Statement about graded exercise therapy in the context of COVID-19

NICE is aware of concerns about graded exercise therapy (GET) for people who are recovering from COVID-19. NICE’s guideline on ME/CFS (CG53) was published in 2007, many years before the current pandemic and it should not be assumed that the recommendations apply to people with fatigue following COVID19.

The recommendations on graded exercise therapy in CG53 only apply to people with a diagnosis of ME/CFS as part of specialist care, and CG53 is clear that this should be part of an individualised, person-centred programme of care, with GET only recommended for people with mild to moderate symptoms.

As the guideline is currently being updated, it is possible that these recommendations may change. The evidence for and against graded exercise therapy is one of the important issues the guideline committee is considering.

NICE plans to consult on the updated guidance in November 2020. NHS England has recently published guidance on After-care needs of inpatients recovering from COVID-19 that includes advice on fatigue.

July 2020

ME Association: Clinician’s Letter to NICE Results in Statement on Graded Exercise for Post-Covid-Syndrome