Sisto, S A, LaManca, J, Cordero, D L et al. · The American journal of medicine · 1996 · DOI
Researchers tested how well women with ME/CFS could exercise compared to healthy controls by having them walk on a treadmill until exhaustion. Women with ME/CFS had lower aerobic fitness levels than healthy controls, but their hearts and lungs appeared to work normally. Importantly, the maximal exercise test did not cause a major flare-up of fatigue or other ME/CFS symptoms.
This study directly addresses whether people with ME/CFS can safely undergo maximal exercise testing and provides objective data on aerobic capacity in this population. The finding that maximal exercise testing did not cause major symptom exacerbation has implications for exercise research methodology and rehabilitation in ME/CFS patients.
This study does not establish whether reduced aerobic fitness is a primary cause of ME/CFS or a consequence of the illness. It also cannot determine whether progressive exercise training would be beneficial or harmful long-term, as the study only measured acute exercise responses. The small sample size and inclusion of only women limits generalizability to all ME/CFS populations.
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
Sisto, S A, LaManca, J, Cordero, D L, Bergen, M T, Ellis, S P, Drastal, S, et al. (1996). Metabolic and cardiovascular effects of a progressive exercise test in patients with chronic fatigue syndrome.. The American journal of medicine. https://doi.org/10.1016/s0002-9343(96)00041-1
BibTeX
@article{mecfsatlas-sisto-1996-metabolic-cardiovascular,
author = {Sisto, S A and LaManca, J and Cordero, D L and Bergen, M T and Ellis, S P and Drastal, S and Boda, W L and Tapp, W N and Natelson, B H},
title = {Metabolic and cardiovascular effects of a progressive exercise test in patients with chronic fatigue syndrome.},
journal = {The American journal of medicine},
year = {1996},
doi = {10.1016/s0002-9343(96)00041-1},
note = {PubMed: 8678084},
url = {https://www.mecfsatlas.com/evidence/sisto-1996-metabolic-cardiovascular},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/sisto-1996-metabolic-cardiovascular
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