An article published on Medscape last Friday (31.10.25), reports that a review of trials found no reliable evidence that graded exercise therapy (GET) benefits patients with ME/CFS — as most studies used criteria which did not include post-exertional malaise (PEM).
Miriam E. Tucker, Medscape
Summary
- A review found no reliable evidence that graded exercise therapy benefits people with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).
- Most studies on exercise for ME/CFS used outdated definitions that didn’t require post-exertional malaise (PEM) — the key symptom of the disease — meaning results may not apply to actual ME/CFS patients.
- The trials often relied on subjective self-reports instead of objective measures and poorly tracked adverse effects, raising concerns about data quality and patient safety.
- Current biological research shows people with PEM experience distinct immune and metabolic abnormalities, suggesting exercise could worsen symptoms.
- Updated US and UK guidelines now advise against graded exercise therapy, calling for better-designed studies that use accurate diagnostic criteria.
Read the article in full on Medscape – search Google using ‘Medscape – No Evidence Supports Using Graded Exercise‘
MEA Comment
This is a useful reminder to all health professionals that graded exercise therapy (GET) should not be prescribed to people with ME/CFS because there is no sound evidence of efficacy and there is also extensive patient evidence that GET can cause serious harm.
Fortunately, here in the UK the 2021 NICE guideline (1.11.9 & Box 4) on ME/CFS makes this very clear.
However, outside the the UK, GET is still being prescribed to people with ME/CFS.
Dr Charles Shepherd,
Trustee and Hon. Medical Adviser to the ME Association,
Member of the 2018-2021 NICE guideline on ME/CFS committee,
Member of the 2002 Chief Medical Officer's Working Group on ME/CFS
