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

FOWLER-DAVIS, Sally, PLATTS, Katharine, THELWELL, Michael, WOODWARD, Amie and HARROP, Deborah (2021). A mixed-methods systematic review of post-viral fatigue interventions: Are there lessons for long Covid? PLOS ONE, 16 (11).

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Official URL: https://journals.plos.org/plosone/article?id=10.13...
Open Access URL: https://journals.plos.org/plosone/article/file?id=... (Published version)
Link to published version:: https://doi.org/10.1371/journal.pone.0259533
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    Abstract

    Objectives: 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’. Method: 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. Results: 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). Conclusion: 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.

    Item Type: Article
    Additional Information: ** From PLOS via Jisc Publications Router ** Licence for this article: http://creativecommons.org/licenses/by/4.0/ **Journal IDs: eissn 1932-6203 **Article IDs: publisher-id: pone-d-21-18781 **History: published_online 09-11-2021; accepted 20-10-2021; submitted 28-06-2021; collection 2021
    Uncontrolled Keywords: Research Article, Medicine and health sciences, Research and analysis methods
    Departments - Does NOT include content added after October 2018: Faculty of Social Sciences and Humanities > Department of Humanities
    Faculty of Social Sciences and Humanities > Department of Law and Criminology
    Faculty of Social Sciences and Humanities > Department of Natural and Build Environment
    Faculty of Social Sciences and Humanities > Department of Psychology, Sociology and Politics
    Identification Number: https://doi.org/10.1371/journal.pone.0259533
    SWORD Depositor: Colin Knott
    Depositing User: Colin Knott
    Date Deposited: 10 Nov 2021 17:40
    Last Modified: 10 Nov 2021 17:45
    URI: http://shura.shu.ac.uk/id/eprint/29308

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