Wei, Zhenya, Wu, Heying, Cui, Chong et al. · Frontiers in neurology · 2025 · DOI
Researchers reviewed 13 studies involving 1,305 ME/CFS patients to see how exercise therapy affects fatigue. Exercise therapy did reduce fatigue overall, but the type of exercise mattered: traditional aerobic exercise was better for reducing overall tiredness, while a gentler practice called Qigong was better for mental fatigue. However, the researchers noted that more research is needed to fully understand whether these treatments are safe for ME/CFS patients.
This meta-analysis provides the most current systematic evidence on exercise therapy effectiveness for ME/CFS, addressing a critical gap since exercise recommendations remain controversial in this population. The finding that different exercise types benefit different fatigue dimensions could help personalize treatment approaches. The authors' cautionary note about safety is particularly important given historical concerns about exercise worsening symptoms in some ME/CFS patients.
This meta-analysis cannot establish causation or determine whether exercise actually treats ME/CFS's underlying mechanisms versus temporarily improving symptom reports. The study does not prove exercise is universally safe or appropriate for all ME/CFS patients, as the authors explicitly state safety evidence remains insufficient. Individual patient responses may vary considerably, and heterogeneity in study designs limits generalizability.
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
Wei, Zhenya, Wu, Heying, Cui, Chong, Wang, Zixu, Xiong, Huazhong, Song, Fujia, et al. (2025). Effectiveness and safety of exercise therapy in patients with myalgic encephalomyelitis/chronic fatigue syndrome: a meta-analysis.. Frontiers in neurology. https://doi.org/10.3389/fneur.2025.1681990
BibTeX
@article{mecfsatlas-wei-2025-effectiveness-safety,
author = {Wei, Zhenya and Wu, Heying and Cui, Chong and Wang, Zixu and Xiong, Huazhong and Song, Fujia and Ren, Jixiang},
title = {Effectiveness and safety of exercise therapy in patients with myalgic encephalomyelitis/chronic fatigue syndrome: a meta-analysis.},
journal = {Frontiers in neurology},
year = {2025},
doi = {10.3389/fneur.2025.1681990},
note = {PubMed: 41356241},
url = {https://www.mecfsatlas.com/evidence/wei-2025-effectiveness-safety},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/wei-2025-effectiveness-safety
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