Effectiveness and safety of exercise therapy in patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): A meta-analysis, 2025, Wei+

[forestglip]

Effectiveness and safety of exercise therapy in patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): A meta-analysis

Zhenya Wei, Heying Wu, Chong Cui, Zixu Wang, Huazhong Xiong, Fujia Song, Jixiang Ren

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Purpose
To promote the development of new therapies, we conduct a systematic review to evaluate the effectiveness and safety of exercise therapy for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).

Methods
PubMed, Web of Science, Embase, and Cochrane were searched for exercise therapy studies on ME/CFS up to March 2024. The literature was updated on June 7, 2025. The meta-analysis was performed using Stata 17.0 and RevMan 5.4.

Results
A total of 13 studies with 1,305 patients were analyzed.

Exercise therapy improved overall scores on fatigue scale-14 (FS-14) (MD=-0.48, 95% CI [-0.77, -0.19], p<0.001) and reduced total fatigue score (MD=-1.59, 95% CI [-2.44, -0.75], p<0.001). With multidimensional fatigue inventory (MFI-20), it showed a non-significant reduction in general fatigue (MD=-0.23, 95% CI [-0.55, 0.10], p=0.168).

Subgroup analysis showed that conventional exercise therapy mainly based on aerobic exercise was more effective in reducing total fatigue score (MD=-5.56, 95% CI [-8.74, -2.38], p=0.001) than Qigong (MD=-0.09, 95% CI [-0.41, 0.23], p<0.001). However, Qigong was more effective in reducing mental fatigue (MD=-0.82, 95% CI [-1.38, -0.26], p=0.004) compared with conventional exercise (MD=-3.40, 95% CI [-5.59, -1.21], p=0.002).

Conclusion
Evidence indicates that exercise therapy alleviates fatigue in ME/CFS patients, with varying effects across intervention types. Conventional aerobic exercise appears more effective for reducing overall fatigue than Qigong. However, Qigong shows greater benefits for reducing mental fatigue.

Given the current limitations, the safety of exercise therapy requires further evaluation, and additional high-quality RCTs are warranted to validate these findings.

Web | Frontiers in Neurology | Abstract only ahead of publication

 

[TiredMathematician]

(MD=-0.09, 95% CI [-0.41, 0.23], p<0.001).

How is p<0.001 when the 95% CI contains the null (0)?

However, Qigong was more effective in reducing mental fatigue (MD=-0.82, 95% CI [-1.38, -0.26], p=0.004) compared with conventional exercise (MD=-3.40, 95% CI [-5.59, -1.21], p=0.002).

How is a mean decrease of 0.82 a greater reduction than a mean decrease of 3.40? Am I missing something here?

 

[Utsikt]

No mention of the quality of the evidence in the abstract, so I’m going to assume it was quite terrible as usual..

 

[rvallee]

No mention of the quality of the evidence in the abstract, so I’m going to assume it was quite terrible as usual..

And 13 studies isn't even 10% of the studies that have been done this century, and there are at least as many before that. Given their odd promotion of Qigong, obviously they made a selective search with intent to promote Chinese medicine, which is also typical of evidence-based medicine trying to promote preferred treatment models.

The whole discipline is frankly a sad joke at this point. There isn't even anything to salvage, the entire concept of pragmatic trials and the evidence-based medicine need to be shut down for their own good and for the sake of human rights and dignity. It's truly only a sign of religion having essentially disappeared as a relevant force in society that the healing power of prayer isn't a prominent evidence-based intervention because it would absolutely be at least as 'effective' as anything ever produced under this garbage ideology.

 

[shak8]

Again, research from any university of Traditional Chinese Medicine is a nationalistic ploy (propaganda) more than science, unless specific chemicals are analyzed.

 

[rvallee]

Again, research from any university of Traditional Chinese Medicine is a nationalistic ploy (propaganda) more than science, unless specific chemicals are analyzed.

And yet utterly indistinguishable from 99% of Western rehabilitation research, just swapping TCM with lifestyle and exercise or whatever woo they happen to personally favour.

There's a lesson here somewhere. A duck-shaped duck-sounding lesson. Ah, well.