Smakowski, Abigail, Adamson, James, Turner, Tracey et al. · Disability and rehabilitation · 2022 · DOI
This study looked at how graded exercise therapy (gradually increasing physical activity) helped ME/CFS patients who were treated at a specialist clinic in London. Researchers tracked patients' fatigue levels, physical ability, and ability to work and socialize over the course of treatment. The results showed that patients improved significantly, with fatigue decreasing and daily functioning improving by the end of treatment.
This study bridges the critical gap between clinical trials and real-world practice by demonstrating that GET does produce measurable improvements for ME/CFS patients in actual clinical settings. Understanding how treatment efficacy translates from controlled trials to everyday practice is essential for patients, clinicians, and healthcare systems making decisions about resource allocation and treatment options.
This study does not establish that GET is safe for all ME/CFS patients or determine which patient subgroups benefit most from treatment. The smaller effect sizes in routine practice compared to RCTs suggest that real-world outcomes may differ from trial conditions, and the study does not definitively explain why these differences exist. Additionally, without a control group, the study cannot distinguish between GET-specific benefits and natural recovery or other contextual factors.
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 →
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