title: An abridged version of the Cochrane review of exercise therapy for chronic fatigue syndrome.
abstract: BACKGROUND
  Chronic fatigue syndrome (CFS), also known as myalgic encephalomyelitis (ME) is estimated to affect between 2 in 1000 and 2 in 100 adults depending on how diagnostic criteria are applied. Patients with CFS have long-lasting fatigue in addition to symptoms including muscle pain, concentration and sleep problems. These symptoms cause significant disability and distress to the people affected. This review is an update of a previous Cochrane review (2004) that showed that exercise therapy was a promising treatment for adults with CFS.
  
  
  OBJECTIVE
  The aim of this systematic review was to determine the effects of exercise therapy for patients with CFS.
  
  
  METHODS
  Systematic review.
  
  
  METHODS
  Health care settings.
  
  
  METHODS
  Participants over 18 years with a primary diagnosis of CFS, able to attend an outpatient clinic for exercise therapy, were included.
  
  
  METHODS
  We searched electronic databases, including SPORTDiscus, up to May 2014 using a comprehensive list of free-text terms for CFS and exercise. Randomized clinical trials from all health care settings with participants over 18 years with a primary diagnosis of CFS, able to attend an outpatient clinic for exercise therapy, were included. We have included 8 randomized clinical studies that reported data from 1518 participants. Seven studies used aerobic exercise such as walking, swimming, or cycling and one study used non-aerobic exercise. The exercise therapies lasted between 12 and 26 weeks. Meta-analysis was done when appropriate.
  
  
  RESULTS
  Exercise therapy was more effective at reducing fatigue than "passive" treatments or no treatment at end of treatment. Exercise therapy also had a positive effect on people's daily physical functioning, sleep quality and self-rated overall health. Nearly twice as many patients reported improvement self-rated overall health after exercise therapy (40 per 100) compared to standard treatment (22 per 100). The evidence was too sparse and/or of too low quality to conclude if exercise therapy has an effect on pain, quality of life, anxiety or depression. Exercise therapy was not found to worsen symptoms for people with CFS, while serious side effects were rare in all exercise and comparison groups.
  
  
  CONCLUSIONS
  Patiens with CFS may generally benefit from and feel less fatigued following exercise therapy, and no evidence suggests that exercise therapy may worsen outcomes.
  
  
  CONCLUSIONS
  Exercise therapy should be considered.
authors.affiliation: Primary Health Care Unit, Norwegian Knowledge Centre for the Health Services, Oslo, Norway - ela@nokc.no.
authors.forename: Lillebeth
authors.initials: L
authors.lastname: Larun
authors.forename: Jan
authors.initials: J
authors.lastname: Odgaard-Jensen
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Price
authors.forename: Kjetil G
authors.initials: KG
authors.lastname: Brurberg
mesh_terms: D000328:Adult; D005081:Exercise Therapy; D015673:Fatigue Syndrome, Chronic / Q000534:rehabilitation*; D006801:Humans