ArticleFrontiers in physiology2023
Post-exertional malaise in daily life and experimental exercise models in patients with myalgic encephalomyelitis/chronic fatigue syndrome.
Article in Frontiers in physiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
- Physical function and psychosocial outcomes after a 6-month self-paced aquatic exercise program for individuals with myalgic encephalomyelitis/chronic fatigue syndrome.European journal of applied physiology · 2025Trial
- Effects of a symptom-titrated exercise program on fatigue and quality of life in people with post-COVID condition - a randomized controlled trial.Scientific reports · 2024Trial
- Multimodal approach to identify neuropsychophysiological subgroups in myalgic encephalomyelitis/chronic fatigue syndrome and their relevance for rehabilitation: protocol for a mechanistic cross-sectional and longitudinal study.Brain, behavior, & immunity - health · 2026Article
- Chronic fatigue syndrome in nursing practice: a concept analysis.BMC nursing · 2026Article
- Myalgic Encephalomyelitis/Chronic Fatigue Syndrome diagnostic reporting in the 2021-2023 National Health Interview Survey.BMC public health · 2026Article
- Current status and future perspectives on the mechanistic and pathophysiological understanding of long COVID.Communications medicine · 2026Article
- Postexertional Symptom Exacerbation after Submaximal Exercise in Individuals with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Postacute Sequelae of COVID-19.Medicine and science in sports and exercise · 2026Article
- Pathophysiological, Translational, and Diagnostic Aspects of ME/CFS: A Focus on Skeletal Muscle Involvement.Diagnostics (Basel, Switzerland) · 2026Review
- Outcomes of Patients with Neurocognitive Symptoms Attending a Long COVID Clinic: A Longitudinal Cohort Study.Journal of general internal medicine · 2026Article
- Myalgic encephalomyelitis/chronic fatigue syndrome and fibromyalgia - overlap, differences, and emerging insights.Journal of translational medicine · 2026Review
- Glymphatic System Dysregulation as a Key Contributor to Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.International journal of molecular sciences · 2025Review
- Pursuing Reduction in Fatigue After COVID-19 via Exercise and Rehabilitation (PREFACER): a protocol for a randomised feasibility trial.BMJ open · 2025Article
- A Mixed-Methods Evaluation of a Post-COVID-Condition Rehabilitation and Recovery Intervention Delivered in a Football Club Community Trust.International journal of environmental research and public health · 2025Article
- Biomarkers of aging: from molecules and surrogates to physiology and function.Physiological reviews · 2025Review
- Public psychology and holistic approaches to prevention and treatment of depression.Frontiers in psychiatry · 2025Article
- Review
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Post-exertional malaise (PEM) is commonly recognized as a hallmark of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and is often used as one of several criteria for diagnosing ME/CFS. In this perspective paper we want to reflect on how PEM is understood, assessed, and evaluated in scientific literature, and to identify topics to be addressed in future research. Studies show that patients use a wide variety of words and concepts to label their experience of PEM in everyday life, and they report physical or mental exertions as triggers of PEM. They also report that PEM may have an immediate or delayed onset and may last from a few days to several months. When standardized exercise tests are used to trigger PEM experimentally, the exacerbation of symptoms has a more immediate onset but still shows a wide variability in duration. There are indications of altered muscular metabolism and autonomic nervous responses if exercise is repeated on successive days in patients with ME/CFS. The decreased muscular capacity appears to be maintained over several days following such controlled exercise bouts. These responses may correspond to patients' experiences of increased exertion. Based on this background we argue that there is a need to look more closely into the processes occurring in the restitution period following exercise, as PEM reaches the peak in this phase.
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