title: Both aerobic exercise and cognitive-behavioral therapy reduce chronic fatigue in FSHD: an RCT.
abstract: OBJECTIVE
  To investigate the effect of aerobic exercise training (AET) and cognitive-behavioral therapy (CBT) on chronic fatigue in patients with facioscapulohumeral muscular dystrophy (FSHD).
  
  
  METHODS
  We performed a multicenter, assessor-blinded, randomized clinical trial (RCT). Fifty-seven patients with FSHD type 1 with severe chronic fatigue were randomly allocated to AET, CBT, or usual care (UC). Outcomes were assessed before treatment, following 16 weeks of intervention, and after a 12-week follow-up. A linear mixed model for repeated measurements was used to study the estimated group differences.
  
  
  RESULTS
  Following treatment, both the AET (28 participants) and CBT (25 participants) intervention groups had less fatigue relative to the UC group (24 participants), with a difference of -9.1 for AET (95% confidence interval [CI] -12.4 to -5.8) and -13.3 for CBT (95% CI -16.5 to -10.2). These beneficial effects lasted through follow-up, with a difference of -8.2 for AET (95% CI -12.4 to -5.8) and -10.2 for CBT (95% CI -14.0 to -6.3). The patients who received CBT had an increase in registered and experienced physical activity, sleep quality, and social participation. The patients who received AET had an increase in registered physical activity only. The increase in registered physical activity in both groups and the improvement in social participation following CBT were still present at follow-up.
  
  
  CONCLUSIONS
  This RCT shows that AET and CBT can ameliorate chronic fatigue in patients with FSHD.
  
  
  METHODS
  This study provides Class III evidence that, in patients with FSHD type 1 and severe chronic fatigue, AET or CBT reduces the severity of chronic fatigue.
authors.affiliation: From the Departments of Rehabilitation (N.V., I.d.G., A.G.) and Neurology (G.P., B.v.E.), Donders Center for Neuroscience, Expert Center for Chronic Fatigue (G.B.), and Department for Health Evidence (J.H.), Radboud University Medical Center, Nijmegen, the Netherlands. Nicole.Voet@RadboudUMC.nl.
authors.forename: Nicoline
authors.initials: N
authors.lastname: Voet
authors.affiliation: From the Departments of Rehabilitation (N.V., I.d.G., A.G.) and Neurology (G.P., B.v.E.), Donders Center for Neuroscience, Expert Center for Chronic Fatigue (G.B.), and Department for Health Evidence (J.H.), Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: Gijs
authors.initials: G
authors.lastname: Bleijenberg
authors.affiliation: From the Departments of Rehabilitation (N.V., I.d.G., A.G.) and Neurology (G.P., B.v.E.), Donders Center for Neuroscience, Expert Center for Chronic Fatigue (G.B.), and Department for Health Evidence (J.H.), Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: Jan
authors.initials: J
authors.lastname: Hendriks
authors.affiliation: From the Departments of Rehabilitation (N.V., I.d.G., A.G.) and Neurology (G.P., B.v.E.), Donders Center for Neuroscience, Expert Center for Chronic Fatigue (G.B.), and Department for Health Evidence (J.H.), Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: Imelda
authors.initials: I
authors.lastname: de Groot
authors.affiliation: From the Departments of Rehabilitation (N.V., I.d.G., A.G.) and Neurology (G.P., B.v.E.), Donders Center for Neuroscience, Expert Center for Chronic Fatigue (G.B.), and Department for Health Evidence (J.H.), Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: George
authors.initials: G
authors.lastname: Padberg
authors.affiliation: From the Departments of Rehabilitation (N.V., I.d.G., A.G.) and Neurology (G.P., B.v.E.), Donders Center for Neuroscience, Expert Center for Chronic Fatigue (G.B.), and Department for Health Evidence (J.H.), Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: Baziel
authors.initials: B
authors.lastname: van Engelen
authors.affiliation: From the Departments of Rehabilitation (N.V., I.d.G., A.G.) and Neurology (G.P., B.v.E.), Donders Center for Neuroscience, Expert Center for Chronic Fatigue (G.B.), and Department for Health Evidence (J.H.), Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: Alexander
authors.initials: A
authors.lastname: Geurts
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D015928:Cognitive Behavioral Therapy / Q000379:methods; D015444:Exercise / Q000502:physiology* / Q000523:psychology; D005081:Exercise Therapy / Q000379:methods / Q000523:psychology; D005221:Fatigue / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020391:Muscular Dystrophy, Facioscapulohumeral / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D016037:Single-Blind Method; D016896:Treatment Outcome; D055815:Young Adult