Vink, Mark, Vink-Niese, Alexandra · Health psychology open · 2018 · DOI
This study re-examined a major 2017 review that had concluded graded exercise therapy (GET) was helpful for ME/CFS. The researchers found serious problems with that review's methods and conclusions. They concluded there is no reliable evidence that GET works for ME/CFS, and safety concerns were not properly reported in the original trials.
This analysis challenges a widely-cited recommendation for ME/CFS treatment and raises concerns about how trials are evaluated and reported. For patients, it supports concerns about GET safety and effectiveness, potentially influencing clinical guidelines and treatment decisions.
This study does not establish what effective treatments for ME/CFS might be, nor does it prove GET causes harm in all patients. It also does not evaluate other exercise-based or rehabilitation approaches that might differ from GET. The re-analysis is limited to critiquing existing trial data rather than conducting new patient assessments.
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
Vink, Mark & Vink-Niese, Alexandra (2018). Graded exercise therapy for myalgic encephalomyelitis/chronic fatigue syndrome is not effective and unsafe. Re-analysis of a Cochrane review.. Health psychology open. https://doi.org/10.1177/2055102918805187
BibTeX
@article{mecfsatlas-vink-2018-graded-exercise,
author = {Vink, Mark and Vink-Niese, Alexandra},
title = {Graded exercise therapy for myalgic encephalomyelitis/chronic fatigue syndrome is not effective and unsafe. Re-analysis of a Cochrane review.},
journal = {Health psychology open},
year = {2018},
doi = {10.1177/2055102918805187},
note = {PubMed: 30305916},
url = {https://www.mecfsatlas.com/evidence/vink-2018-graded-exercise},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/vink-2018-graded-exercise
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