Post-Exertional Symptom Exacerbation after Sub-Maximal Exercise in Individuals with [ME/CFS] and Post-Acute Sequelae of COVID-19, 2025, Berardi et al

[EndME]

Overall the authors conclusion seems to be: Exercise should be recommended as treatment for ME/CFS as long as it doesn't trigger PEM. But the PACE trial showed that even if you recruit a group of people that don't necessarily have PEM you don't get any worthwhile treatment outcomes. Wasn't it PACE authors themselves that suggested that all groups look more or less the same following treatment?

 

[Utsikt]

PEM and PESE are typically used as synonyms. I don't think one can critisise the authors for that.

I thought PESE was part or PENE, which is a concept that speculates far too much about the cause of the symptoms?

Regardless, they seem to think it means post-exercise-SE.

Maybe the additional 0 is a typo?

Might be. The supplementary file includes tracked changes in the pdf so the attention to detail isn’t great.

 

[EndME]

I thought PESE was part or PENE, which is a concept that speculates far too much about the cause of the symptoms?

Regardless, they seem to think it means post-exercise-SE.

Since they mention physical, cognitive, or emotional stressors as confounders for PESE they seem to be aware of some greater picture, despite their focus elsewhere.

If someone believes that something is anways just people with maladaptive thoughts then they probably have no reason to think that the cause of worsening has to be restricted to thinking one can only gets worse after exercise in the first place, because it's all just thoughts anyways.

 

[Utsikt]

Since they mention physical, cognitive, or emotional stressors as confounders for PESE they seem to be aware of some greater picture, despite their focus elsewhere.

But they do not mention it outside the limitations and did not even attempt to control it whatsoever. So they can’t think it’s very important.