title: Effects of a self-regulation based physical activity program (the "4-STEPS") for unexplained chronic fatigue: a randomized controlled trial.
abstract: BACKGROUND
  This study aimed at assessing the effects of a self-regulation-based brief physical activity program for patients suffering from unexplained chronic fatigue, the "4-STEPS to control your fatigue program".
  
  
  METHODS
  A 12-week randomized controlled trial was conducted. Adult patients meeting the CDC criteria for idiopathic chronic fatigue were randomized to either the control condition (standard care) or the intervention condition (4-STEPS). The 4-STEPS was based on self-regulation principles and consisted of motivational interviewing and self-regulation skills training. All patients were assessed at baseline and post-treatment (12 weeks) for fatigue severity (primary outcome) and impact, physical activity (leisure time physical activity, number of daily steps and personal activity goal progress), health-related quality of life, somatic distress and psychological distress (depression and anxiety).
  
  
  RESULTS
  Ninety-one patients (45 intervention and 46 control patients) received the allocated intervention. At post-treatment, statistical analysis revealed a significant difference for subjective experience of fatigue (4.73 points; g = 0.51) in favour of the intervention group. Mixed design ANCOVAs showed a significant effect of the 4-STEPS on fatigue severity, leisure time physical activity, personal activity goal progress and health-related quality of life. No significant effects were found for number of daily steps and somatic and psychological distress.
  
  
  CONCLUSIONS
  The 4-STEPS program has significant beneficial effects at post-treatment. This brief self-regulation-based intervention looks promising for the management of unexplained chronic fatigue.
  
  
  BACKGROUND
  ISRCTN70763996.
authors.affiliation: Health and Medical Psychology Unit, Leiden university, Wassenaarseweg 52, P.O. BOX 955, 2300 RB, Leiden, The Netherlands, mmarques@ispa.pt.
authors.forename: M
authors.initials: M
authors.lastname: Marques
authors.forename: V
authors.initials: V
authors.lastname: De Gucht
authors.forename: I
authors.initials: I
authors.lastname: Leal
authors.forename: S
authors.initials: S
authors.lastname: Maes
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology; D005221:Fatigue / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D011788:Quality of Life; D012927:Social Control, Informal