Collin, Simon M, Norris, Tom, Deere, Kevin C et al. · Archives of disease in childhood · 2018 · DOI
This study followed children in England from age 11 to 16 years to see if being physically active at age 11 was connected to developing long-lasting, disabling fatigue later on. Children who were more physically active at age 11 had lower chances of developing chronic disabling fatigue by age 13, while those who spent more time sitting had higher chances. However, this connection weakened by age 16, suggesting the relationship may be more complicated than a simple cause-and-effect.
Understanding factors preceding ME/CFS onset, including activity patterns, could help identify at-risk adolescents and inform prevention or early intervention strategies. The study highlights that the relationship between physical activity and disabling fatigue is complex, suggesting that blanket activity recommendations may not apply uniformly and that bidirectional causality must be considered.
This study does not prove that increasing physical activity prevents ME/CFS onset, as reverse causation likely explains much of the association—fatigue symptoms at age 13 may have begun earlier and already reduced activity levels by age 11. The absence of association at age 16 suggests the relationship is not straightforward or durable, and observational data cannot establish causation without additional intervention evidence.
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 →
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