Behandeling van patiënten met chronisch vermoeidheidssyndroom met gedoseerde oefentherapie en/of cognitieve gedragstherapie.

Both cognitive behaviour therapy and graded exercise therapy are proven effective therapies that can improve outcome, however both therapies are only moderately effective. The hypothesis is that a combination of graded exercise training and cognitive behavioural therapy is more effective than each of these therapies alone.



Study design:

Prospective intervention study.



Study population:

Patients with chronic fatigue syndrome, 18-65 yr old. An internal physician will refer patients eligable for this study to the investigator. All patients will be recruted in the Netherlands.



Intervention:

Group one receives graded exercise training by a sports physician, group two receives cognitive behavioural therapy by a clinical physchologist and group three receives both cognitive behaviour therapy and graded exercise therapy by both a sports physician and a clinical psychologist.



Main study parameters/endpoints:

The main study parameter will be fatigue, the main symptom in chronic fatigue syndrome, measured by a validated questionnaire (CIS-20) at 6 months treatment. Secondary endpoints will be fatigue at 3 months treatment, psychiatric symptoms, functional impairment, physical condition, work participation and medical consumption at 3 and 6 months treatment.

The hypothesis is that a combination of graded exercise training and cognitive behavioural therapy is more effective than each of these therapies alone.

Baseline, 3 and 6 months.

Graded exercise therapy:

The duration is gradually increased to 3 times 30 minutes in 6 months. The treatment starts with an intake interview followed by 3 individual sessions of 1 hours in 6 months.



Cognitive behaviour therapy:

The treatment starts with an intake interview followed by 14 individual sessions of 2 hours in 6 months and 2 follow-up sessions.



Combined Graded exercise therapy and Cognitive behaviour therapy:

The treatment starts with an intake interview followed by 10 to 12 individual sessions of 2 hours and 2 follow-up sessions with the psychologist and 3 sessions with the sports physician of 1 hour in 6 months.