Nijs, Jo, Aelbrecht, Senne, Meeus, Mira et al. · Disability and rehabilitation · 2011 · DOI
This review looked at multiple studies comparing people with ME/CFS to healthy people who don't exercise much. The research found that people with ME/CFS are generally less active in their daily lives and have weaker muscles than similar healthy controls. However, the studies disagreed somewhat about exercise capacity, though overall the evidence suggests people with ME/CFS have reduced ability to exercise.
This review provides evidence that ME/CFS involves measurable physical impairments beyond subjective fatigue, including reduced muscle strength and activity levels. Understanding these objective deficits helps validate the physiological nature of the condition and supports the need for appropriate rehabilitation strategies tailored to patients' actual capabilities.
This review does not establish whether the reduced muscle strength and activity are primary causes of ME/CFS or consequences of the disease. The conflicting data on exercise capacity means no definitive conclusion about this variable can be drawn. Additionally, this review cannot determine whether graded exercise therapy is safe or effective for CFS patients.
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, Aelbrecht, Senne, Meeus, Mira, Van Oosterwijck, Jessica, Zinzen, Evert, & Clarys, Peter (2011). Tired of being inactive: a systematic literature review of physical activity, physiological exercise capacity and muscle strength in patients with chronic fatigue syndrome.. Disability and rehabilitation. https://doi.org/10.3109/09638288.2010.541543
BibTeX
@article{mecfsatlas-nijs-2011-tired-being,
author = {Nijs, Jo and Aelbrecht, Senne and Meeus, Mira and Van Oosterwijck, Jessica and Zinzen, Evert and Clarys, Peter},
title = {Tired of being inactive: a systematic literature review of physical activity, physiological exercise capacity and muscle strength in patients with chronic fatigue syndrome.},
journal = {Disability and rehabilitation},
year = {2011},
doi = {10.3109/09638288.2010.541543},
note = {PubMed: 21166613},
url = {https://www.mecfsatlas.com/evidence/nijs-2011-tired-being},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/nijs-2011-tired-being
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