Boruch, Alex, Branchaw, Grace, O'Connor, Patrick J et al. · Current topics in behavioral neurosciences · 2024 · DOI
This review examined how physical activity affects fatigue in people with ME/CFS and similar long-term illnesses, compared to healthy people. In healthy adults, exercise usually makes people feel more energized, but in people with ME/CFS and related conditions, exercise often makes fatigue worse. Short-term exercise programs show small improvements in fatigue for healthy people, but little to no improvement for those with these chronic illnesses.
This study highlights a critical distinction: exercise recommendations that benefit healthy people may worsen outcomes for ME/CFS patients. Understanding why ME/CFS responds differently to exercise is essential for developing safe, personalized treatment approaches and avoiding potentially harmful activity prescriptions based on general population guidelines.
This review does not establish the specific biological mechanisms causing exercise intolerance in ME/CFS or whether any form of physical activity could eventually be beneficial. It also does not prove that exercise is harmful long-term for all CMI patients, as data on longer-term interventions and individual variability remain limited. Correlation between activity and fatigue worsening does not establish causation at the mechanistic level.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Boruch, Alex, Branchaw, Grace, O'Connor, Patrick J, & Cook, Dane B (2024). Physical Activity and Fatigue Symptoms: Neurotypical Adults and People with Chronic Multisymptom Illnesses.. Current topics in behavioral neurosciences. https://doi.org/10.1007/7854_2024_502
BibTeX
@article{mecfsatlas-boruch-2024-physical-activity,
author = {Boruch, Alex and Branchaw, Grace and O'Connor, Patrick J and Cook, Dane B},
title = {Physical Activity and Fatigue Symptoms: Neurotypical Adults and People with Chronic Multisymptom Illnesses.},
journal = {Current topics in behavioral neurosciences},
year = {2024},
doi = {10.1007/7854_2024_502},
note = {PubMed: 39037494},
url = {https://www.mecfsatlas.com/evidence/boruch-2024-physical-activity},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/boruch-2024-physical-activity
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