SYSTEMATIC REVIEW article
Front. Neurol.
Sec. Neurorehabilitation
Effectiveness and safety of exercise therapy in patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): A meta-analysis
Provisionally accepted
- 1Changchun University of Chinese Medicine, Changchun, China
- 2The Affiliated Hospital of Changchun University of Traditional Chinese Medicine, Changchun, China
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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.
Keywords: chronic fatigue syndrome, Exercise Therapy, effectiveness, Meta-analysis, Qigong
Received: 08 Aug 2025; Accepted: 10 Nov 2025.
Copyright: © 2025 Wei, Wu, Cui, Wang, Xiong, Song and Ren. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jixiang Ren, renjx2003@163.com
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