A Cochrane review [Abstract] 1 included eight studies on the effectiveness of exercise therapy for chronic fatigue syndrome (CFS), with a total of 1518 subjects. All studies were conducted with outpatients diagnosed with 1994 criteria of the Centers for Disease Control and Prevention or the Oxford criteria, or both. Exercise therapy lasted from 12 to 26 weeks. Seven studies used variations of aerobic exercise therapy such as walking, swimming, cycling or dancing whilst one study used anaerobic exercise. Control groups consisted of passive control (eight studies, 971 patients; e.g. treatment as usual, relaxation, flexibility) or CBT (two studies, 351 participants), cognitive therapy (one study), supportive listening (one study), pacing (one study), pharmacological treatment (one study) and combination treatment (one study).
Exercise therapy compared with 'passive' control. Exercise therapy probably reduces fatigue at end of treatment (SMD −0.66, 95% CI −1.01 to −0.31; 7 studies, 840 participants). There is uncertainty if fatigue is reduced in the long term and about the risk of serious adverse reactions.
Exercise therapy compared with CBT. Exercise therapy may make little or no difference to fatigue at end of treatment (MD 0.20, 95% CI ‐1.49 to 1.89; 1 study, 298 participants), or at long‐term follow‐up (SMD 0.07, 95% CI −0.13 to 0.28; 2 studies 351 participants).
Exercise therapy compared with adaptive pacing. Exercise therapy may slightly reduce fatigue at end of treatment (MD −2.00, 95% CI −3.57 to −0.43; scale 0 to 33; 1 study, 305 participants; low‐certainty evidence) and at long‐term follow‐up (MD −2.50, 95% CI −4.16 to −0.84; scale 0 to 33; 1 study, 307 participants; low‐certainty evidence).
Comment: The quality of evidence is downgraded by imprecise results (limited study size for each comparison).
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