Purpose
A prominent symptom of Myalgic Encephalomyelitis, Chronic Fatigue Syndrome, or Systemic Exertion Intolerance Disease (ME/CFS/SEID) is persistent fatigue that is worsened by physical exertion. Here the population effect of a single bout of exercise on fatigue symptoms in people with ME/CFS/SEID was estimated and effect moderators were identified.
Methods
Google Scholar was systematically searched for peer-reviewed articles published between February 1991 and May 2015. Studies were included where people diagnosed with ME/CFS/SEID and matched control participants completed a single bout of exercise and fatigue self-reports were obtained before and after exercise. Fatigue means, standard deviations, and sample sizes were extracted to calculate effect sizes and the 95% CI. Effects were pooled using a random-effects model and corrected for small-sample bias to generate mean Δ. Multi-level regression modeling adjusted for nesting of effects within studies. Moderators identified a priori were diagnostic criteria, fibromyalgia comorbidity, exercise factors (intensity, duration, type) and measurement factors.
Results
Seven studies examining 159 people with ME/CFS/SEID met inclusion criteria, and 47 fatigue effects were derived. The mean fatigue effect was Δ = 0.73 (95% CI = 0.24, 1.23). Fatigue increases were larger for people with ME/CFS/SEID when fatigue was measured four or more hours after exercise ended rather than during or immediately after exercise ceased.
Conclusions
This preliminary evidence indicates that acute exercise increases fatigue in people with ME/CFS/SEID more than in control groups, but effects were heterogeneous between studies. Future studies with no-exercise control groups of people with ME/CFS/SEID are needed to obtain a more precise estimate of the effect of exercise on fatigue in this population.