Physical activity, participation and health-related quality of life in chronic fatigue syndrome and multiple osteochondromas
Chronic fatigue and pain are prevalent symptoms in the adult general population (approximately >20%), debilitating in nature and often co-occurring in various chronic conditions. Both symptoms have been found to negatively affect health-related quality of life (HRQOL), one of the primary outcomes of healthcare and rehabilitation. HRQOL is seen as a comprehensive concept that can be influenced by biological factors, such as fatigue and pain, psychological as well as social factors. Despite the established high prevalence and negative effects of fatigue, it is not always taken into account in clinical research on chronic pain, and its importance is frequently overlooked in clinical practice. This thesis is therefore interested in the impact of chronic fatigue in patients who also experience chronic pain. Fatigue is proposed as a transdiagnostic rather than a disease-specific symptom. To explore this hypothesis, two distinct patient populations experiencing chronic fatigue and pain were included in this doctoral thesis, patients with chronic fatigue syndrome (CFS) and patients with multiple osteochondromas (MO). Because HRQOL is an important health care outcome, this doctoral thesis is centered around the exploration of disease-specific and transdiagnostic bio-, psycho-, social determinants of HRQOL in patients with chronic fatigue and pain, and specifically taking the physical activity level into account due to its established positive relationship with health in the general population. The first part (chapter 2-4) focuses on measurement instruments to evaluate activity limitations and participation restrictions, which are considered more objectively measured subitems of HRQOL, and the physical activity level and pattern in patients with CFS. The second part of this thesis (chapter 5-6) focuses on the physical activity level and HRQOL in patients with MO, and transdiagnostic and disease-specific determinants of HRQOL. The results of this thesis show that fatigue and pain are co-occurring symptoms that may not be overlooked. Patients may report significant reductions in their physical activity level, mental and physical HRQOL and several determinants negatively related herewith were identified. The thesis concludes with directions for future impact: measuring the physical activity level and HRQOL in clinical practice and related future research needs; opportunities for a preventive approach to prevent psychological symptoms, activity limitations and participation restrictions; and needs regarding the expansion of occupational therapy in primary care to provide appropriate treatment to patients with chronic fatigue and pain.
Antwerp : University of Antwerp & Maastricht University , 2024
234 p.
Supervisor: Meeus, Mira [Supervisor]
Supervisor: Smeets, Rob J.E.M. [Supervisor]
Supervisor: Huijnen, Ivan P.J. [Supervisor]
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The publisher created published version Available from 25.04.2025
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Creation 22.04.2024
Last edited 26.04.2024
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