Cochrane · systematic review · CD003200
Exercise therapy for chronic fatigue syndrome
Larun, L, Brurberg, KG, Odgaard-Jensen, J, et al. · Cochrane Database of Systematic Reviews · 2019 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
55
current version
GRADE rated
31
No studies
24
Included studies
NR
No studies 24 · 43.6%Ungraded 0 · 0%Very low 16 · 29.1%Low 12 · 21.8%Moderate 3 · 5.5%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyExercise therapy versus control for chronic fatigue syndrome
Population: men and women aged over 18 years with chronic fatigue syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
FatigueMeasured at end of treatment (12‐26 weeks) Exercise therapy vs control | no estimate extracted | 7 studies · 840 participants | Moderate Downgraded: risk of bias, inconsistency |
FatigueMeasured after 52‐70 weeks Exercise therapy vs control | no estimate extracted | 4 studies · 670 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Participants with serious adverse reactions Measured after 52 weeks Measured according to European Union Clinical Trials Directive by recording the number of serious reactions Exercise therapy vs control | RR 0.99 [0.14, 6.97] | 1 study · 319 participants | Very low Downgraded: risk of bias, imprecision |
Pain Measured at end of treatment Exercise therapy vs control | no estimate extracted | NR | No studies |
Pain intensity Measured after 52 weeks Exercise therapy vs control | no estimate extracted | 1 study · 43 participants | Very low Downgraded: risk of bias, imprecision |
Physical functioning Measured at end of treatment; 12‐24 weeks Exercise therapy vs control | no estimate extracted | 5 studies · 725 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Physical functioning Measured after 52‐70 weeks Exercise therapy vs control | no estimate extracted | 3 studies · 621 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Quality of Life (QoL) Measured at end of treatment Exercise therapy vs control | no estimate extracted | NR | No studies |
Quality of Life (QoL) Measured after 52 weeks Exercise therapy vs control | no estimate extracted | 1 study · 44 participants | Very low Downgraded: risk of bias, imprecision |
Depression Measured at end of treatment; 12‐26 weeks Exercise therapy vs control | no estimate extracted | 5 studies · 504 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Depression Measured after 52‐70 weeks Exercise therapy vs control | no estimate extracted | 4 studies · 654 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Sleep Measured at end of treatment, 12‐26 weeks Exercise therapy vs control | no estimate extracted | 2 studies · 323 participants | Low Downgraded: risk of bias, imprecision |
Sleep Measured after 52‐70 weeks Exercise therapy vs control | no estimate extracted | 3 studies · 610 participants | Low Downgraded: risk of bias, imprecision |
Exercise therapy versus psychological treatment for chronic fatigue syndrome
Population: men and women aged over 18 years with chronic fatigue syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Fatigue Measured at end of treatment, 24 weeks Exercise therapy vs psychological treatment | no estimate extracted | 1 study · 298 participants | Low Downgraded: risk of bias, imprecision |
Fatigue Measured after 52 weeks Exercise therapy vs psychological treatment | no estimate extracted | 2 studies · 351 participants | Moderate Downgraded: risk of bias |
Participants with serious adverse reactions Measured after 52 weeks Measured according to European Union Clinical Trials Directive by recording the number of serious reactions Exercise therapy vs psychological treatment | RR 0.67 [0.11, 3.96] | 1 study · 321 participants | Very low Downgraded: risk of bias, imprecision |
Pain intensity End of treatment Exercise therapy vs psychological treatment | no estimate extracted | NR | No studies |
Pain intensity Measured after 52 weeks Exercise therapy vs psychological treatment | no estimate extracted | 1 study · 43 participants | Very low Downgraded: risk of bias, imprecision |
Physical functioning Measured at end of treatment, 24 weeks Exercise therapy vs psychological treatment | no estimate extracted | 1 study · 298 participants | Low Downgraded: risk of bias, imprecision |
Physical functioning Measured after 52 weeks Exercise therapy vs psychological treatment | no estimate extracted | 2 studies · 348 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Quality of Life (QoL) Exercise therapy vs psychological treatment | no estimate extracted | NR | No studies |
Quality of Life (QoL) Measured after 52 weeks Measured on the Quality of Life Scale, 16‐112 points High score means better quality of life Exercise therapy vs psychological treatment | no estimate extracted | 1 study · 44 participants | Very low Downgraded: risk of bias, imprecision |
Depression Exercise therapy vs psychological treatment | no estimate extracted | NR | No studies |
Depression Measured after 52 weeks HADS depression score (0‐21 points) or Beck Depression Inventory‐II (0‐63 points) Low score means fewer symptoms Exercise therapy vs psychological treatment | no estimate extracted | 2 studies · 331 participants | Moderate Downgraded: risk of bias |
Sleep Exercise therapy vs psychological treatment | no estimate extracted | NR | No studies |
Sleep Measured after 52 weeks Jenkins Sleep Scale, 0‐20 points Low score means better sleep Exercise therapy vs psychological treatment | no estimate extracted | 1 study · 287 participants | Low Downgraded: risk of bias, imprecision |
Exercise therapy versus adaptive pacing therapy for chronic fatigue syndrome
Population: men and women aged over 18 years with chronic fatigue syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Fatigue Measured at end of treatment, 24 weeks Exercise therapy vs adaptive pacing therapy | no estimate extracted | 1 study · 305 participants | Low Downgraded: risk of bias, imprecision |
Fatigue Measured at end of treatment, 52 weeks Exercise therapy vs adaptive pacing therapy | no estimate extracted | 1 study · 307 participants | Low Downgraded: risk of bias, imprecision |
Participants with serious adverse reactions Measured after 52 weeks Measured according to European Union Clinical Trials Directive by recording the number of serious reactions Exercise therapy vs adaptive pacing therapy | RR 0.99 [0.14, 6.97] | 1 study · 319 participants | Very low Downgraded: risk of bias, imprecision |
Pain End of treatment and long term Exercise therapy vs adaptive pacing therapy | no estimate extracted | NR | No studies |
Physical functioning Measured at end of treatment, 24 weeks Exercise therapy vs adaptive pacing therapy | no estimate extracted | 1 study · 305 participants | Low Downgraded: risk of bias, imprecision |
Physical functioning Measured at end of treatment, 52 weeks Exercise therapy vs adaptive pacing therapy | no estimate extracted | 1 study · 307 participants | Low Downgraded: risk of bias, imprecision |
Quality of Life (QOL) End of treatment and long term Exercise therapy vs adaptive pacing therapy | no estimate extracted | NR | No studies |
Depression Measured at end of treatment Exercise therapy vs adaptive pacing therapy | no estimate extracted | NR | No studies |
Depression Measured after 52 weeks HADS depression score, 0‐21 points Low score means fewer symptoms Exercise therapy vs adaptive pacing therapy | no estimate extracted | 1 study · 293 participants | Low Downgraded: risk of bias, imprecision |
Sleep Measured at end of treatment Exercise therapy vs adaptive pacing therapy | no estimate extracted | NR | No studies |
Sleep Measured after 52 weeks Jenkins Sleep Scale, 0‐20 points Low score means better sleep Exercise therapy vs adaptive pacing therapy | no estimate extracted | 1 study · 294 participants | Low Downgraded: risk of bias, imprecision |
Exercise therapy versus antidepressants for chronic fatigue syndrome
Population: men and women aged over 18 years with chronic fatigue syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
FatigueMeasured at end of treatment, 26 weeks Exercise therapy vs antidepressants | no estimate extracted | 1 study · 48 participants | Very low Downgraded: risk of bias, imprecision |
Fatigue Long term Exercise therapy vs antidepressants | no estimate extracted | NR | No studies |
Serious adverse reactions End of treatment and long term Exercise therapy vs antidepressants | no estimate extracted | NR | No studies |
Pain End of treatment and long term Exercise therapy vs antidepressants | no estimate extracted | NR | No studies |
Physical functioning End of treatment and long term Exercise therapy vs antidepressants | no estimate extracted | NR | No studies |
Qualityof Life (QOL) End of treatment and long term Exercise therapy vs antidepressants | no estimate extracted | NR | No studies |
Depression Measured at end of treatment, 26 weeks Exercise therapy vs antidepressants | no estimate extracted | 1 study · 48 participants | Very low Downgraded: risk of bias, imprecision |
Depression Long term Exercise therapy vs antidepressants | no estimate extracted | NR | No studies |
Sleep End of treatment and long term Exercise therapy vs antidepressants | no estimate extracted | NR | No studies |
Exercise therapy plus antidepressants versus antidepressants alone for chronic fatigue syndrome
Population: men and women aged over 18 years with chronic fatigue syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
FatigueMeasured at end of treatment, 26 weeks Exercise therapy plus antidepressants vs antidepressants alone | no estimate extracted | 1 study · 43 participants | Very low Downgraded: risk of bias, imprecision |
Fatigue Long term Exercise therapy plus antidepressants vs antidepressants alone | no estimate extracted | NR | No studies |
Serious adverse reactions End of treatment and long term Exercise therapy plus antidepressants vs antidepressants alone | no estimate extracted | NR | No studies |
Pain End of treatment and long term Exercise therapy plus antidepressants vs antidepressants alone | no estimate extracted | NR | No studies |
Physical functioning End of treatment and long term Exercise therapy plus antidepressants vs antidepressants alone | no estimate extracted | NR | No studies |
Quality of Life (QOL) End of treatment and long term Exercise therapy plus antidepressants vs antidepressants alone | no estimate extracted | NR | No studies |
Depression Measured at end of treatment, 26 weeks HADS depression score, 0‐21 points Lowest score is least symptoms Exercise therapy plus antidepressants vs antidepressants alone | no estimate extracted | 1 study · 44 participants | Very low Downgraded: risk of bias, imprecision |
Depression Long term Exercise therapy plus antidepressants vs antidepressants alone | no estimate extracted | NR | No studies |
Sleep End of treatment and long term Exercise therapy plus antidepressants vs antidepressants alone | no estimate extracted | NR | No studies |
Comparison
Population: males and females over 18 years of age with chronic fatigue syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Fatiguea: FS, Fatigue Scale (0 to 11 points) (end of treatment) | no estimate extracted | 1 study · 148 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Fatiguea: FS, Fatigue Scale (0 to 33 points) (end of treatment) | no estimate extracted | 3 studies · 540 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Fatiguea: FS, Fatigue Scale (0 to 42 points) (end of treatment) | no estimate extracted | 3 studies · 152 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Participants with serious adverse reactions | RR 0.99 [0.14, 6.97] | 1 study · 319 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Quality of Life (QOL) Scale (16 to 112 points) ( | no estimate extracted | 1 study · 44 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Physical functioning: SF‐36 subscale (0 to 100 points) (end of treatment) | no estimate extracted | 5 studies · 725 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Depression: HADS depression score (0 to 21 points) (end of treatment) | no estimate extracted | 5 studies · 504 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Sleep: Jenkins Sleep Scale (0 to 20 points) (end of treatment) | no estimate extracted | 2 studies · 323 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Self‐perceived changes in overall health (end of treatment) | RR 1.83 [1.39, 2.4] | 4 studies · 489 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Drop‐out (end of treatment) | RR 1.63 [0.77, 3.43] | 6 studies · 843 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Comparison
Population: males and females over 18 years of age with chronic fatigue syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Fatiguea: FS, Fatigue Scale (0 to 11 points) (end of treatment) | no estimate extracted | 1 study · 148 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Fatiguea: FS, Fatigue Scale (0 to 33 points) (end of treatment) | no estimate extracted | 3 studies · 540 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Fatiguea: FS, Fatigue Scale (0 to 42 points) (end of treatment) | no estimate extracted | 3 studies · 152 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Participants with serious adverse reactions | RR 0.99 [0.14, 6.97] | 1 study · 319 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Quality of Life (QOL) Scale (16 to 112 points) ( | no estimate extracted | 1 study · 44 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Physical functioning: SF‐36 subscale (0 to 100 points) (end of treatment) | no estimate extracted | 5 studies · 725 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Depression: HADS depression score (0 to 21 points) (end of treatment) | no estimate extracted | 5 studies · 504 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Sleep: Jenkins Sleep Scale (0 to 20 points) (end of treatment) | no estimate extracted | 2 studies · 323 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Self‐perceived changes in overall health (end of treatment) | RR 1.83 [1.39, 2.4] | 4 studies · 489 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Drop‐out (end of treatment) | RR 1.63 [0.77, 3.43] | 6 studies · 843 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Comparison
Population: males and females over 18 years of age with chronic fatigue syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Fatiguea: FS, Fatigue Scale (0 to 11 points) (end of treatment) | no estimate extracted | 1 study · 148 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Fatiguea: FS, Fatigue Scale (0 to 33 points) (end of treatment) | no estimate extracted | 3 studies · 540 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Fatiguea: FS, Fatigue Scale (0 to 42 points) (end of treatment) | no estimate extracted | 3 studies · 152 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Participants with serious adverse reactions | RR 0.99 [0.14, 6.97] | 1 study · 319 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Quality of Life (QOL) Scale (16 to 112 points) ( | no estimate extracted | 1 study · 44 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Physical functioning: SF‐36 subscale (0 to 100 points) (end of treatment) | no estimate extracted | 5 studies · 725 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Depression: HADS depression score (0 to 21 points) (end of treatment) | no estimate extracted | 5 studies · 504 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Sleep: Jenkins Sleep Scale (0 to 20 points) (end of treatment) | no estimate extracted | 2 studies · 323 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Self‐perceived changes in overall health (end of treatment) | RR 1.83 [1.39, 2.4] | 4 studies · 489 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Drop‐out (end of treatment) | RR 1.63 [0.77, 3.43] | 6 studies · 843 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Comparison
Population: males and females over 18 years of age with chronic fatigue syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Fatiguea: FS, Fatigue Scale (0 to 11 points) (end of treatment) | no estimate extracted | 1 study · 148 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Fatiguea: FS, Fatigue Scale (0 to 33 points) (end of treatment) | no estimate extracted | 3 studies · 540 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Fatiguea: FS, Fatigue Scale (0 to 42 points) (end of treatment) | no estimate extracted | 3 studies · 152 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Participants with serious adverse reactions | RR 0.99 [0.14, 6.97] | 1 study · 319 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Quality of Life (QOL) Scale (16 to 112 points) ( | no estimate extracted | 1 study · 44 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Physical functioning: SF‐36 subscale (0 to 100 points) (end of treatment) | no estimate extracted | 5 studies · 725 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Depression: HADS depression score (0 to 21 points) (end of treatment) | no estimate extracted | 5 studies · 504 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Sleep: Jenkins Sleep Scale (0 to 20 points) (end of treatment) | no estimate extracted | 2 studies · 323 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Self‐perceived changes in overall health (end of treatment) | RR 1.83 [1.39, 2.4] | 4 studies · 489 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Drop‐out (end of treatment) | RR 1.63 [0.77, 3.43] | 6 studies · 843 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Comparison
Population: males and females over 18 years of age with chronic fatigue syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Fatiguea: FS, Fatigue Scale (0 to 11 points) (end of treatment) | no estimate extracted | 1 study · 148 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Fatiguea: FS, Fatigue Scale (0 to 33 points) (end of treatment) | no estimate extracted | 3 studies · 540 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Fatiguea: FS, Fatigue Scale (0 to 42 points) (end of treatment) | no estimate extracted | 3 studies · 152 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Participants with serious adverse reactions | RR 0.99 [0.14, 6.97] | 1 study · 319 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Quality of Life (QOL) Scale (16 to 112 points) ( | no estimate extracted | 1 study · 44 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Physical functioning: SF‐36 subscale (0 to 100 points) (end of treatment) | no estimate extracted | 5 studies · 725 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Depression: HADS depression score (0 to 21 points) (end of treatment) | no estimate extracted | 5 studies · 504 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Sleep: Jenkins Sleep Scale (0 to 20 points) (end of treatment) | no estimate extracted | 2 studies · 323 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Self‐perceived changes in overall health (end of treatment) | RR 1.83 [1.39, 2.4] | 4 studies · 489 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Drop‐out (end of treatment) | RR 1.63 [0.77, 3.43] | 6 studies · 843 participants | Low Downgraded: risk of bias, imprecision, inconsistency |