Guided graded Exercise Self-help for chronic fatigue syndrome: patient experiences and perceptions

Anna Cheshire, Damien Ridge, Lucy Clark, Peter White

Research output: Contribution to journalArticlepeer-review

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Purpose: This study explored patient experiences of Guided graded Exercise Self-help (GES) delivered as part of a randomised controlled trial for people with chronic fatigue syndrome/myalgic encephalomyelitis. The trial found that GES was better than specialist medical care at reducing fatigue and improving physical functioning.

Methods: Semi-structured interviews were conducted with patients reporting improvement (n = 9) and deterioration (n = 10), and analysis involved thematic “constant comparison.”

Results: The improved group described more facilitators to doing GES, and were more likely to describe high levels of self-motivation, whereas the deteriorated group described more barriers to GES (including worse exacerbation of symptoms after GES, greater interference from comorbid conditions, and obstacles to GES in their lives), and had been ill for longer. Having the capacity to do GES was important; of note, those with relatively lower levels of functioning sometimes had more time and space in their lives to support their GES engagement. We identified an important “indeterminate phase” early on, in which participants did not initially improve.

Conclusions: GES may be improved by targeting those most likely to improve, and teaching about the indeterminate phase.
Original languageEnglish
Pages (from-to)368-377
Number of pages10
JournalDisability and Rehabilitation
Issue number3
Early online date16 Oct 2018
Publication statusPublished - 30 Jan 2020


  • Chronic fatigue syndrome
  • myalgic encephalomyelitis
  • graded exercise therapy
  • randomised controlled trial
  • qualitative

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