Review Effects of traditional Chinese mind-body exercises for patients with chronic fatigue syndrome: A systematic review and meta-analysis 2023 Kong et al

Indeed. Any properly qualified charlatan knows it has to be a chicken suit.

 

The Cochrane Larun et al review gets a shout out - spreading disinformation across the globe.

Tai Chi - the movement practice that looks like a slowed down version of a martial art
Qigong - as far as I can work out, tai chi is actually a sort of qigong. It seems to be a general term for exercise combined with breathing and a meditative state, and covers a wide range of forms.
If anyone has better knowledge, by all means tell us.

 

tldr: they did all the things:

including this:

but not this:

 

There's potentially a lot of studies out there.

A large number of the studies were excluded because it was determined that they did not study chronic fatigue syndrome, although I haven't seen anything about how they identified chronic fatigue syndrome.

 

13 studies, 8 of them with a publication date in 2015 or later (and therefore new studies since Cochrane Larun et al's search).

Outcomes are mostly surveys, short followup times. There are a few molecules measured e.g. neuropeptide y.

All studies except one judged to be of low risk of bias...

 

When you have an active control (CBT, moxibustion, point application), the exercise interventions have similar results. We've heard that before.

Long term followup

12 weeks is hardly long term followup, but it looks like only two studies did it, or at least only two studies reported on some of their outcomes. One reported results for fatigue, sleep, anxiety and depression; one reported results for anxiety and depression. All versus a passive control.

The recording of adverse events seems pretty bad. Only one study recorded a range of adverse events, and they were of the muscle ache, knee pain and dizziness variety. One other study recorded mild muscle ache but it was not distinguishable from the adverse effects record in the CBT arm.

 

So, here we go, for the discussion:

So, you can either take the endorsement of this multi-study review with all the bells and whistles of the Cochrane tools and processes but no objective outcomes. It finds moderate certainty evidence that the exercise modalities reduce fatigue in the short term compared to people given no treatment. It finds that you can give people with CFS all sorts of treatments including these ones and the short term benefit is all about the same. There's little evidence at 12 weeks, but it is reported that there is low certainty evidence that these traditional exercise regimes help fatigue. And seemingly there is no evidence beyond 12 weeks.

Or you can pay heed to @alktipping's word of caution combined with the often hard-won community knowledge that exercise of any sort is not the answer to ME/CFS.

 

More from the discussion

this was written to criticise another team's effort at a meta-analysis, due to

I think they all have some more fundamental problems. There's no mention of dropouts in the paper, no exclusion of studies on the ground of an intolerable risk of bias.

And fair enough too. Cochrane seems to have rather negative feelings towards poorly-evidenced Chinese therapies; it seems to reserve its protectionist practices and promotion activities for poorly evidenced western mind-body therapies. Make pseudo-science accessible to all.
(This is not to criticise exercise of any cultural leaning. It's a good thing, we know that. It just does not fix ME/CFS and has a high risk of harming.)


They are trying harder than many reviews I have seen to encourage better studies

They mention the need for long-term outcomes and objective outcomes, although the type of objective outcomes they mention (immune function status) are horribly prone to cherry picking, with measures that aren't helpful quietly getting shelved. There's the usual note that 'we just need to tweak the offering, choose just the right sort of exercise for just the right intensity and time'.

 

Yeah, it doesn't seem that qigong is anything particularly mysterious, it's just exercise e.g.

Qigong is exercise; qigong applied to a patient group to improve symptoms is exercise therapy. There's no reason for Cochrane to say there have been no recent trials of exercise therapy.