Transcutaneous Vagus Nerve Stimulation as a Complementary Therapy to Exercise in Chronic Fatigue
- Conditions
- Chronic Fatigue Syndrome
- Interventions
- Other: APA programOther: Active transcutaneous VNSOther: Sham transcutaneous VNS
- Registration Number
- NCT06170645
- Brief Summary
Chronic fatigue is enhanced by adapted physical activity (APA) programs. Patients consulting on St Etienne hospital and suffering from fibromyalgia and long Covid benefit from a 4-6 week APA program, with 2 sessions per week. While most patients are improved by these exercise-training programs, for some the benefits remain very modest, and patients describe persistent fatigue. The literature unanimously describes the necessity of longer APA protocols (8-12 weeks, 2-3 sessions/week) for fatigue reduction in fibromyalgia and long Covid. However, it seems difficult to adhere to an optimal program as described in the literature for these fatigued patients. The investigators want to test a device that would both reduce fatigue and improve recovery between APA sessions, in order to gradually reach the recommendations for APA practice. Transcutaneous vagal nerve stimulation (tVNS) seems to be a promising approach. Thus, combining an APA intervention with a tVNS protocol could potentiate the expected and now well-known effect of exercise.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 60
- Patient over 18 years old
- Signature of informed consent
- Confirmed diagnosis of fibromyalgia or long Covid (ACR 2016 criteria and persistent symptoms lasting more than 6 months after a positive RT-PCR test, respectively)
- Persistent fatigue after an exercise rehabilitation program (FSS score > 36)
- Physical inactivity, i.e. <150 minutes per week of physical activity
- Pre-existing atrial fibrillation,
- Left ventricular ejection fraction <40%
- Severe heart failure
- Recent stroke or myocardial infarction (<6 months)
- Unilateral or bilateral vagotomy
- Pregnancy or breastfeeding
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Patients with active tVNS APA program Patients consulting on St Etienne hospital and suffering from fibromyalgia and long Covid will be included. Patients with active tVNS Active transcutaneous VNS Patients consulting on St Etienne hospital and suffering from fibromyalgia and long Covid will be included. Patients with sham tVNS APA program Patients consulting on St Etienne hospital and suffering from fibromyalgia and long Covid will be included. Patients with sham tVNS Sham transcutaneous VNS Patients consulting on St Etienne hospital and suffering from fibromyalgia and long Covid will be included.
- Primary Outcome Measures
Name Time Method Fatigue evaluation assessed by autonomic nervous system activity Month : 0; 3 The root mean square of successive differences in heart rate (in milliseconds) will be measured from a nocturnal Holter ECG recording (Novacor, Paris, France) at the end of the 3-month APA and tVNS programme (month 3) and compared with pre-programme values (inclusion).
- Secondary Outcome Measures
Name Time Method Medical Outcome Study Short Form questionnaire (MOS-SF 12) Month : 0; 6 Quality of life assessed by the MOS-SF 12 questionnaire , score from 0 to 100. A low score reflects a perception of poor health, loss of function and the presence of pain. A high score reflects a perception of good health, absence of functional deficit and pain.
Fatigue Severity Scale (FSS) Month : 0; 6 Subjective fatigue assessed by FSS, score from 9 to 63. The higher the score, the more severe the fatigue is and the more it affects the person's activities.
Adult Physical Activity Questionnaire (APAQ) Month : 0; 6 Physical activity assessed by the APAQ, time spend to physical activity in hours/day.
Ratio of Low Frequency to High Frequency (LF/HF) Month : 0; 6 The autonomic balance (sympathetic/parasympathetic) will be analysed by measuring the LF/HF ratio on the basis of a nocturnal Holter ECG recording (Novacor, Paris, France).
Pittsburgh questionnaire Month : 0; 6 Quality of sleep assessed by Pittsburgh questionnaire (score 0 to 21). The 7 components of the score add up to give an overall score ranging from give an overall score ranging from 0 to 21 points, with 0 meaning that there are no difficulties, and 21 indicating major difficulties.
6-minute walk test (6MWT) Month : 0; 6 Physical condition assessed by the walking distance covered in the 6MWT, walking distance in m.
Step count per day Month : 0; 6 Objective physical activity assessed by step count per day using a Garmin Vivofit 4 activity tracker.
Trial Locations
- Locations (1)
Centre Hospitalier de Saint-Etienne
🇫🇷Saint-Etienne, France