Kujawski, Sławomir, Cossington, Jo, Słomko, Joanna et al. · Journal of clinical medicine · 2020 · DOI
This study looked at why some people with ME/CFS could complete a gradual exercise programme while others had to stop. Researchers measured several body functions—like nervous system activity, reaction time, and heart rate—before the programme started. They found that people whose bodies showed higher stress responses and slower reaction times were more likely to drop out of the exercise programme.
Exercise recommendations for ME/CFS are controversial, and this study provides objective physiological markers that may help identify which patients are at risk of being unable to tolerate structured exercise programmes. Understanding these predictive factors could guide more personalised exercise approaches and prevent harm from inappropriate exercise prescriptions.
This study does not prove that high sympathetic drive or slow reaction time *causes* exercise intolerance; these are only associations in a small sample. It does not establish whether these physiological traits are inherent limitations or reflect ME/CFS disease severity. The findings may not generalise to other exercise intensities, durations, or delivery formats, nor do they address whether non-completion represents true inability versus other barriers (e.g., social, psychological, logistical).
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
Kujawski, Sławomir, Cossington, Jo, Słomko, Joanna, Dawes, Helen, Strong, James Wl, Estevez-Lopez, Fernando, et al. (2020). Prediction of Discontinuation of Structured Exercise Programme in Chronic Fatigue Syndrome Patients.. Journal of clinical medicine. https://doi.org/10.3390/jcm9113436
BibTeX
@article{mecfsatlas-kujawski-2020-prediction-discontinuation,
author = {Kujawski, Sławomir and Cossington, Jo and Słomko, Joanna and Dawes, Helen and Strong, James Wl and Estevez-Lopez, Fernando and Murovska, Modra and Newton, Julia L and Hodges, Lynette and Zalewski, Paweł},
title = {Prediction of Discontinuation of Structured Exercise Programme in Chronic Fatigue Syndrome Patients.},
journal = {Journal of clinical medicine},
year = {2020},
doi = {10.3390/jcm9113436},
note = {PubMed: 33114704},
url = {https://www.mecfsatlas.com/evidence/kujawski-2020-prediction-discontinuation},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/kujawski-2020-prediction-discontinuation
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