activity management in chronic fatigue syndrome

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  • randomised controlled trials (1,2) have shown the benefits of graded exercise in the treatment of chronic fatigue syndrome (CFS)
  • patients must not attempt too high a level of activity in case of relapse; this may lead to cycles of under and overactivity
  • activity must be increased by small tolerable increments

An individualised graded exercise programme which is delivered by a specialist where possible on a one to one basis for those with mild to moderate chronic fatigue syndrome (CFS)

  • this programme should initially start with low intensity exercise five days a week; following this the patient should be reviewed and if coping well with current activity levels the duration of exercise should be increased by 20% until the recommended level of 30 minutes exercise five times per week

    • once the patient is maintaining low intensity exercise for this time the intensity can then be increased slowly

    • review of progress should be often

    • vigorous exercise should be avoided as this can cause worsening of symptoms

During relapses exercise should be encouraged and where possible maintained at current states

Other resources for patients:

The ME Association

Action for ME

Contributors May 2012:

  • Dr Alethea Beck General Practitioner, Scotland
  • Dr Andrew Murray Sports and Exercise Medicine registrar, Scotland


Last edited 09/2021 and last reviewed 10/2021