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Fatigue Exacerbation by Interval or Continuous Exercise in Chronic Fatigue Syndrome


Medicine & Science in Sports & Exercise: October 2016 - Volume 48 - Issue 10 - p 1875–1885
doi: 10.1249/MSS.0000000000000983
Clinical Sciences

Purpose: The objective of this study is to determine whether the typical exacerbation of symptoms in patients with chronic fatigue syndrome (CFS) after a bout of exercise differs between high-intensity interval training (HIIT) or continuous (CONT) aerobic exercise of the same duration and mechanical work.

Methods: Participants with specialist-diagnosed CFS performed two 20-min bouts of cycling in a randomized crossover study. The bouts were either moderate-intensity continuous (70% age-predicted HR maximum) or high-intensity interval exercise, separated by at least 2 wk. Self-report questionnaires capturing fatigue, the related symptoms, and actigraphy were collected across 2 d before and 4 d after the exercise. Comparisons between exercise bouts were made using paired sample t-tests.

Results: Fourteen moderately affected participants who were unable to work, but not bed bound, completed the study (nine female, 32 ± 10 yr, 67 ± 11 kg). Mechanical work was matched successfully between the exercise bouts (HIIT, 83,037, vs CONT, 83,348 J, P = 0.84). Mean HR (HIIT, 76% ± 5%, vs CONT, 73% ± 6% age-predicted HR maximum, P < 0.05) and RPE (6–20) in the legs (HIIT, 15.4 ± 1.4, vs CONT, 13.2 ± 1.2, P < 0.001) were higher for the interval compared with continuous exercise. Mean fatigue scores (0–10) were similar before each exercise challenge (HIIT, 4.5 ± 1.8, vs CONT, 4.1 ± 1.7, P = 0.43). Participants reported an increase in fatigue scores after both challenges (mean difference: HIIT, 1.0 ± 1.3, P < 0.01; CONT, 1.5 ± 0.7, P < 0.001), but these exacerbations in fatigue were not statistically or clinically different (P = 0.20).

Conclusions: High-intensity interval exercise did not exacerbate fatigue any more than continuous exercise of comparable workload. This finding supports evaluation of HIIT in graded exercise therapy interventions for patients with CFS.

1Fatigue Clinic, Lifestyle Clinic, School of Medical Sciences, University of New South Wales, Sydney, NSW, AUSTRALIA; 2Inflammation and Infection Research Centre, School of Medical Sciences, University of New South Wales, Sydney, NSW, AUSTRALIA; and 3Neuroscience Research Australia, University of New South Wales, Sydney, AUSTRALIA

Address for correspondence: Carolina Sandler, B.Sc., School of Medical Sciences, The University of New South Wales, Sydney, NSW, 2052 Australia; E-mail:

Submitted for publication January 2016.

Accepted for publication May 2016.

© 2016 American College of Sports Medicine