interventions ( aquatic exercise ) and were asked to maintain their normal treatments . The severity and perception of fatigue and quality of life ( QoL ) were measured using the Fatigue Severity Scale ( FSS ) , Modified Fatigue Impact Scale ( MFIS ) , and Multicultural Quality of Life Index ( MQLIM ) question naires . RESULTS The repeated measure ANOVA demonstrated significant effects of aquatic exercise on the changes in the scores of physical and psychosocial fatigue perception , QoL , and fatigue severity ( P=0.001 ) . However , its effect was not significant for cognitive fatigue perception ( P>0.05 ) . General linear models show that the percentages of variation , as explained by the aquatic exercises , were highest in the QoL and the physical and psychosocial fatigue perceptions .  CONCLUSION Aquatic exercise can improve the QoL and decrease fatigue severity and fatigue perception , specifically in the physical and psychosocial domain for MS patients . However , it was not effective in improving cognitive fatigue perception The purpose of this study was to compare the performance of measures of health-related quality of life in a r and omized controlled trial of respiratory rehabilitation versus conventional community care for patients with chronic airflow limitation . The study included 89 stable patients with moderate to severe chronic airflow limitation with measurement of health status at 12 , 18 , and 24 weeks . Outcomes included two disease-specific ( the Oxygen Cost Diagram and the Chronic Respiratory Question naire [ CRQ ] ) measures , a generic health profile ( the Sickness Impact Profile [ SIP ] ) , and two utility measures ( the St and ard Gamble and the Quality of Well-Being index [ QWB ] ) . Of the measures , only the four domains of the CRQ ( dyspnea , fatigue , mastery , and emotional function ) showed statistically significant differences ( P < or = 0.05 ) between treatment and control groups . Correlation between change in the CRQ and change in other relevant measures , including the 6-minute walk test and global ratings of change in dyspnea , fatigue , and emotional function were generally weak to moderate ( from 0.19 to 0.51 ) . All correlations between change in the QWB , SIP , and St and ard Gamble and other measures were very weak or weak ( up to 0.30 ) . Correlation between change in the three generic measures were all very weak ( < 0.15 ) . The results suggest that unless investigators include responsive and valid disease-specific measures of health-related quality of life in controlled trials in chronic diseases , they risk misleading conclusions about the effect of treatments on health status Background Few studies have evaluated the impact of physical activity ( PA ) on cognition and fatigue , and none have considered the effects of PA on the relationship between cognition and fatigue . Objectives We evaluated the effect of PA in people with multiple sclerosis ( pwMS ) in a 6-month-long single-blind r and omized controlled trial . We focused on the impact of exercise on cognition , fatigue , and the relationship between cognition and fatigue . Methods We recruited pwMS , who were then r and omly assigned 1:1 to either a  PA protocol group or a  control group ( CG ) . All patients underwent assessment s using the Brief International Cognitive Assessment for Multiple Sclerosis including symbol digit modality test ( SDMT ) , Berg Balance Scale ( BBS ) , gait analysis , 6-Minute Walk Test , Timed Up and Go ( TUG ) test , and the Modified Fatigue Impact Scale ( MFIS ) at the beginning of the study ( T0 ) , at the end of the study ( EOS ) 24 weeks after T0 , and at 24 weeks following the EOS ( FU ) . Results A Wilcoxon test revealed a significant effect of exercise in the PA group , but not in the CG . Significant differences between T0 and EOS were found in the spatiotemporal parameters of gait , and performance on the SDMT , TUG , BBS , and MFIS . These differences were also present during the FU period . A regression model revealed that the baseline MFIS score predicted processing speed improvement ( R2 = 0.65 , p < 0.01 ) , as the SDMT T score increased by 0.3 for each one-unit increase in the MFIS score at T0 . Conclusion PA affects multiple aspects of the pathology in pwMS . Patients with greater fatigue must not be discouraged from exercise , as they may greatly benefit from PA . Specifically , PA was shown to improve information processing speed
Limited evidence was found for the psychometric properties and clinical usability of these instruments .
However , the CFS-activities and participation question naire ( APQ ) is a disease-specific instrument with moderate content and construct validity .
PURPOSE To summarize measurement instruments used to evaluate activity limitations and participation restrictions in patients with chronic fatigue syndrome ( CFS ) and review the psychometric properties of these instruments .
Chronic fatigue syndrome causes activity limitations and participation restrictions in one or more areas of life .