Post-Exertional Symptom Exacerbation after Sub-Maximal Exercise in Individuals with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Post-Acute Sequelae of COVID-19
Berardi, Giovanni; Janowski, Adam; McNally, Samuel; Post, Andrew; Garg, Alpana; Sluka, Kathleen A.
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I think it would help PwME if we had a short questionnaire that does a good job of identifying postexertional malaise (PEM), the cardinal symptom of this illness. It could be useful in two ways:
1. Doctors, especially those in primary care, could use it to help diagnose people who have ME/CFS...
A brief, comprehensive measure of post-exertional malaise, Jason and Chee
https://www.explorationpub.com/Journals/ent/Article/1004116
Abstract
Aim: Post-exertional malaise (PEM) has been a challenging construct to measure, particularly with self-report instruments, which have the benefits of...
New CPET Guidelines: What They Mean for People with ME/CFS
The American College of Sports Medicine’s Guidelines for Exercise Testing and Prescription, for the first time, includes a section on ME/CFS. ACSM is a leading authority on exercise science, and these guidelines serve as a foundational...
Link to published paper here
Preprint:
Heightened innate immunity may trigger chronic inflammation, fatigue and post-exertional malaise in ME/CFS
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is characterized by unexplained fatigue, post-exertional malaise (PEM), and cognitive...
I thought it would be helpful to post a link to the DePaul University web page with their symptom questionnaires:
https://csh.depaul.edu/about/centers-and-institutes/ccr/myalgic-encephalomyelitis-cfs/Pages/measures.aspx
Copy of Facebook post by Leonard Jason:
From the DePaul Group:
Are you 18 or older? Do you experience Post-Exertional Malaise? Or are you a member of the general population interested in contributing to research?
We are conducting a brief online survey as part of a research study focused on...
I am currently going through a pretty bad PEM episode (it's actually the first time I realise I have PEM; I used to call it 'a setback').
One of the symptoms is insomnia/sleep disturbances (trouble falling asleep and staying asleep). It makes sense to me that better quality sleep would support...
Abstract
Post-exertional malaise (PEM) is a defining symptom of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), yet its molecular underpinnings remain elusive.
This study investigated the temporal–longitudinal DNA methylation changes associated with PEM using a structured two-day...
I've never heard of this, but a quick forum search on 'fever PEM' brought up this from last Thursday (my bolding):
That's a really big surprise to me.
Worth a thread of its own or a poll?
PEM is generally the main cause of disability in ME/CFS and it is typically delayed with respect to the activity that triggered it.
It seems possible that PEM is closely related to maintenance and restorative processes that occur in the body. More activity during the day would lead to more...
Exercise-Induced Symptom Exacerbation and Adverse Events in Moderate-to-Severe Traumatic Brain Injury
Gallow, Sara BPhysio; McGinley, Jennifer PhD; Olver, John MD, FAFRM; McKenzie, Dean PhD; Williams, Gavin PhD
Objective
To determine the incidence of exercise-induced symptom exacerbation and...
Full title: Fatigue, Interoplastic and Nociplastic Distress in Myalgic Encephalomyelitis / Chronic Fatigue Syndrome, Gulf War Illness and Chronic Idiopathic Fatigue
https://www.frontiersin.org/journals/neuroscience/articles/10.3389/fnins.2025.1530652/abstract
Myalgic Encephalomyelitis /...
Postorgasmic Illness Syndrome: Insights from Recent Literature on a Rare but Fascinating Disorder
Krystian Wdowiak, Agnieszka Maciocha & Julia Wąż
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Abstract
Post-orgasmic illness syndrome (POIS) is a rare condition characterised by flu-like and allergic symptoms that...
368 - Relation of Immune Profile to Exercise-Induced Pain and Fatigue in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Post-acute Sequelae of SARS-CoV-2 Infection
Giovanni Berardi, Adam Janowski, Samuel McNally, Gregorius Bernhard, Alpana Garg, Kathleen Sluka
Abstract
Individuals with...
Cerebral hemodynamics to acute exercise in Veterans with Gulf War Illness
Grace E. Branchaw
Committee Members:
Dr. Dane Cook, Chair
Dr. Jill Barnes
Dr. Jee-Seon Kim
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Introduction
Gulf War Illness (GWI) is a chronic multisymptom illness (CMI) affecting approximately one...
Physical Therapy Management of Postural Orthostatic Tachycardia Syndrome Using a Pacing-Forward Clinical Approach: A Case Report
Powers CD, Miranda NA, Davenport TE
Abstract
Objective: Postural Orthostatic Tachycardia Syndrome (POTS) is a form of autonomic dysfunction that affects hemodynamic...
https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2025.1534352/abstract
Background:
Post-exertional malaise (PEM) is a central feature of Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and has emerged as a prominent feature of Long COVID. The optimal clinical...
Wearable heart rate variability monitoring identifies autonomic dysfunction and thresholds for post-exertional malaise in Long COVID
Twan Ruijgt, Anouk Slaghekke, Anneke Ellens, Kasper Janssen, Rob CI Wust
Objectives
Patients with Long COVID experience disabling fatigue, autonomic dysfunction...
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