ReviewHealth psychology open
Graded exercise therapy for myalgic encephalomyelitis/chronic fatigue syndrome is not effective and unsafe. Re-analysis of a Cochrane review.
Review in Health psychology open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 3 syntheses or guidelines pooled it, 36 citations in OpenAlex.
- Effectiveness of non-pharmacological therapies in complementary and alternative medicine on improving fatigue levels, oxidative stress, inflammation, and endocrine levels in animal models of chronic fatigue-like conditions: a systematic review and network meta-analysis.Frontiers in physiology · 2026Pooled it
- Effect of nonpharmacologic therapies on depressive symptoms in patients with chronic fatigue syndrome: a network meta-analysis.Frontiers in psychiatry · 2025Pooled it
- Long COVID and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)-A Systemic Review and Comparison of Clinical Presentation and Symptomatology.Medicina (Kaunas, Lithuania) · 2021Pooled it
- How does the Untire app alleviate cancer-related fatigue? A longitudinal mediation analysis.Psycho-oncology · 2022Trial
- Clinical Practice Guideline Recommendations for Post-Acute Sequelae of COVID-19.Infection & chemotherapy · 2025Review
- The PACE Trial's GET Manual for Therapists Exposes the Fixed Incremental Nature of Graded Exercise Therapy for ME/CFS.Life (Basel, Switzerland) · 2025Article
- Review
- Associations between physical activity, long COVID symptom intensity, and perceived health among individuals with long COVID.Frontiers in psychology · 2024Article
- A Review Article on Exercise Intolerance in Long COVID: Unmasking the Causes and Optimizing Treatment Strategies.Medical science monitor : international medical journal of experimental and clinical research · 2023Review
- The Updated NICE Guidance Exposed the Serious Flaws in CBT and Graded Exercise Therapy Trials for ME/CFS.Healthcare (Basel, Switzerland) · 2022Review
- Is It Useful to Question the Recovery Behaviour of Patients with ME/CFS or Long COVID?Healthcare (Basel, Switzerland) · 2022Review
- An Audit of UK Hospital Doctors' Knowledge and Experience of Myalgic Encephalomyelitis.Medicina (Kaunas, Lithuania) · 2021Article
- Moxibustion for Chronic Fatigue Syndrome: A Systematic Review and Meta-Analysis.Evidence-based complementary and alternative medicine : eCAM · 2021Review
- Beating cancer-related fatigue with the Untire mobile app: Results from a waiting-list randomized controlled trial.Psycho-oncology · 2020Article
- Beating Cancer-Related Fatigue With the Untire Mobile App: Protocol for a Waiting List Randomized Controlled Trial.JMIR research protocols · 2020Article
- Cognitive-behavioural therapy combined with music therapy for chronic fatigue following Epstein-Barr virus infection in adolescents: a feasibility study.BMJ paediatrics open · 2020Article
- Cognitive-behavioural therapy combined with music therapy for chronic fatigue following Epstein-Barr virus infection in adolescents: a randomised controlled trial.BMJ paediatrics open · 2020Article
- Work Rehabilitation and Medical Retirement for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Patients. A Review and Appraisal of Diagnostic Strategies.Diagnostics (Basel, Switzerland) · 2019Review
- The 'cognitive behavioural model' of chronic fatigue syndrome: Critique of a flawed model.Health psychology openArticle
- Cognitive behavioural therapy for myalgic encephalomyelitis/chronic fatigue syndrome is not effective. Re-analysis of a Cochrane review.Health psychology openReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The analysis of the 2017 Cochrane review reveals flaws, which means that contrary to its findings, there is no evidence that graded exercise therapy is effective. Because of the failure to report harms adequately in the trials covered by the review, it cannot be said that graded exercise therapy is safe. The analysis of the objective outcomes in the trials provides sufficient evidence to conclude that graded exercise therapy is an ineffective treatment for myalgic encephalomyelitis/chronic fatigue syndrome.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.