Randomised controlled trial of graded exercise in patients with the chronic fatigue syndrome
BMJPublished 7 June 1997Open access
K. Y Fulcher, Peter D. White
Citations442
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Abstract
These findings support the use of appropriately prescribed graded aerobic exercise in the management of patients with the chronic fatigue syndrome.
Keywords
MedicineHealth Professions
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Controlled Clinical TrialsMeta-analysis in clinical trials
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This paper examines eight published reviews each reporting results from several related trials in order to evaluate the efficacy of a certain treatment for a specified medical condition and suggests a simple noniterative procedure for characterizing the distribution of treatment effects in a series of studies.
Psychiatry ResearchThe Pittsburgh sleep quality index: A new instrument for psychiatric practice and research
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The clinimetric and clinical properties of the PSQI suggest its utility both in psychiatric clinical practice and research activities.
PubMedThe MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection.
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A 36-item short-form survey designed for use in clinical practice and research, health policy evaluations, and general population surveys to survey health status in the Medical Outcomes Study is constructed.
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Medical CareThe MOS 36-Item Short Form Health Survey
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The validity of using the written form of the SF-36 on a sample of patients with chronic mental illness was demonstrated and appears to be an appropriate outcome measure for changes in physical and role functioning in consumers of outpatient mental health programs.
American Heart JournalClinical exercise testing
1,222 Citations1976Idelle M. Weisman, R. Jorge Zeballos
An Introduction to Exercise Testing, Interpretation of Stage 1 Exercise Test Results, and Approaches to Clinical Exercise Testing.
Journal of the Royal Society of MedicineA Report–Chronic Fatigue Syndrome: Guidelines for Research
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A detailed examination of data from Philadelphia showed that control for season and weather was adequate for removing all long-term seasonal and subseasonal patterns from the mortality data, and that using a very flexible nonlinear fit to the weather factors did not disturb the association with TSP.
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Journal of Epidemiology & Community HealthShort term effects of air pollution on health: a European approach using epidemiologic time series data: the APHEA protocol.
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In spite of delays in diagnosis, progression of an established neurologic deficit did not appear to occur in this study, however, the development of secondary deficits was significant in the delayed diagnosis group.
Archives of Internal MedicineComparison of Patients With Chronic Fatigue Syndrome, Fibromyalgia, and Multiple Chemical Sensitivities
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Demographic and clinical factors and health locus of control do not clearly distinguish patients with CFS, FM, and MCS.
BMJAir pollution and daily mortality in London: 1987-92
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It is suggested that air pollution due to particles and ozone may be associated with increased daily mortality in London and the evidence is less convincing for nitrogen dioxide and sulphur dioxide.
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Journal of Neurology Neurosurgery & PsychiatryClinical and experimental application of the percutaneous twitch superimposition technique for the study of human muscle activation.
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The use of percutaneous stimulation for twitch superimposition in the human quadriceps has been compared with stimulation via the femoral nerve and inhibition was demonstrated in patients with muscle pain and joint pathology and in subjects with a previous history of knee or joint injury.
Annals of Emergency MedicineLow-risk criteria for cervical-spine radiography in blunt trauma: A prospective study
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Cervical-spine radiology may not be necessary in patients without spinous tenderness in the neck, intoxication, altered level of alertness, or other severely painful injury.
Annual Review of Public HealthAcute Respiratory Effects of Particulate Air Pollution
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American Journal of EpidemiologyCORRELATES OF COGNITIVE FUNCTION IN AN ELDERLY COMMUNITY POPULATION
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There was a strong inverse relation between age and performance on all four cognitive tests in analyses adjusted for sex only as well as in those adjusted for the effects of other variables.
PubMedAortic dissecting aneurysms: causative factors in 204 subjects.
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The results show that hypertension, Marfan's syndrome, and traumatic, atherosclerotic, or inflammatory injuries of the aortic media are factors associated with dissection.
American Journal of Respiratory and Critical Care MedicineAcute Effects of Summer Air Pollution on Respiratory Symptom Reporting in Children
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The present findings support the conclusion that current levels of sulfur dioxide and black smoke may have an effect on the respiratory health of susceptible persons.
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The American Journal of SurgeryClinical indications for cervical spine radiographs in the traumatized patient
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It is confirmed that the expression of PD is markedly influenced by the age of onset, and the pattern of cognitive impairment in PD was consistent with that associated with a subcortical dementia.
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Where the exercise is of several minutes' duration, RPE is increased by sleep deprivation and by physical fatigue, and where the exercise period is as short as 30 s, sleep deprivation has no effect and physical fatigue causes only a small change in the perception of exercise intensity.
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It is concluded that limited, directed CT of the cervical spine is appropriate in the initial evaluation of patients at risk, particularly if plain radiographs are inadequate, but is of limited value in the evaluation of ligamentous injury of the upper cervical spine.
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67 Citations1992Patricia B Rosen, Norman E. McSwain +3 more
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The empirically defined fatigue syndrome probably is a valid and reliable condition in the 6 months following glandular fever and both the fatigue syndrome and state were more reliable diagnoses over time than depressive disorders.
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PubMedThe use of nonfatiguing strengthening exercises in post-polio syndrome.
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The data indicate that there is little support across research groups for any specific relationship and, at best, the effect of alcohol consumption accounts for only a small proportion of variance.
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Cognitive dysfunction related to aging was found to be a more significant factor than decline with alcohol use and alcohol-related differences in intellectual functioning tended to diminish with increasing subject age.
Environmental Health PerspectivesAssessment of the Health Effects of Atmospheric Sulfur Oxides and Particulate Matter: Evidence from Observational Studies
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