Exercise Therapy for Chronic Fatigue Syndrome

January 4, 2017 in STSMPT

Chronic fatigue syndrome (CFS) is characterized by severe, disabling fatigue; musculoskeletal pain; sleep disturbances; headaches; reduced concentration; and impaired short-term memory. Current research is finding prevalence to be as high as 2.54 in 100 – much higher than previously thought.1 Multiple guidelines call for the prescription of exercise therapy as part of the treatment plan for chronic fatigue syndrome. This was bolstered in part by a 2004 Cochrane review concluding that exercise therapy has strong potential in CFS treatment, but that larger studies were needed to address the safety of the therapy. Such studies have been conducted, and an updated Cochrane review on exercise therapy for chronic fatigue syndrome was recently published.2


The current review includes eight randomized controlled trials including 1,518 patients. The authors conclude that exercise therapy tends to cause patients to feel less fatigued, have better sleep, have better physical function, and report greater self-perceived general health. Exercise therapy for chronic fatigue syndrome commonly involves graded exercise characterized by a baseline achievable activity goal, followed by negotiated, incremental increases. There were no serious adverse events. The studies tended to use different scales, but for example, one study found a mean before and after difference in fatigue of 6.06 points on a 0 to 11 scale. Interventions ranged from 12 to 26 weeks. Control groups included usual care, relaxation, flexibility, cognitive behavioral therapy, supportive listening, pacing, and pharmacological treatment.




  1. Reeves W, Jones J, Maloney E, et al. Prevalence of chronic fatigue syndrome in metropolitan, urban, rural, Georgia. Popul Health Metr. 2007; 5:5.
  2. Larun L, Bruberg K, Odgaard-Jensen J, Price J. Exercise therapy for chronic fatigue syndrome (Review). Cochrane Database Syst Rev. 2015; (2): CD003200.
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