The efficacy of cognitive behavior therapy and aerobic exercise training for decreasing experienced fatigue in patients with facioscapulohumeral dystrophy.

In facioscapulohumeral dystrophy (FSHD) muscle function is impaired and declines over time. Currently there is no effective therapeutic treatment available for FSHD. Loss of muscle strength contributes to experienced fatigue through a lower level of physical activity. Fatigue and physical inactivity determine social dependency and loss of participation. Therefore, to decrease experienced fatigue and improve quality of life, two distinctly different therapeutic approaches can be followed: aerobic exercise training (AET) to maintain functional capacity or a cognitive-behavioral approach (CBT) to stimulate an active life-style yet avoiding excessive physical strain. There is preliminary evidence for the effectiveness of aerobic exercise in FSHD. CBT has been proven effective in chronic fatigue syndrome and post-cancer fatigue. AET and CBT are hypothesized to be both more effective in improving activity level and, with that, decreasing experienced fatigue of FSHD patients compared to the usual care. The maintenance of the beneficial effects of CBT may be longer than those of AET, because the changes in activity level are achieved more intrinsically.

Aerobic exercise therapy (AET) and cognitive behavioral therapy (CBT) are hypothesized to be both more effective in improving activity level and, with that, decreasing experienced fatigue of FSHD patients compared to the usual care. The maintenance of the beneficial effects of CBT may be longer than those of AET, because the changes in activity level are achieved more intrinsically.

- at baseline t=0

- after the treatment period t = 4 months

- after three motnhs follow-up t = 7 months

- aftre 6 months follow-up t = 10 months

Cognitive behavioral therapy, 1-hour session, once a week in the expert centre of chronic fatigue, during 16 weeks.

OR aerobic exercise therapy, 1-hour session, three times a week, one session at a rehabilitation centre, two sessions at home during 16 weeks.