8/27/2023 0 Comments Actimeter tremor indexTrying to gain a better understanding of the biology, and possibly better treatment approaches, should not come in place of humanistic skills and a committed and healing relationship based on mutual trust and respect. What does a patient want-to have a normal EMG or to be able to walk? To have increased activity measured objectively or to be able to resume his/her social and professional life? To have his own subjective feelings being recognized as real, or to have to constantly find "objective" evidence that serves to prove it? To be given help and support to lead a normal life as possible, or to have normalization of some lab value? Many physicians have mostly become prescription writing technocrats. This very important/essential part of medicine was gradually left in the hands of complementary healers, therapists and probably in recent years also patient support groups. Probably there are situations in which it does matter and situations in which it matters less.īut, modern medicine has probably been focusing too much on measurable so-called objective parameters and too little on how patients experience their illness and what makes them feel better (or worse) physically and emotionally. The question that remains unanswered is what would be the long term outcome of patients with mild-moderate asthma who receive treatment that only makes them feel better, without affecting objective measurable parameters. Treatment with ventolin (or any other medication) has its risks and maybe this risk is unjustified if we can achieve the same results with saline. The conclusion of the authors was that patient subjective scores are unreliable and only objective measurements should be used in clinical trials.īut, there was an editorial that questioned this approach and asked if what we can measure is more important than what the patient feels.Īfter all patients don't come to the physician because they have an abnormal peak flow measurement but because they have breathing difficulties that interfere with their life. Interestingly all forms of treatment had a similar effect on the dyspnea score (as compared to no treatment), but only ventolin led to significant improvement in the peak flow measures. They measured peak flow but also asked patients to document their dyspnea score-which was how they perceived their shortness of breath. They compared treatment with a ventolin inhaler, to treatment with various types of placebos, and to no treatment at all. There was a trial published in the NEJM regarding asthma patients, with mild-moderate disease. ![]() "Rheumatoid arthritis (RA) patients who used an individualized, Internet-based exercise program may be more likely to get daily physical activity than their counterparts who only receive general information on exercise via the Internet, but their self reports of increased activity did not correspond with activity recorded by electronic monitoring devices, according to a study in the December 15 issue of Arthritis Care & Research." Apparently it's not just CFS patients who have this finding of reported increased activity not matching actometer results.Ĭan the Web Help Doctors Get RA Patients Moving? Maybe I happened to come across the following article when searching about Actilog V3.0. Identifying physical activity patterns in chronic fatigue syndrome using actigraphic assessment. The paper above also references the following paper as describing the Actometer in more detail. I tried Googling both and got more results for actimeter but both seem to be used. Heh, my other question was how to spell it. ![]() The paper above will include references to the three earlier pro-CBT studies which measures were taken from. It's written in a very pro-CBT way, and there's no acknowledgement that the lack of improvement in activity levels could indicate that CBT is not an effective treatment - they act as if we can be certain that subjective questionnaire scores are a true and accurate measure of fatigue levels, and that objectively measured levels of activity can only be used to observe the manner in which CBT effectively reduces fatigue. 'How does cognitive behaviour therapy reduce fatigue in patients with chronic fatigue syndrome? The role of physical activity.' Psychol Med. This paper releases actometer readings from three prior studies which had been presented as showing CBT to be effective, and it was only 9 years (I think) after the first study was released that we got the actometer readings showing no improvement in activity levels.īleijenberg G, Prins JB, Wiborg JF, Knoop H, Stulemeijer M.
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