Sick, Johanna, König, Daniel · Healthcare (Basel, Switzerland) · 2023 · DOI
This review looked at seven studies involving 935 people with long-COVID symptoms who were not hospitalized during their initial infection. The studies found that exercise programs improved fitness, physical function, and reduced symptoms like shortness of breath, fatigue, and depression. The exercise was generally well-tolerated, but the authors urge caution for people with post-exertional malaise or ME/CFS, since these conditions may respond differently to exercise.
This review is critical for ME/CFS patients because it highlights an important distinction: while exercise may benefit some long-COVID patients, it explicitly warns against standard exercise protocols for those with post-exertional malaise and ME/CFS, conditions where exertion can worsen symptoms. This reinforces the need for personalized, cautious approaches in this vulnerable population rather than one-size-fits-all exercise recommendations.
This review does not establish causation or prove that exercise is universally safe for all PCS patients, particularly those with ME/CFS or PEM. The inclusion of only seven studies with potentially varying methodologies and the lack of large, rigorously controlled trials means efficacy and safety thresholds remain incompletely defined. The authors explicitly recommend further high-quality randomized controlled trials before firm conclusions can be drawn.
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
Sick, Johanna & König, Daniel (2023). Exercise Training in Non-Hospitalized Patients with Post-COVID-19 Syndrome-A Narrative Review.. Healthcare (Basel, Switzerland). https://doi.org/10.3390/healthcare11162277
BibTeX
@article{mecfsatlas-sick-2023-exercise-training,
author = {Sick, Johanna and König, Daniel},
title = {Exercise Training in Non-Hospitalized Patients with Post-COVID-19 Syndrome-A Narrative Review.},
journal = {Healthcare (Basel, Switzerland)},
year = {2023},
doi = {10.3390/healthcare11162277},
note = {PubMed: 37628475},
url = {https://www.mecfsatlas.com/evidence/sick-2023-exercise-training},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/sick-2023-exercise-training
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