Fatigue

Sandra Utz et al. (2025) · Biomedicines

This prospective observational study followed 101 adults with long-standing fibromyalgia syndrome (FMS) through a two-week integrative inpatient stay in Bamberg, Germany, with no control group. FMS is a chronic condition marked by widespread pain, fatigue, sleep problems, anxiety and depression, and the authors describe it as the third most common rheumatic disease. The program was built on classical European naturopathy: water-based therapies and heat, exercise, plant-based nutrition or medical fasting, herbal remedies and mind-body practices such as relaxation. The question was whether such a combined approach would ease symptoms at discharge and six months later. Of 134 patients who joined (127 women, ages 22 to 80), 101 returned questionnaires on admission, at discharge and after six months. During the stay they took part in meditative movement, physical therapy, hydrotherapy, lectures and cooking classes, and some had whole-body heat sessions or a 5-day fast on under 300 kcal a day. Pain, fatigue, anxiety, depression, stress and quality of life were measured with standard questionnaires (such as the HADS for anxiety and depression and the MFI-20 for fatigue) and compared over time with repeated-measures statistics. Overall pain intensity dropped from 71.5 to 63.0 on a 0-100 scale at discharge (a moderate effect, dz = 0.62) and was still lower at six months (64.4). Current pain fell sharply during the stay (6.56 to 4.37 out of 10) but crept back to 5.96 at six months. Fatigue improved from 71.1 to 63.3 and then partly returned (68.0). Anxiety and depression scores each fell by roughly 2.5 points at discharge and were still lower than baseline at six months. Stress and feelings of helplessness improved mainly after discharge, and mental quality of life rose between discharge and follow-up. Patients who fasted kept their pain gains at six months (p = 0.006), whereas non-fasters did not (p = 0.062), although this difference was borderline (interaction p = 0.050) and not randomised. The results come from an uncontrolled, single-centre sample in which a quarter of the participants did not complete the six-month questionnaire, so the changes cannot be attributed to the program alone. More than half the patients reported obstacles to continuing the methods at home, such as lack of time and exhaustion. The authors call for randomised trials with long-term follow-up and propose a follow-up day-clinic programme to help consolidate the learned self-management skills and everyday routines.

Lolita Rapolienė et al. (2026) · BMC complementary medicine and therapies

This multicenter randomized controlled trial of 243 analyzed adults in Lithuania explored whether a short course of balneotherapy, a spa-based therapy using mineral water, therapeutic mud and salt, eases stress, anxiety and depression. Balneotherapy has a long tradition in European spa towns and is increasingly discussed as a complementary approach to stress-related mental health problems. The researchers wanted to know whether an 11-day standardized program works, whether adding a nature walk or an inpatient stay changes the results, and whether benefits last six months. Adults aged 18 to 65 who rated their stress as moderate to high were assigned to one of four groups: outpatient balneotherapy (64 people), outpatient balneotherapy plus nature therapy (63), an inpatient balneotherapy stay (64), or a no-treatment control group (52). The daily program combined a pool session with light exercise, a warm mineral water bath, a 20-minute sapropel mud wrap and 25 minutes of salt therapy. Questionnaires measured stress, depression, anxiety, fatigue, sleep and daily functioning, and saliva samples tracked the stress hormone cortisol, at baseline, right after treatment, and after 3 and 6 months. Right after treatment, people in all three spa groups reported clear improvements. Stress intensity dropped by about 2.6 points on a 10-point scale (p < 0.001), and depression scores fell by 10.7 to 12.5 points on an 80-point scale (p < 0.001), compared with a 1.3-point change in the control group (p = 0.253, no real change). Anxiety, fatigue and sleep problems improved too: fatigue fell by 4.1 to 5.1 points on the 10-50 Fatigue Assessment Scale (p < 0.001) while the control group did not change (p = 0.775), sleep quality rose by about 2 points on a 10-point scale (p < 0.001), and cortisol fell significantly in two of the three groups. Many gains were still present at six months, strongest after the inpatient stay. About 15% of participants had mild skin reactions to the mineral water, and no serious adverse events occurred. The authors suggest balneotherapy could be a safe complementary option for stress. Important limits apply: the paper reports mainly within-group changes rather than direct group comparisons, controls received no treatment, participants knew what they were getting, many people dropped out by six months, spa resources differed by center, and some questionnaires were not formally validated in Lithuanian. The control group also reported lower stress intensity (-1.18 points, p < 0.001), which shows that part of the improvement occurred without treatment. Larger, longer trials are recommended.

Hong Xu et al. (2024) · Menopause (New York, N.Y.)

This meta-analysis pooled 11 randomized trials testing whether mind-body exercise programs, including tai chi, yoga, Pilates, qigong, and mindfulness-based stress reduction (MBSR, an 8-week meditation and gentle-movement program), help women going through perimenopause or postmenopause, a life stage marked by declining estrogen that can weaken bones, disrupt sleep, and affect mood. These practices pair physical movement with controlled breathing and present-moment attention, offering a non-drug alternative for women wary of hormone therapy's cancer-risk profile. The review combined 11 trials from six countries, involving just over 1,000 women, comparing mind-body exercise groups against women who continued their normal daily activities without a structured exercise program. The trials varied widely, from 6-week programs to a full year, and used five different practices, so results were combined statistically using methods that account for this variety. Across the pooled data, mind-body exercise meaningfully helped on every measure studied: bone density improved (drawing on Pilates and tai chi trials), sleep quality improved (drawing on Pilates, yoga, qigong, and MBSR trials), and both anxiety and depression symptoms dropped substantially (also drawing on that same four-practice group), while fatigue eased too. The anxiety and depression improvements were the largest effects seen, though the studies contributing to them varied considerably in their findings (a statistical marker called heterogeneity was high), meaning some trials showed much bigger benefits than others. Taken together, the findings support mind-body exercise as a safe, reasonable option for managing the physical and emotional challenges of the menopause transition, giving women another evidence-based choice beyond hormone therapy. Because the analysis pooled several different practices together rather than testing each one separately with its own effect size, it shows that mind-body exercise as a category helps, without pinpointing exactly how much benefit comes from any one specific practice like yoga versus tai chi. The individual trials were also generally small and only partially blinded, since exercise programs are hard to disguise from participants.

Qing Li et al. (2025) · Journal of occupational health

This randomized crossover trial studied 30 Japanese men, average age 63, who were at risk of developing chronic obstructive pulmonary disease (COPD) — a common lung condition that narrows airways and makes breathing harder over time, and one of the world's leading causes of death. Each man spent one day forest bathing (Shinrin-yoku, the Japanese practice of mindfully immersing yourself in a forest) in a cypress forest, and another day walking a similar distance through a nearby city, in random order — so each person acted as their own comparison. Both walks covered the same distance at the same gentle pace under the guidance of a certified forest therapist, and participants avoided alcohol and ate the same meals throughout the 3-day trip. Researchers measured inflammation markers and oxygen levels in the blood before and after each walk, checked blood-oxygen saturation with a fingertip sensor, and had participants complete standard questionnaires about breathing symptoms, sleep quality, mood, and fatigue. Forest bathing lowered several inflammation markers (CRP, IL-6, and α1-antitrypsin) significantly more than the city walk did, and raised blood-oxygen saturation, while the city walk produced no such oxygen improvement. COPD-related breathing symptoms dropped significantly after forest bathing but stayed about the same after the city walk. Sleep quality improved across most measures after forest bathing, and mood scores showed less anger, confusion, depression, and anxiety, with people feeling notably more energetic than after the city walk. Fatigue and physical discomfort also eased more after time in the forest. Both walks used the same amount of physical effort (confirmed by matched blood-lactate levels), meaning the extra benefits of the forest walk likely came from the forest environment itself — its cleaner air, plant-released aromatic compounds (phytoncides), and calming, multisensory setting — rather than simply from walking. In people at risk of COPD, these results suggest that spending a day in a forest, walking gently and mindfully, may ease inflammation, improve breathing-related symptoms, and boost mood and sleep more than an equivalent walk in the city. Forest bathing is not a treatment for COPD; the authors caution that diagnosed COPD calls for medical supervision and flat, easy trails. The study is small (30 men) and tested only two single days, so it can't yet say whether these benefits last with regular practice or apply to women or other age groups.

Norka Ulloa Del Carpio et al. (2024) · Frontiers in pharmacology

This 2024 review pulled together the science on maca (Lepidium meyenii), an Andean root long eaten as food and used as a traditional remedy. Maca's chemical makeup varies with the plant's ecotype, growing conditions, and processing, giving rise to a complex mix of bioactive compounds called macamides, macaenes, and glucosinolates. Rather than running one new experiment, the authors gathered evidence from lab studies, animal research, and human clinical trials to map out what science currently knows, and does not yet know, about maca's effects and safety. Because this is a literature review rather than a single study, there is no one group of participants or one experimental design to describe. Instead, the authors drew on a mix of test-tube studies, rodent experiments, and human trials identified across the maca research, including safety data submitted for the United States Pharmacopeia's evaluation of maca as a dietary ingredient for the National Formulary, covering root powder, gelatinized powder, and various purified extracts sold as supplements. The review's central finding is that maca appears to act as an adaptogen (a substance that helps the body handle stress) by influencing the hypothalamus-pituitary-adrenal axis (the body's central stress-response system), likely through macamide compounds working via serotonin and cannabinoid-receptor pathways. Lab and animal studies point to neuroprotective, anti-inflammatory, and antioxidant effects, including in models of prostate enlargement and lung and liver inflammation. In humans, the review describes maca research as concentrated on sexual health, with reported improvements in sexual desire, erectile function, and general wellbeing in men, plus some evidence for easing menopausal symptoms in women and improving physical performance, though the review does not provide the specific numbers behind these findings. Safety testing found generally low toxicity, though a small number of people reported side effects such as stomach upset, headache, and irritability, and rare reports of vaginal bleeding or a manic episode. The authors are candid that inconsistent study designs, doses, and treatment lengths across the maca research make results hard to compare directly, and they call for more standardized studies to pin down maca's mechanisms and confirm its benefits before firmer guidance can be offered. This review is best read as a map of where maca's promising leads are, especially sexual health and neuroprotection, rather than as proof of any specific effect on any one condition.

Dilek Yildirim et al. (2025) · Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer

This single-blind randomized controlled trial with 100 hospitalized adults explored whether inhaling lavender essential oil could ease two of the most disruptive symptoms of chemotherapy for blood cancer patients: fatigue and poor sleep. Fatigue here means a persistent, whole-body exhaustion that isn't relieved by rest and that chemotherapy drugs are known to intensify, while sleep quality captures how deep, continuous, and restorative a night's sleep actually is rather than just its duration. Lavender oil, extracted from a hybrid of two Mediterranean Lavandula species, is inhaled rather than ingested, working through its scent's effect on the brain's limbic system rather than any drug-like mechanism. Fifty adults with hematological cancers (multiple myeloma, leukemias, lymphomas) receiving chemotherapy in an Istanbul hospital were assigned to inhale two drops of lavender oil from a shoulder-pinned sponge for 20 minutes each night before bed, for five consecutive nights; another 50 received unscented saline the same way. Neither group knew which oil they were smelling. Fatigue was scored with the 22-item Piper Fatigue Scale and sleep with the six-item Richards-Campbell Sleep Questionnaire, both completed at baseline and again the morning after the fifth night. By night six, the lavender group's overall sleep score was meaningfully higher than the saline group's (70.80 vs. 59.16 out of 100, p = 0.001 — lavender users reported deeper, less interrupted sleep), with clear advantages in sleep depth, time to fall asleep, and number of awakenings. Fatigue told the same story in reverse: the lavender group's fatigue score dropped to 4.54 versus 5.51 in the control group (p = 0.001, lower is better), with the steepest improvements in the subscales measuring fatigue's effect on daily activities, physical sensations, and mental clarity. A statistical model combining lavender use and sleep score explained about 17% of the variation in how fatigued patients felt (R² = 0.171, p < 0.001) — a modest but real share, meaning sleep and scent worked together rather than independently. One subscale, emotional response to fatigue, improved but didn't quite reach statistical significance (p = 0.052). For hematology-oncology nurses, this points to an inexpensive, side-effect-free option — no adverse events were reported — that can be added to nightly care without special training or equipment. The trial only tracked five nights, so whether the benefit holds up over a full chemotherapy course is unknown, and the researchers grouped all blood cancer types together rather than testing whether effects differ by diagnosis. Larger, longer trials are needed before lavender aromatherapy becomes a standard recommendation rather than a promising adjunct.

Yolanda Nadal-Nicolás et al. (2020) · International journal of environmental research and public health

This randomized controlled trial with 24 women asked whether hands-on massage therapy can move the needle on fibromyalgia — the chronic condition that combines widespread muscle pain with fatigue, unrefreshing sleep, and mood struggles. Researchers in Alicante, Spain recruited women aged 47 to 59 with rheumatologist-confirmed fibromyalgia affecting the neck and upper back, then randomized them to real treatment or a convincing placebo. The real treatment was manual therapy with moderate finger pressure on the back of the neck and upper back — fifteen minutes, twice a week, for four weeks, growing gradually firmer as each patient tolerated. The placebo was clever: an ultrasound machine applied to the same area for the same time, but switched off and used without gel, so participants experienced an equally plausible clinical ritual. Pain, fatigue, sleep, anxiety, and mood were measured before and after the month of treatment. Pain responded decisively. The manual therapy group's pain scores dropped by 4.2 points from baseline (p<0.001 — a large within-group effect of 2.07), and after treatment they sat 2.9 points below the placebo group (p=0.044, a moderate between-group effect of 0.59). Everything else stayed flat: fatigue, sleep quality, anxiety, and mood showed no significant improvement over placebo. An interesting side note - fatigue and poor sleep moved together (R=0.411), as did pain and anger-hostility scores (R=0.436), hinting at how fibromyalgia symptoms interlock. For women with fibromyalgia, this trial offers a practical, specific prescription: gentle-to-moderate pressure massage on the neck and upper back, twice weekly, genuinely reduces pain beyond the placebo effect — but on this evidence it should be expected to help pain, not the full fibromyalgia symptom cluster. The trial was small (24 analyzed), dropout hit the placebo arm harder, and all participants were women from one region, so larger trials are needed before firmer conclusions.

Mahendra Kumar Trivedi et al. (2024) · Neuropsychopharmacology reports

This 2023 randomized controlled trial investigated the effects of remote biofield energy therapy on cognitive and motor functions in adults with perceived neuropsychological problems. Biofield energy therapy is a non-pharmacological intervention that utilizes the energy surrounding and permeating the human body to enhance healing and well-being. The study involved 114 participants aged 20 to 55 years, who were randomly assigned to three groups: a control group, a sham control group, and a biofield intervention group. Cognitive and motor functions were assessed using the NIH Toolbox at baseline (day 0), day 90, and day 180. Results indicated that the biofield intervention group experienced significant improvements in language function (p < 0.0001), working memory (p < 0.0001), and episodic memory (p < 0.0001) scores compared to both the control and sham control groups. Additionally, significant enhancements were observed in locomotion, standing balance, dexterity, grip strength, and muscle endurance (p < 0.05 to p < 0.0001). No adverse effects were reported, suggesting that remote biofield energy therapy is a safe and effective non-invasive intervention for improving cognitive and motor functions in adults with neuropsychological impairments. However, this study had limitations, including a small sample size and the need for further research to validate these findings across diverse populations and settings. Larger randomized controlled trials are necessary to establish the efficacy and mechanisms of biofield energy therapy in clinical practice.

Bernie Garrett et al. (2021) · Nursing open

This 2021 rapid evidence assessment examined ten years of research on Therapeutic Touch (TT), one of the most widely practiced energy healing methods in nursing. TT practitioners hold their hands near — but not on — a patient's body, aiming to sense and rebalance the human biofield (a proposed energy field surrounding the body, related to concepts like qi and prana in traditional systems). Developed in 1972 within nursing, TT is still taught in nursing schools today, so two researchers set out to answer a direct question: how well does the recent evidence actually hold up? The reviewers screened seven research databases for every clinical TT study published between January 2009 and March 2020, following PRISMA systematic-review guidelines. From 3,290 records they identified 21 qualifying studies — 15 randomized controlled trials among them — covering 1,302 patients from premature infants to adults in their 90s, in settings from cancer care to post-surgical recovery. Each study was scored for evidence quality and risk of bias using standard appraisal tools. On the surface the results look remarkable: 18 of 21 studies reported benefits — less pain, less anxiety, better sleep, reduced nausea. But quality told a different story. Over 70% of the studies scored the minimum possible evidence rating, and only 4 of 21 had a low risk of bias — and those four stronger studies all found no difference between TT and control treatments (meaning the positive results came almost entirely from the weakest research). No study reported any adverse effects, so safety was not a concern. The review's picture of TT: it appears safe and many participants find it relaxing, but there is currently no high-quality evidence it works better than placebo or other relaxation approaches, and sessions can cost around $120/hour. The reviewers recommend that research first validate whether the biofield can be reliably detected and measured — foundational work that biofield science is actively pursuing — before more clinical trials are run.

Mahendra Kumar Trivedi et al. (2024) · Health psychology research

This randomized, placebo-controlled, double-blind study provides evidence on the effectiveness of distant biofield energy healing for psychological and mental health-related symptoms. The study involved 114 participants (55 male, 59 female) who exhibited one or more psychological symptoms, such as anxiety, depression, and cognitive impairment. Participants were divided into three groups: a biofield intervention group, a control group, and a sham control group. The biofield intervention group received two sessions of distant energy healing, while the other groups received similar treatments to control for baseline responses. Results indicated that the biofield intervention group experienced significant improvements in psychological symptoms, with a p-value of less than 0.0001, suggesting a strong statistical significance. This means that the improvements observed were unlikely to be due to chance. Participants reported reductions in fatigue, sleep disturbances, anxiety, and emotional trauma, among other symptoms. Importantly, no adverse effects were reported in any of the groups throughout the trial, indicating that the biofield therapy was safe. These findings point to distant biofield energy healing as a possible complementary approach in mental health, on this study's evidence. However, it is essential to note that this study was conducted at a single center with a relatively small sample size, which may limit the generalizability of the results. Future research with larger, more diverse populations is necessary to confirm these findings and explore the mechanisms behind the observed effects. In summary, this study suggests distant biofield energy healing may improve mental health and overall quality of life measures; the authors frame it as a complement to conventional treatment.