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==Exercise therapy in CFS review== The Cochrane review on [[Graded exercise therapy|exercise therapy]] (graded exercise therapy) in [[chronic fatigue syndrome]] has frequently been cited as a justification for this controversial intervention in patients with ME/CFS.<ref name="mrc2018">{{Cite web | url = https://mrc.ukri.org/news/browse/criticism-of-the-pace-trial/ | title = Criticism of the PACE trial | last = Medical Research Council|first = | date = 2018-08-28 | website = mrc.ukri.org|language=en|access-date=2019-03-05 | authorlink = Medical Research Council|archive-date=|url-status=}}</ref><ref name="Barry2017">{{Cite journal | last = Barry|first = Benjamin K. | last2 = Lloyd | first2 = Andrew R. | last3 = Bogg | first3 = Tina | last4 = Cassar | first4 = Joanne | last5 = Casson | first5 = Sally M. | last6 = Sandler | first6 = Carolina X. | last7 = Li | first7 = Sophie H. | date = 2017-05-01 | title = Randomised controlled trial of online continuing education for health professionals to improve the management of chronic fatigue syndrome: a study protocol | url = https://bmjopen.bmj.com/content/7/5/e014133 | journal = BMJ Open|language=en | volume = 7 | issue = 5| pages = e014133|doi=10.1136/bmjopen-2016-014133|issn=2044-6055|pmid=28495811}}</ref> The review, however, has been criticized for having methodological flaws,<ref name="vink2018">{{Cite journal | last = Vink|first = Mark | last2 = Vink-Niese | first2 = Alexandra | date = Jul 2018 | title = Graded exercise therapy for myalgic encephalomyelitis/chronic fatigue syndrome is not effective and unsafe. Re-analysis of a Cochrane review | url = https://www.ncbi.nlm.nih.gov/pubmed/30305916 | journal = Health Psychology Open | volume = 5 | issue = 2 | pages = 2055102918805187|doi=10.1177/2055102918805187|issn=2055-1029|pmc=|pmid=30305916|quote= | authorlink = Mark Vink | author-link2 = Alexandra Vink-Niese|via=}}</ref> and a formal complaint by a patient outlined significant flaws, leading to further revisions.<ref name="CourtneyComplaint" /> Cochrane revised the exercise therapy for CFS review six times since 2015, publishing a final version with altered conclusions in October 2019.<ref name="exercisetherapy2Oct2019" /> Cochrane stated that the review is "substantially out of date and in need of updating."<ref name="Cochrane2019Note">{{Cite web | last = | first = | url = https://www.cochranelibrary.com/content?templateType=information&urlTitle=/cdsr/doi/10.1002/14651858.CD003200.pub8&doi=10.1002/14651858.CD003200.pub8&type=cdsr&contentLanguage= | website = Cochrane Database of Systematic Reviews|language=en | title = Exercise therapy for chronic fatigue syndrome {{!}} Information | date = Oct 2, 2019|access-date=2021-12-27}}</ref> On May 21, 2020, Cochrane made a new announcement committing to a full review: <blockquote>"In the last nine months, this Cochrane Review has been modified by the review’s authors and evaluated by independent peer reviewers and editors. It now places more emphasis on the limited applicability of the evidence to definitions of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) used in the included studies, the long-term effects of exercise on symptoms of fatigue, and acknowledges the limitations of the evidence about harms that may occur...<br /> [T]oday we are committing to the production of a full update of this Cochrane Review, beginning with a comprehensive review of the protocol, which will be developed in consultation with an independent advisory group that we intend to convene."<ref name="ednote2Oct2019"/>
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