Nijs, Jo, Vanherberghen, Katrien, Duquet, William et al. · Physical therapy · 2004
Many ME/CFS patients with pain avoid movement because they fear it will make them worse (a condition called kinesiophobia). This study tested whether this fear of movement actually relates to how much exercise patients can do or how disabled they are. Researchers found that fear of movement was common in ME/CFS patients, but surprisingly, it did not predict exercise capacity or activity limitations.
This finding challenges a common assumption that fear of movement significantly limits ME/CFS patients' physical capacity. If fear of movement is not the primary driver of exercise limitation in ME/CFS, it suggests researchers should investigate other mechanisms—such as post-exertional malaise or physiological deconditioning—to better understand activity limitation in this population.
This study does not prove that kinesiophobia never affects ME/CFS outcomes; it only shows lack of correlation in this specific sample. The cross-sectional design cannot establish causation or temporal relationships. The study also does not address whether kinesiophobia might be important in ME/CFS patients without widespread pain, or whether psychological interventions targeting fear of movement would or would not help.
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
Nijs, Jo, Vanherberghen, Katrien, Duquet, William, & De Meirleir, Kenny (2004). Chronic fatigue syndrome: lack of association between pain-related fear of movement and exercise capacity and disability.. Physical therapy. https://pubmed.ncbi.nlm.nih.gov/15283620/
BibTeX
@article{mecfsatlas-nijs-2004-chronic-fatigue,
author = {Nijs, Jo and Vanherberghen, Katrien and Duquet, William and De Meirleir, Kenny},
title = {Chronic fatigue syndrome: lack of association between pain-related fear of movement and exercise capacity and disability.},
journal = {Physical therapy},
year = {2004},
note = {PubMed: 15283620},
url = {https://www.mecfsatlas.com/evidence/nijs-2004-chronic-fatigue},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/nijs-2004-chronic-fatigue
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