Sick, Johanna, Steinbacher, Verena, Kotnik, Daniel et al. · European journal of physical and rehabilitation medicine · 2025 · DOI
This study tested whether exercise could help people recover from long-lasting COVID-19 symptoms like fatigue and reduced fitness. Sixty-three people with post-COVID symptoms were divided into three groups: one did endurance exercise, one did mixed strength and endurance exercise, and one did no exercise. After 12 weeks, both exercise groups improved their heart fitness and felt less fatigued, while the non-exercise group showed less improvement.
For ME/CFS, this study is relevant as it rigorously tests whether exercise rehabilitation is safe and effective in a post-viral condition with similar fatigue symptoms. The study's explicit exclusion of patients with post-exertional malaise provides important safety data, and the finding that both exercise types improved outcomes supports non-pharmacological rehabilitation options for chronic post-viral illness.
This study does not prove that exercise rehabilitation is universally safe or effective for ME/CFS patients with post-exertional malaise, as such patients were excluded. It also does not establish which training modality is superior, and the improvements in HRQoL occurred in all groups including controls, suggesting placebo or natural recovery effects may play a role.
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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