Jacobson, Eric · Journal of alternative and complementary medicine (New York, N.Y.) · 2011 · DOI
Structural Integration (SI) is a hands-on therapy that focuses on improving how your body moves and holds itself, rather than treating specific symptoms. This review looked at what we know about how SI might work—such as making muscles and connective tissues more flexible and improving how your nervous system processes movement and stress—and found that small studies have reported improvements in pain, movement, balance, and well-being in some conditions including chronic fatigue.
ME/CFS patients often experience post-exertional malaise and altered pain processing that may relate to nervous system dysfunction and movement dyscoordination. This review identifies theoretical mechanisms—particularly improved sensory processing and vagal tone—that could be relevant to ME/CFS pathophysiology, though current evidence is too preliminary to support clinical recommendations.
This review does not demonstrate that Structural Integration is effective for ME/CFS or any condition, as it summarizes only preliminary evidence from small, uncontrolled studies. The absence of rigorous randomized controlled trials means we cannot distinguish treatment effects from placebo response or natural recovery. No conclusions about causation or mechanism can be drawn from these preliminary data.
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
Jacobson, Eric (2011). Structural integration, an alternative method of manual therapy and sensorimotor education.. Journal of alternative and complementary medicine (New York, N.Y.). https://doi.org/10.1089/acm.2010.0258
BibTeX
@article{mecfsatlas-jacobson-2011-structural-integration,
author = {Jacobson, Eric},
title = {Structural integration, an alternative method of manual therapy and sensorimotor education.},
journal = {Journal of alternative and complementary medicine (New York, N.Y.)},
year = {2011},
doi = {10.1089/acm.2010.0258},
note = {PubMed: 21992437},
url = {https://www.mecfsatlas.com/evidence/jacobson-2011-structural-integration},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/jacobson-2011-structural-integration
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