# Exercise therapy for Chronic Fatigue Syndrome



## M&M (Jan 20, 2002)

This was posted to the Co-Cure list:


> quote:Exercise therapy for chronic fatigue syndrome.Cochrane Database Syst Rev. 2004;(3):CD003200.Reviewers: Edmonds M, McGuire H, Price J.NLM Citation: PMID: 15266475BACKGROUND: Chronic fatigue syndrome (CFS) is an illness characterised bypersistent medically unexplained fatigue. CFS is a serious health-careproblem with a prevalence of up to 3%. Treatment strategies for CFSinclude psychological, physical and pharmacological interventions.OBJECTIVES: To investigate the relative effectiveness of exercise therapyand control treatments for CFS.SEARCH STRATEGY: CCDANCTR-Studies and CENTRAL were searched using"Chronic Fatigue" and Exercise. The Journal of Chronic Fatigue Syndromeand CFS conferences were handsearched. Experts in the field werecontacted. Clinicaltrials.gov and controlled-trials.com were searched.SELECTION CRITERIA: Only Randomised Controlled Trials (RCT) includingparticipants with a clinical diagnosis of CFS and of any age wereincluded.DATA COLLECTION AND ANALYSIS: The full articles of studies identifiedwere inspected by two reviewers (ME and HMG). Continuous measures ofoutcome were combined using standardised mean differences. An overalleffect size was calculated for each outcome with 95% confidenceintervals. One sensitivity analysis was undertaken to test the robustnessof the results.MAIN RESULTS: Nine studies were identified for possible inclusion in thisreview, and five of those studies were included. At 12 weeks, thosereceiving exercise therapy were less fatigued than the controlparticipants (SMD -0.77, 95% CIs -1.26 to -0.28). Physical functioningwas significantly improved with exercise therapy group (SMD -0.64, CIs-0.96 to -0.33) but there were more dropouts with exercise therapy (RR1.73, CIs 0.92 to 3.24). Depression was non-significantly improved in theexercise therapy group compared to the control group at 12 weeks (WMD-0.58, 95% CIs -2.08 to 0.92).Participants receiving exercise therapywere less fatigued than those receiving the antidepressant fluoxetine at12 weeks (WMD -1.24, 95% CIs -5.31 to 2.83). Participants receiving thecombination of the two interventions, exercise + fluoxetine, were lessfatigued than those receiving exercise therapy alone at 12 weeks,although again the difference did not reach significance (WMD 3.74, 95%CIs -2.16 to 9.64).When exercise therapy was combined with patienteducation, those receiving the combination were less fatigued than thosereceiving exercise therapy alone at 12 weeks (WMD 0.70, 95% CIs -1.48 to2.88).REVIEWERS' CONCLUSIONS: There is encouraging evidence that some patientsmay benefit from exercise therapy and no evidence that exercise therapymay worsen outcomes on average. However the treatment may be lessacceptable to patients than other management approaches, such as rest orpacing. Patients with CFS who are similar to those in these trials shouldbe offered exercise therapy, and their progress monitored. Further highquality randomised studies are needed.


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## Guest (Aug 16, 2004)

As you know, MM, I have been officially diagnosed with FMS but not CFS even though I do suffer from chronic fatigue, and I wanted to support your post by saying that I agree that moderate exercise does help. I know it hurts, and if overdone can cause excessive fatigue... even nausea for me.... but a certain amount seems to be beneficial.Evie


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