Karmisholt, Katrine, Gøtzsche, Peter C · Danish medical bulletin · 2005
This review looked at whether physical activity helps prevent disease in people who already have certain health conditions. The researchers examined 17 high-quality studies published between 1998-2004. Physical activity was helpful for some conditions like heart disease and arthritis, but did not show benefits for chronic fatigue syndrome, depression, or several other conditions.
This study is directly relevant to ME/CFS because it explicitly evaluated whether exercise interventions improve outcomes in people with chronic fatigue syndrome and found no demonstrated benefit. This evidence counters assumptions that physical activity is universally therapeutic and highlights the need for disease-specific rather than generic exercise recommendations.
This study does not prove that physical activity is harmful in ME/CFS—only that existing evidence does not show it helps. The review does not assess post-exertional malaise (PEM) or define what type, intensity, or duration of physical activity was tested. It also does not establish why ME/CFS differs from conditions where exercise was beneficial.
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
Karmisholt, Katrine & Gøtzsche, Peter C (2005). Physical activity for secondary prevention of disease. Systematic reviews of randomised clinical trials.. Danish medical bulletin. https://pubmed.ncbi.nlm.nih.gov/16009053/
BibTeX
@article{mecfsatlas-karmisholt-2005-physical-activity,
author = {Karmisholt, Katrine and Gøtzsche, Peter C},
title = {Physical activity for secondary prevention of disease. Systematic reviews of randomised clinical trials.},
journal = {Danish medical bulletin},
year = {2005},
note = {PubMed: 16009053},
url = {https://www.mecfsatlas.com/evidence/karmisholt-2005-physical-activity},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/karmisholt-2005-physical-activity
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