Table 3 RCTs with nonpharmacological interventions
Intervention | N. of participants (N. of arms, control) | Period (week) | Primary measurement (subscale) | Significance |
|---|---|---|---|---|
CBT | ||||
 iCBT [41] | 240 (3, waitlist) | 27 | CIS (fatigue) | P < 0.01 |
 Group CBT [42] | 204 (3, waitlist) | 24 | CIS (fatigue), SF-36 (physical score) | CIS: d > 0.8 |
 CBT [43] | 122 (2, MRT) | 24 | CIS (fatigue), SF-36 | Not significant |
 FITNET [44] | 135 (2, usual care) | 48 | SAR, CIS (fatigue), CHQ (physical score) | P < 0.01 |
 CBT + GET [46] | 120 (2, usual care) | 24 | SF-36 | Not significant |
 CBT [46] | 640 (4, MC) | 24 | Chalder scale, SF-36 (physical score) | P < 0.01 |
 Family-focused CBT [47] | 63 (2, psychoeducation) | 24 | SAR | Not significant |
 Group CBT [48] | 153 (3, education + support, MC) | 16 | SF-36 (physical, mental score) | Not significant |
 CBT [49] | 71 (2, waitlist) | 20 | CIS (fatigue), SF-36 (physical score), SAR | CIS, SF-36: P < 0.01, SAR: P < 0.05 |
 CBT [50] | 278 (3, guided support, no treatment) | 32 | CIS (fatigue), SIP-8 | CIS: P < 0.01, SIP: P < 0.05 |
 CBT [51] | 60 (2, relaxation) | 16–24 | Chalder scale, SF-36 (physical score) | Chalder scale: P < 0.01 |
 CBT [52] | 60 (2, MC) | 16 | Karnofsky normal function scale | P < 0.01 |
Exercise | ||||
 Guided exercise self-help [53] | 211 (2, MC) | 12 | Chalder scale, SF-36 (physical score) | P < 0.01 |
 Qigong [54] | 64 (2, waitlist) | 16 | Chalder scale, SF-12 | Not significant |
 GET [46] | 640 (4, MC) | 24 | Chalder scale, SF-36 (physical score) | P < 0.01 |
 GET [55] | 49 (2, MC) | 12 | Self-rated global change score | P < 0.05 |
 Education to encourage graded exercise [56] | 148 (4, MC) | 16 | SF-36 (physical score) | P < 0.01 |
 Graded aerobic exercise [57] | 66 (crossover, flexibility therapy) | 12 | CGI | Not significant |
Self-care | ||||
 Fatigue self-management [58] | 137 (3, usual care) | 12 | FSS | Not significant |
 Group-based self-management [59] | 137 (2, usual care) | 16 | SF-36 (physical score) | Not significant |
 Guided self-instruction [60] | 123 (2, waitlist) | 20 | CIS (fatigue), SF-36 (physical, social score) | CIS: P < 0.01 |
 Stepped care [61] | 171 (2, CBT) | 16 | CIS (fatigue), SIP-8, SF-36 (physical score) | Not significant |
 Guided self-instruction [62] | 169 (2, waitlist) | 16 | CIS (fatigue), SIP-8, SF-36 (physical score) | CIS, SIP8: P < 0.01 |
Rehabilitation | ||||
 Pragmatic rehabilitation [63] | 302 (3, supportive listening, general treatment) | 18 | Chalder scale, SF-36 (physical score) | Not significant |
 Integrative, consumer-driven rehabilitation [64] | 47 (2, delayed program) | 16 | CFS Symptom Rating Form, The QoL Index | P < 0.05 |
Acupuncture | ||||
 Acupuncture [65] | 150 (3, sa-am, no treat) |  | FSS | P < 0.05 |
 Acupuncture [66] | 100 (2, sham) |  | Chalder scale, SF-12, GHQ-12 (mental score) | Chalder scale: P < 0.05 |
Others | ||||
 Abdominal tuina [67] | 77 (2, acupuncture) |  | Chalder scale, SAS, HAMD | P < 0.05 |
 Adaptive pacing [46] | 640 (4, MC) | 24 | Chalder scale, SF-36 (physical score) | Not significant |
 Low-sugar, low-yeast diet [68] | 52 (2, healthy eating) | 24 | Chalder scale, SF-36 | Not significant |
 Distant healing [69] | 409 (4, not knowing, no treat) | 24 | SF-36 (mental score) | Not significant |