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Children with chronic fatigue helped by training course

A training course for children with chronic fatigue syndrome (CFS) was shown to be effective in improving physical activity levels and ‘probably’ cost-effective in the first study to evaluate the effectiveness of an intervention other than CBT for the condition.

The study found that a training course known as the Lightning Process was effective in improving the physical activity levels of children with CFS and in reducing their fatigue and anxiety. The Lightning Process is also likely to be cost-effective at NICE thresholds.

The Lightning Process, based on osteopathy, life coaching and neurolinguistic programming, is a three-day training programme with theory sessions about the interaction of the body and mind, practical sessions about cognitive strategies for achieving goals and homework tasks, followed by follow-up phone calls.

The study, led by researchers in Bristol, randomised 100 patients aged 12-18 with mild to moderate CFS to receive standard medical care either with or without the Lightning Process. Physical function was improved in children receiving the Lightning Process after six months, with patients scoring, on average, 12.5 points higher on a patient-reported physical function survey than those were receiving standard medical care alone.

The researchers also found that the Lightning Process patients had reduced fatigue and anxiety levels after six months compared with those receiving standard medical care. There was also less depression in Lightning Process patients at 12 months and they had improved school attendance compared with the standard medical care group.

An economic analysis looked at the cost of administering the Lightning Process as well as the amount of additional healthcare resources used by the child, such as GP visits, and health-related travel costs. When the figures were adjusted for missing resource use data, the Lightning Process was found to be more cost-effective than standard care after 12 months, with a difference in average net cost of £1,474 at 12 months.

The authors acknowledge that since the control group still received standard care for ethical reasons, they do not know whether the Lightning Process is effective on its own and called for further research.

They said in the paper: ‘We do not know which aspects of the Lightning Process are the most important or helpful. Some young people who received the Lightning Process value the theory, others the practical sessions or the homework.

‘Further research is needed to understand why the Lightning Process improves outcomes at six and 12 months and which aspects of the Lightning Process contribute to its effectiveness.’

Arch. Dis. Child. 2017; available online 20 September

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