Larun, Lillebeth, Brurberg, Kjetil G, Odgaard-Jensen, Jan et al. · The Cochrane database of systematic reviews · 2019 · DOI
This review looked at whether exercise therapy helps people with ME/CFS. Researchers found that exercise probably reduces tiredness compared to usual care, and may slightly improve physical function and sleep. However, the long-term benefits are unclear, and the evidence comparing exercise to other treatments like cognitive behavioural therapy is limited.
This systematic review provides the most comprehensive evidence synthesis on exercise therapy for ME/CFS to date. It is important because exercise remains a commonly recommended intervention for ME/CFS, yet the quality and strength of evidence supporting its effectiveness—and potential harms—remained unclear until this rigorous analysis.
This review does not prove that exercise is safe or beneficial for all ME/CFS patients, as the evidence on serious adverse reactions was very limited and based on few participants. It also does not establish whether findings apply to patients diagnosed using criteria other than the 1994 CDC or Oxford criteria, nor does it resolve whether structured exercise could worsen post-exertional malaise in individual patients. The high risk of bias in included trials means true effect sizes may differ from reported estimates.
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
Larun, Lillebeth, Brurberg, Kjetil G, Odgaard-Jensen, Jan, & Price, Jonathan R (2019). Exercise therapy for chronic fatigue syndrome.. The Cochrane database of systematic reviews. https://doi.org/10.1002/14651858.CD003200.pub8
BibTeX
@article{mecfsatlas-larun-2019-exercise-therapy,
author = {Larun, Lillebeth and Brurberg, Kjetil G and Odgaard-Jensen, Jan and Price, Jonathan R},
title = {Exercise therapy for chronic fatigue syndrome.},
journal = {The Cochrane database of systematic reviews},
year = {2019},
doi = {10.1002/14651858.CD003200.pub8},
note = {PubMed: 31577366},
url = {https://www.mecfsatlas.com/evidence/larun-2019-exercise-therapy},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/larun-2019-exercise-therapy
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