Evidence map›Paper›PMID 42033546›Full record

ArticleJournal of occupational rehabilitation2026

Work Ability and Functioning Among Individuals with Persistent Indoor Environment-Related Symptoms or Chronic Fatigue: Nine-Month Follow-Up of a Web-Based Randomized Controlled Trial.

Aki Vuokko, Mari Immonen, Päivi Lappalainen, Katariina Keinonen, Markku Sainio, Raimo Lappalainen, Tiina Paunio, Sanna Selinheimo

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In one paragraph

Article in Journal of occupational rehabilitation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04532827 (The Effectiveness of Web-based Rehabilitation for Enhancing Workability and Daily Functioning for Persistent Physical Symptoms.), which is not on this map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04532827 naunknown statusnot on this map

The Effectiveness of Web-based Rehabilitation for Enhancing Workability and Daily Functioning for Persistent Physical Symptoms.

TypeinterventionalSponsorFinnish Institute of Occupational HealthRan2020 to 2023Enrolled105ConditionsPersistent Physical Symptoms, Indoor Environment Associated Symptoms, Indoor Air Associated Symptoms, Chronic Fatigue SyndromeArmsCase formulation with web-program
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Aki VuokkoFinnish Institute of Occupational Health, Panuntie 6, 00620, Helsinki, Finland. aki.vuokko@ttl.fi.ORCID http://orcid.org/0009-0004-8057-3235
Mari ImmonenFinnish Institute of Occupational Health, Panuntie 6, 00620, Helsinki, Finland.
Päivi LappalainenDepartment of Psychology, University of Jyväskylä, Jyväskylä, Finland.ORCID http://orcid.org/0000-0001-9038-894X
Katariina KeinonenDepartment of Psychology, University of Jyväskylä, Jyväskylä, Finland.ORCID http://orcid.org/0000-0003-3228-5357
Markku SainioRehabilitation Unit for Persistent Symptoms, Helsinki University Hospital, Helsinki, Finland.ORCID http://orcid.org/0000-0002-3145-1301
Raimo LappalainenDepartment of Psychology, University of Jyväskylä, Jyväskylä, Finland.ORCID http://orcid.org/0000-0001-6683-134X
Tiina PaunioFinnish Institute of Occupational Health, Panuntie 6, 00620, Helsinki, Finland.ORCID http://orcid.org/0000-0002-5560-0666
Sanna SelinheimoFinnish Institute of Occupational Health, Panuntie 6, 00620, Helsinki, Finland.ORCID http://orcid.org/0000-0003-0563-9017

Funding

Social Insurance Institution of Finland 75/331/2019
6 · The paper itself

Abstract

purposePersistent physical symptoms (PPS) can significantly impair work ability and daily functioning, exacerbated by comorbid illness worry (IW). This randomized controlled trial (RCT) examined the effectiveness of guided internet-based treatment on work ability and daily functioning of working-aged individuals with PPS associated with indoor environment (IE) and/or chronic fatigue (CF) with disability. The intervention was based on acceptance and commitment therapy (ACT) combined with individual case formulation, compared to treatment as usual (TAU). IW's role in moderating effects was explored.

methodsIn this RCT (Clinicaltrials.gov NCT04532827), 103 individuals with PPS linked to IE, CF or both were assigned to a video-based case conceptualization and 10-week internet-based ACT with TAU (iACT + TAU; n = 50) or TAU alone (n = 53). Self-reported work ability and daily functioning were assessed from pre-intervention to 9-month follow-up, examining the potential moderating effect of baseline IW. Analyses used linear mixed models and Type III ANOVA.

resultsOf the 103 participants, 62% completed the 9-month follow-up. Baseline demographics showed no significant differences between treatment groups. Significant positive interaction (treatment group and time) effects for work ability were found in the iACT + TAU group at post-measurement (β = 0.41, p = 0.041), 3-month (β = 0.58, p = 0.004), and 9-month (β = 0.47, p = 0.022) follow-ups. Daily functioning improved significantly at 3-month (β = 0.57, p = 0.007), particularly in the work domain (β = 0.67, p = 0.003). IW and PPS group did not moderate outcomes.

conclusionInternet-based ACT with individual case formulation was associated with improved work ability for individuals with PPS associated with IE and CF, providing preliminary support for further examination as a potential frontline treatment.

Indexed as

Acceptance and commitment therapyChronic fatigueFunctioningIndoor environmentPersistent physical symptomsWork ability

Identifiers

PMID42033546

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.