Windthorst, Petra, Mazurak, Nazar, Kuske, Marvin et al. · Journal of psychosomatic research · 2017 · DOI
This study tested two different treatments for ME/CFS in 28 women: heart rate variability biofeedback (HRV-BF), which uses technology to help regulate breathing and nervous system activity, and graded exercise training (GET), which involves gradually increasing physical activity. Both treatments reduced fatigue, but they helped in different ways—HRV-BF appeared to help more with mood and depression, while GET seemed to improve physical functioning more.
This study provides preliminary evidence that different therapeutic approaches to ME/CFS may target distinct symptom domains—mental versus physical health—suggesting that personalized or combined treatment strategies could optimize patient outcomes rather than using one-size-fits-all interventions.
This pilot study does not establish that HRV-BF or GET is definitively effective for ME/CFS, as the small sample size (n=28) and lack of control group limit statistical power and generalizability. The findings do not clarify which treatment is superior overall, only that they may have different profiles of benefit. Long-term effectiveness beyond the 5-month follow-up period remains unknown.
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
Windthorst, Petra, Mazurak, Nazar, Kuske, Marvin, Hipp, Arno, Giel, Katrin E, Enck, Paul, et al. (2017). Heart rate variability biofeedback therapy and graded exercise training in management of chronic fatigue syndrome: An exploratory pilot study.. Journal of psychosomatic research. https://doi.org/10.1016/j.jpsychores.2016.11.014
BibTeX
@article{mecfsatlas-windthorst-2017-heart-rate,
author = {Windthorst, Petra and Mazurak, Nazar and Kuske, Marvin and Hipp, Arno and Giel, Katrin E and Enck, Paul and Nieß, Andreas and Zipfel, Stephan and Teufel, Martin},
title = {Heart rate variability biofeedback therapy and graded exercise training in management of chronic fatigue syndrome: An exploratory pilot study.},
journal = {Journal of psychosomatic research},
year = {2017},
doi = {10.1016/j.jpsychores.2016.11.014},
note = {PubMed: 28107894},
url = {https://www.mecfsatlas.com/evidence/windthorst-2017-heart-rate},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/windthorst-2017-heart-rate
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