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Original research
Physical activity patterns among children and adolescents with mild-to-moderate chronic fatigue syndrome/myalgic encephalomyelitis
  1. Emma Solomon-Moore1,
  2. Russell Jago2,
  3. Lucy Beasant3,
  4. Amberly Brigden3,
  5. Esther Crawley3
  1. 1 Department for Health, University of Bath, Bath, UK
  2. 2 Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
  3. 3 Centre for Child and Adolescent Heath, University of Bristol Medical School, Bristol, UK
  1. Correspondence to Dr Emma Solomon-Moore; e.solomon-moore{at}


Objective Chronic fatigue syndromemyalgic encephalomyelitis (CFS/ME) is relatively common among children and adolescents; however, little is known about the physical activity levels and patterns of this population. The aim of this study was to examine the underlying patterns of physical activity among youth with mild-to-moderate CFS/ME. Cross-sectional associations between physical activity patterns with self-reported physical function, pain, fatigue, anxiety and depression were also examined.

Design Baseline cross-sectional data from the Managed Activity Graded Exercise iN Teenagers and pre-Adolescents randomised controlled trial.

Patients Children and adolescents (aged 8–17 years) diagnosed with mild-to-moderate CFS/ME who wore an accelerometer for at least three valid weekdays.

Analyses Latent profile analysis was used to identify physical activity patterns. Linear regression models examined associations between physical activity classes and self-reported physical function, pain, fatigue, anxiety and depression.

Results 138 children and adolescents (72.5% females) had valid data. Overall, participants did less than half the government recommended level of physical activity for children and adolescents, but not all were inactive: three (2.2%) did more than 1 hour of physical activity every day, and 13 (9.4%) achieved an average of 60 min a day. Adolescents (≥12 years) were less active than younger children, but activity levels were similar between genders. Three latent classes emerged from the data: ‘active’, ‘light’ and ‘inactive’. Compared with being ‘inactive’, being in the ‘light’ class was associated with greater self-reported physical function (10.35, 95% CI 2.32 to 18.38) and lower fatigue (−1.60, 95% CI −3.13 to −0.06), while being ‘active’ was associated with greater physical function (15.26, 95% CI 0.12 to 30.40), but also greater anxiety (13.79, 95% CI 1.73 to 25.85).

Conclusions Paediatricians need to be aware that physical activity patterns vary widely before recommending treatment.

Clinical trial registration ISRCTN registry: 23 962 803

  • chronic fatigue syndrome
  • physical activity
  • children
  • adolescents
  • latent profile analysis

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  • Contributors ES-M analysed and interpreted the data, drafted the initial manuscript and reviewed and revised the manuscript. RJ designed the physical activity measurement component of the study, supervised data analysis and critically reviewed the manuscript for important intellectual content. LB and AB designed the data collection instruments, collected data and reviewed and revised the manuscript. EC conceptualised and designed the study, supervised data collection and critically reviewed the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

  • Funding This work was supported by the National Institute for Health Research (Senior Research Fellowship, SRF-2013-06-013).

  • Disclaimer The views expressed in this publication are those of the authors and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health.

  • Competing interests All authors have completed the ICMJE uniform disclosure form at and declare: EC has received a Senior Research Fellowship from the National Institute for Health Research; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.

  • Patient consent for publication Not required.

  • Ethics approval Ethical approval was received from the NHS research ethics committee (Ref: 15/SW/0124).

  • Provenance and peer review Not commissioned; externally peer reviewed.