title: [Exercise therapy for patients with chronic fatigue syndrome].
abstract: BACKGROUND
  Post-exertional fatigue is the main symptom of chronic fatigue syndrome. Evidence-based guidelines recommend cognitive behavioral therapy and graded exercise therapy. In this article, we present a systematic review of outcome studies and discuss procedures for individualized exercise therapy for patients with chronic fatigue syndrome.
  
  
  METHODS
  The effect of exercise treatment for these patients was assessed through a meta-analysis of randomized controlled trials which were identified through a systematic literature review. Effect size was calculated for fatigue, pain and health-related quality of life and the GRADE system was used to estimate the documentation level (quality of the evidence and strength of the recommendations).
  
  
  RESULTS
  Seven outcome studies were included in the meta-analysis. They demonstrated that exercise therapy seems to reduce fatigue, but the results were inconclusive for pain and health-related quality of life. The documentation level is moderate to low and further research can modify the results in positive or negative directions. We found no indications of adverse effects of individualized exercise programs which were adapted to the patients' functional level and included adequate follow-up.
  
  
  CONCLUSIONS
  In light of general knowledge about positive health effects of exercise therapy and empirically based hypotheses about disease mechanisms in chronic fatigue syndrome, we conclude that further research has a high probability of confirming recommendations on individualized exercise therapy to these patients.
authors.affiliation: Allmennmedisinsk forskningsenhet i Bergen, Uni helse, Kalfarveien 31, Bergen. ela@nokc.no
authors.forename: Lillebeth
authors.initials: L
authors.lastname: Larun
authors.forename: Kirsti
authors.initials: K
authors.lastname: Malterud
mesh_terms: D019317:Evidence-Based Medicine; D005081:Exercise Therapy; D015673:Fatigue Syndrome, Chronic / Q000523:psychology / Q000534:rehabilitation / Q000628:therapy*; D006801:Humans; D017063:Outcome Assessment, Health Care; D010147:Pain Measurement; D017410:Practice Guidelines as Topic; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome