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| ID | Type | Description | Link |
|---|---|---|---|
| 2023-A01792-43 | Other Identifier | ANSM |
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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patients with active tVNS | Experimental | Patients consulting on St Etienne hospital and suffering from fibromyalgia and long Covid will be included. |
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| Patients with sham tVNS | Sham Comparator | Patients consulting on St Etienne hospital and suffering from fibromyalgia and long Covid will be included. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| APA program | Other | An APA program of 12 weeks, 2 sessions of 1h/week for mixed endurance, strengthening and stretching work. The program can be realized at home or in structure. |
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| Measure | Description | Time Frame |
|---|---|---|
| Fatigue evaluation assessed by autonomic nervous system activity | 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). | Month : 0; 3 |
| Measure | Description | Time Frame |
|---|---|---|
| Fatigue Severity Scale (FSS) | 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. | Month : 0; 6 |
| Medical Outcome Study Short Form questionnaire (MOS-SF 12) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| David HUPIN, MD | Contact | (0)4 77 82 84 13 | +33 | david.hupin@chu-st-etienne.fr |
| Hélène RAINGARD, CRA | Contact | (0)4 77 12 08 26 | +33 | helene.raingard@chu-st-etienne.fr |
| Name | Affiliation | Role |
|---|---|---|
| David HUPIN, MD | Centre Hospitalier Universitaire de Saint Etienne | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Centre Hospitalier de Saint-Etienne | Recruiting | Saint-Etienne | 42055 | France |
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| ID | Term |
|---|---|
| D015673 | Fatigue Syndrome, Chronic |
| ID | Term |
|---|---|
| D009135 | Muscular Diseases |
| D009140 | Musculoskeletal Diseases |
| D004679 | Encephalomyelitis |
| D000090862 | Neuroinflammatory Diseases |
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| Active transcutaneous VNS | Other | After each APA session, a 1h-tVNS session is delivered on the conchae aurea of the left ear, in resting condition. Parameters of tVNS : frequency 20Hz, impulsion 200ms, amplitude 1mA below the unpleasant sensation level. |
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| Sham transcutaneous VNS | Other | After each APA session, a 1h-tVNS session is delivered on the left earlobe, in resting condition. Parameters of tVNS : frequency 20Hz, impulsion 200ms, amplitude 1mA below the unpleasant sensation level. |
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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. |
| Month : 0; 6 |
| Pittsburgh questionnaire | 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. | Month : 0; 6 |
| 6-minute walk test (6MWT) | Physical condition assessed by the walking distance covered in the 6MWT, walking distance in m. | Month : 0; 6 |
| Adult Physical Activity Questionnaire (APAQ) | Physical activity assessed by the APAQ, time spend to physical activity in hours/day. | Month : 0; 6 |
| Step count per day | Objective physical activity assessed by step count per day using a Garmin Vivofit 4 activity tracker. | Month : 0; 6 |
| Ratio of Low Frequency to High Frequency (LF/HF) | 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). | Month : 0; 6 |
| D009422 | Nervous System Diseases |
| D009468 | Neuromuscular Diseases |
| D002908 | Chronic Disease |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |