Clinical Outcomes

SF-36 and NSHA Outcome Data Summary

Aggregated, anonymized outcomes from CFS Recovery's coaching system. For healthcare provider review. Data current as of April 2026.

Data current as of March 2026

5,313
Assessments
2,418
Unique Clients
825
Tracked Longitudinally

Population Profile

Age range: 9 to 86 years (median: 40)

Illness duration: 1 month to 50 years (median: 48 months)

Severity at intake: 30.6% housebound or worse

Average symptoms at intake: 12.5 simultaneous symptoms

Conditions: CFS/ME, long COVID, post-viral fatigue, fibromyalgia, POTS, dysautonomia

NSHA Longitudinal Outcomes (n=825)

Median tracking period: 124 days

Physical Capabilities
64.1%
Cognitive Capabilities
58.5%
Symptom Count Reduction
47.5%
Activity Level
36.1%

Percentage of clients showing measurable improvement from baseline.

SF-36 Health Survey Outcomes (n=90)

Percentage-point improvement from baseline, grouped by client tenure at follow-up. These bands are different clients at different stages, not repeated measurements of the same clients over time (see Methodology). The 12+ month band is small (n=14).

Domain 0-6 Months 6-12 Months 12+ Months
General Health +18% +28% +57%
Physical Functioning +16% +28% +34%
Role Limitation (Physical) +14% +29% +36%
Role Limitation (Emotional) +35% +29% +50%
Energy / Fatigue +18% +24% +17%
Emotional Wellbeing +16% +20% +12%
Social Functioning +26% +37% +55%
Pain +8% +8% +39%

Most severe cases (those starting at the lowest baseline scores) averaged +41% improvement across all 8 SF-36 domains, versus +22% for the average client. Part of this gap reflects regression to the mean, since clients selected at the floor tend to move upward on remeasurement. We present it as an observed pattern worth studying, not as proof of effect.

Cross-Instrument Validation

52 clients completed both the NSHA and SF-36. Of these 52, 47 improved on their overall SF-36 score, and 23 improved on both instruments at the same time. Agreement between an independent, internationally validated instrument and our own supports the reliability of the observed gains, though it does not establish cause.

Methodology and Limitations

This data represents aggregated, anonymized outcomes from a self-selected coaching population. It is not derived from a randomized controlled trial.

The SF-36 Health Survey (scored with the standard RAND-36 algorithm) is administered once at enrollment (baseline) and once at follow-up. Each client completes a single follow-up, timed to their program (6 months for Academy and the 6-month Platinum term, 12 months for the 12-month term, or at cancellation). Follow-ups are grouped into the 0-6, 6-12, and 12+ month bands by tenure, so those bands represent different clients at different stages, not repeated measurements of the same clients over time. The Nervous System Health Assessment (NSHA) is a proprietary instrument tracking physical capabilities, cognitive function, symptom count, and activity level; its longitudinal figures compare each client's first and most recent assessment within-person.

Limitations include self-selection bias (clients who complete a follow-up may differ from those who do not, which can bias results upward), self-reported data, no control group, small subgroups (the 12+ month SF-36 band is n=14), and regression to the mean in the most-severe subgroup analysis. The NSHA "improved" figures count any measurable positive change from baseline. We are transparent about these limitations and welcome discussion with interested practitioners.

Figures reflect data as of April 2026. The SF-36 sample is actively growing: approximately 600 additional clients have completed baseline surveys, and their follow-up surveys are being collected now. Updated results will be reported as this cohort matures, whichever direction they move.

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