People receiving Lightning Process therapy in addition to usual chronic fatigue syndrome care had improved physical function, fatigue and anxiety symptoms, according to a small UK study.
The research investigated whether a treatment called the Lightning Process helped teenagers being treated for chronic fatigue syndrome (CFS), also known as ME (myalgic encephalomyelitis).
The study randomly split 100 young participants into two groups: those who received standard CFS/ME treatment and those who received the standard treatment plus the Lightning Process (LP).
LP treatment involved an intensive three-day group-therapy course aiming to teach participants how to use their brain to improve their body’s health.
Improved School Attendance
Researchers found those who received the LP were more active, less tired and less anxious after six months. At 12 months, they also had improved depression scores and school attendance.
It’s not known what causes CFS/ME, but there are a number of theories, such as it being triggered by an infection.
Living with the condition can be difficult, with extreme tiredness and other symptoms making everyday activities challenging. As well as support from family and friends, it might also be useful for people with chronic fatigue syndrome to talk to others with the condition and perhaps find a local support group.
The study was carried out by researchers from the University of Bristol and the University of Nottingham in the UK.
This was a randomised controlled trial involving teenagers who had been diagnosed with CFS/ME. They were randomised to receive either usual care, or usual care plus the LP.
Lightning Process Therapy
The Lightning Process is a therapy developed from osteopathy, life coaching and neurolinguistic programming, and is used for a variety of conditions.
CFS/ME is a long-term illness with a wide range of symptoms, the most common being extreme tiredness.
It can also cause sleep problems, concentration problems, muscle or joint pain, headaches, a sore throat, flu-like symptoms, feeling dizzy or sick, or a fast or irregular heartbeat.
Current accepted treatments include cognitive behavioral therapy (CBT), a structured exercise program called graded exercise therapy, and medication to control pain, nausea and sleep problems.
The Study Methodology
The researchers randomised 100 children aged 12 to 18 with diagnosed CFS/ME to receive either specialist medical care (SMC) or SMC plus the LP, and followed them up at 3, 6 and 12 months.
There were 51 participants in the SMC-only group. The SMC focused on improving sleep, and using activity management to establish a baseline level of activity (including school attendance, exercise and social activity) that was then gradually increased.
Sessions were delivered by professionals such as doctors, psychologists and physiotherapists. The number and timing of sessions were agreed with the teenager and their family.
There were 49 participants in the SMC-plus-LP group. In addition to the same SMC, they attended an LP course consisting of three different sessions, lasting four hours each, on consecutive days. They attended in groups of two to five.
The first was a theory session looking at:
- stress response
- how the mind and body interact
- how thought processes can be positive or negative
This was followed by a group session in which participants were asked to think about what they could take responsibility for and change.
The third was a practical session in which participants were asked to choose a goal they wished to achieve, such as being able to stand for a longer period of time. They were given different thinking strategies to perform before and during attempting to achieve the goal. They also chose a further goal, to be attempted at home.
Each participant was offered two follow-up phone calls.
Outcomes assessed were:
- physical function, measured using the 36-Item Short-Form Health Survey Physical Function Subscale (SF-36-PFS)
- quality of life using quality-adjusted life years (QALYs), measured using the EQ-5D-Y standardised instrument
- fatigue, using the Chalder Fatigue Scale
- pain, using the Visual Analogue Scale (VAS)
- anxiety and depression, using the Hospital Anxiety and Depression Scale (HADS)
- school attendance (days per week)
- child’s use of health services, educational services or health-related travel, and other family costs, using a questionnaire
At six months after randomisation, data from 81 participants showed that those in the SMC-plus-LP group were:
They had better physical function compared with the SMC-only group according to the SF-36-PFS scale of 0 to 100, where lower scores indicate worse physical function. The SMC-plus-LP group’s average increased from a baseline of 53 to 81.7, and the SMC-only group’s increased from 56 to 70.2 (adjusted difference in means 12.5, 95% confidence interval [CI] 4.5 to 20.5).
They had less fatigue, scoring 14.4 compared with 19.8 in the SMC-only group on a scale of 0 to 33, where higher scores indicate more fatigue (adjusted difference in means 4.7, 95% CI 7.9 to 1.6).
They had greater improvement in anxiety symptoms as measured by the HADS (scored from 0 to 21, with higher scores indicating worse symptoms) than the SMC-only group. The SMC-plus-LP average score was 6.1, compared with 9.0 for the SMC-only group (adjusted difference in means 3.3, 95% CI 5.6 to 1).
At 12 months after randomisation, data from 79 participants showed that the SMC-plus-LP-group were:
More active, less fatigued and less anxious
They still had better physical function, less fatigue and improved anxiety symptoms compared with the SMC-only group.
The SMC-plus-LP group also had greater improvement in depression symptoms on the HADS – scored from 0 to 21, with higher scores indicating more-severe symptoms (adjusted difference in means -1.7, 95% CI -3.3 to -0.2).
Attending school more often
School attendance, as measured by attendance in the previous week, was better for the SMC-plus-LP group, at 4.1 days on average, than the SMC-only group’s 3.1 days (adjusted difference in means 0.9, 95% CI 0.2 to 1.6).
The researchers concluded that:
“This is the first randomised trial investigating the effectiveness of the LP for any condition. It is the first trial that has demonstrated the effectiveness of an intervention other than CBT for paediatric CFS/ME. The addition of the LP to SMC improved physical function at 6 and 12 months in adolescents with CFS/ME and this difference increased at 12 months.”
The results from this very small randomised controlled trial showed that people having LP therapy in addition to usual CFS/ME care had improved physical function, fatigue and anxiety symptoms at six months, and improved school attendance and depressive symptoms at 12 months.
But there are a number of limitations to this research that need to be considered:
- Participants in both groups improved, so both treatments were effective to some extent.
- This was a very small trial, and the results analysis involved fewer than the 100 people recruited. It would need to be repeated in a much larger group to demonstrate more robust findings.
- A number of outcomes were looked at, so it was very likely that some of them would return positive findings by chance – the improvements might not have been due to the LP therapy.
- Participants were not blinded – they were aware of the group they were in; therefore, their self-reported outcomes might have been biased. They may have been more likely to report positive outcomes because they knew they were getting additional therapy in the LP group.
- Of all those eligible to participate in the trial, fewer than 30% agreed to take part. The reason why the majority didn’t want to is unknown.
As the LP therapy was given in addition to the usual CFS/ME care, it certainly cannot be suggested as a replacement for the current usual care.
There’s no single way of managing CFS/ME that works for everyone and, if you have the condition, you should be offered a treatment plan based on your symptoms. Your doctor should discuss all options with you and make you aware of any benefits and risks.
The research was funded by the Linbury Trust and the Ashden Trust. Additional support came from an NIHR Clinician Scientist fellowship followed by an NIHR Senior Research Fellowship.
Crawley EM, Gaunt DM, Garfield K, et al
Clinical and cost-effectiveness of the Lightning Process in addition to specialist medical care for paediatric chronic fatigue syndrome: randomised controlled trial
Archives of Disease in Childhood Published Online First: 20 September 2017. doi: 10.1136/archdischild-2017-313375