Summary of findings 4. Exercise therapy versus antidepressants for chronic fatigue syndrome.
| Exercise therapy versus antidepressants for chronic fatigue syndrome | ||||||
|
Patient or population: men and women aged over 18 years with chronic fatigue syndrome Intervention: exercise therapy Comparison: antidepressant (fluoxetine) Setting: outpatient | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | Number of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Antidepressant | Exercise | |||||
|
Fatigue
Measured at end of treatment, 26 weeks Measured with Chalder Fatigue Scale, 0‐42 Low score means less fatigue |
Mean fatigue score was 30.2 points | Mean fatigue score in the exercise group was 1.99 lower (8.28 lower to 4.30 higher) | 48 (1 study) | ⊕⊝⊝⊝ Very lowa,b | The effect of exercise therapy is uncertain | |
|
Fatigue Long term |
No available data for this outcome | No studies looked at fatigue at long term | ||||
|
Serious adverse reactions End of treatment and long term |
No available data for this outcome | No studies looked at serious adverse reactions | ||||
|
Pain End of treatment and long term |
No available data for this outcome | No studies looked at pain | ||||
|
Physical functioning End of treatment and long term |
No available data for this outcome | No studies looked at physical functioning | ||||
|
Qualityof Life (QOL) End of treatment and long term |
No available data for this outcome | No studies looked at quality of life | ||||
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Depression Measured at end of treatment, 26 weeks Measured with HADS depression score, 0‐21 points Low score means fewer symptoms |
Mean depression score was 7.32 points | Mean depression score in the exercise group was 0.15 points higher (2.41 higher to 2.11 lower) | 48 (1 study) | ⊕⊝⊝⊝ Very lowa,b | The effect of exercise therapy on depression is uncertain | |
|
Depression Long term |
No available data for this outcome | No studies looked at depression | ||||
|
Sleep End of treatment and long term |
No available data for this outcome | No studies looked at sleep | ||||
| *The basis for the assumed risk (e.g. median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; HADS: Hospital Anxiety and Depression Scale; QoL: quality of life; RR: risk ratio; SF‐36: Short Form 36; SMD: standardised mean difference | ||||||
| GRADE Working Group grades of evidence. High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate; the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited; the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate; the true effect is likely to be substantially different from the estimate of effect. | ||||||
aRisk of bias (certainty downgraded by ‐2): risk of performance and attrition bias. bImprecission (certainty downgraded by ‐2): confidence interval encompass potential benefits and harms. One study with few participants.