A mixed-methods systematic review of post-viral fatigue interventions: Are there lessons for long Covid?

<h4>Objectives</h4>Fatigue syndromes have been widely observed following post-viral infection and are being recognised because of Covid19. Interventions used to treat and manage fatigue have been widely researched and this study aims to synthesise the literature associated with fatigue i...

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Autores principales:	Sally Fowler-Davis, Katharine Platts, Michael Thelwell, Amie Woodward, Deborah Harrop
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/57b708ff76404b9eb22d6ce24fca8ad8
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spelling	oai:doaj.org-article:57b708ff76404b9eb22d6ce24fca8ad82021-12-02T20:07:42ZA mixed-methods systematic review of post-viral fatigue interventions: Are there lessons for long Covid?1932-620310.1371/journal.pone.0259533https://doaj.org/article/57b708ff76404b9eb22d6ce24fca8ad82021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0259533https://doaj.org/toc/1932-6203<h4>Objectives</h4>Fatigue syndromes have been widely observed following post-viral infection and are being recognised because of Covid19. Interventions used to treat and manage fatigue have been widely researched and this study aims to synthesise the literature associated with fatigue interventions to investigate the outcomes that may be applicable to 'long Covid'.<h4>Method</h4>The study was registered with PROSPERO (CRD42020214209) in October 2020 and five electronic databases were searched. Papers were screened, critically appraised and data extracted from studies that reported outcomes of fatigue interventions for post-viral syndromes. The narrative synthesis includes statistical analysis associated with effectiveness and then identifies the characteristics of the interventions, including identification of transferable learning for the treatment of fatigue in long Covid. An expert panel supported critical appraisal and data synthesis.<h4>Results</h4>Over 7,000 research papers revealed a diverse range of interventions and fatigue outcome measures. Forty papers were selected for data extraction after final screening. The effectiveness of all interventions was assessed according to mean differences (MD) in measured fatigue severity between each experimental group and a control following the intervention, as well as standardised mean differences as an overall measure of effect size. Analyses identified a range of effects-from most effective MD -39.0 [95% CI -51.8 to -26.2] to least effective MD 42.28 [95% CI 33.23 to 51.34]-across a range of interventions implemented with people suffering varying levels of fatigue severity. Interventions were multimodal with a range of supportive therapeutic methods and varied in intensity and requirements of the participants. Those in western medical systems tended to be based on self- management and education principles (i.e., group cognitive behavioural therapy (CBT).<h4>Conclusion</h4>Findings suggest that the research is highly focussed on a narrow participant demographic and relatively few methods are effective in managing fatigue symptoms. Selected literature reported complex interventions using self-rating fatigue scales that report effect. Synthesis suggests that long Covid fatigue management may be beneficial when a) physical and psychological support, is delivered in groups where people can plan their functional response to fatigue; and b) where strengthening rather than endurance is used to prevent deconditioning; and c) where fatigue is regarded in the context of an individual's lifestyle and home-based activities are used.Sally Fowler-DavisKatharine PlattsMichael ThelwellAmie WoodwardDeborah HarropPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 11, p e0259533 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Sally Fowler-Davis Katharine Platts Michael Thelwell Amie Woodward Deborah Harrop A mixed-methods systematic review of post-viral fatigue interventions: Are there lessons for long Covid?
description	<h4>Objectives</h4>Fatigue syndromes have been widely observed following post-viral infection and are being recognised because of Covid19. Interventions used to treat and manage fatigue have been widely researched and this study aims to synthesise the literature associated with fatigue interventions to investigate the outcomes that may be applicable to 'long Covid'.<h4>Method</h4>The study was registered with PROSPERO (CRD42020214209) in October 2020 and five electronic databases were searched. Papers were screened, critically appraised and data extracted from studies that reported outcomes of fatigue interventions for post-viral syndromes. The narrative synthesis includes statistical analysis associated with effectiveness and then identifies the characteristics of the interventions, including identification of transferable learning for the treatment of fatigue in long Covid. An expert panel supported critical appraisal and data synthesis.<h4>Results</h4>Over 7,000 research papers revealed a diverse range of interventions and fatigue outcome measures. Forty papers were selected for data extraction after final screening. The effectiveness of all interventions was assessed according to mean differences (MD) in measured fatigue severity between each experimental group and a control following the intervention, as well as standardised mean differences as an overall measure of effect size. Analyses identified a range of effects-from most effective MD -39.0 [95% CI -51.8 to -26.2] to least effective MD 42.28 [95% CI 33.23 to 51.34]-across a range of interventions implemented with people suffering varying levels of fatigue severity. Interventions were multimodal with a range of supportive therapeutic methods and varied in intensity and requirements of the participants. Those in western medical systems tended to be based on self- management and education principles (i.e., group cognitive behavioural therapy (CBT).<h4>Conclusion</h4>Findings suggest that the research is highly focussed on a narrow participant demographic and relatively few methods are effective in managing fatigue symptoms. Selected literature reported complex interventions using self-rating fatigue scales that report effect. Synthesis suggests that long Covid fatigue management may be beneficial when a) physical and psychological support, is delivered in groups where people can plan their functional response to fatigue; and b) where strengthening rather than endurance is used to prevent deconditioning; and c) where fatigue is regarded in the context of an individual's lifestyle and home-based activities are used.
format	article
author	Sally Fowler-Davis Katharine Platts Michael Thelwell Amie Woodward Deborah Harrop
author_facet	Sally Fowler-Davis Katharine Platts Michael Thelwell Amie Woodward Deborah Harrop
author_sort	Sally Fowler-Davis
title	A mixed-methods systematic review of post-viral fatigue interventions: Are there lessons for long Covid?
title_short	A mixed-methods systematic review of post-viral fatigue interventions: Are there lessons for long Covid?
title_full	A mixed-methods systematic review of post-viral fatigue interventions: Are there lessons for long Covid?
title_fullStr	A mixed-methods systematic review of post-viral fatigue interventions: Are there lessons for long Covid?
title_full_unstemmed	A mixed-methods systematic review of post-viral fatigue interventions: Are there lessons for long Covid?
title_sort	mixed-methods systematic review of post-viral fatigue interventions: are there lessons for long covid?
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/57b708ff76404b9eb22d6ce24fca8ad8
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A mixed-methods systematic review of post-viral fatigue interventions: Are there lessons for long Covid?

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