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Energy envelope theory is a form of pacing that states patients should aim to stay within their "envelope" of available energy, and by avoiding exceeding their energy levels the worsening of symptoms after mental and physical exertion (post-exertional malaise) should reduce, allowing for "modest" gains in functioning as a result. [13]
The hallmark feature of ME/CFS is a worsening of symptoms after exertion, known as post-exertional malaise or post-exertional symptom exacerbation. [6] PEM involves increased fatigue and is disabling. It can also include flu-like symptoms, pain, cognitive difficulties, gastrointestinal issues, nausea, and sleep problems. [10]: 6
The Canadian Consensus Criteria require "post exertional malaise and/or [post exertional] fatigue" instead. [20] [21] [22] [18] [23] On the other hand, the older Oxford Criteria lack any mention of PEM, [24] and the Fukuda Criteria consider it optional. Depending on the definition of ME/CFS used, PEM is present in 60 to 100% of ME/CFS patients. [6]
The biggest differences between criteria are whether post-exertional malaise (PEM) is required, and the number of symptoms needed. [ 1 ] The pathology of ME/CFS is poorly understood, and it can be a difficult condition to diagnose because there is no standard test, many symptoms are non-specific, and because doctors and patients may be ...
A 2022 review commissioned by the CDC concluded that weak evidence suggests that GET has "small to moderate" benefits, including reduced fatigue, decreased depression and anxiety, and better sleep. It said these results are of uncertain relevance to people with severe ME/CFS, a diagnosis according to modern criteria, or post-exertional malaise.
Post-acute infection syndromes (PAISs) or post-infectious syndromes are medical conditions characterized by symptoms attributed to a prior infection. While it is commonly assumed that people either recover or die from infections, long-term symptoms—or sequelae —are a possible outcome as well. [ 1 ]
Post-exertional malaise (PEM) and exercise intolerance are common symptoms of post-acute infection syndromes. [5] Post-exertional malaise is a worsening of symptoms after minimal physical or mental activity, [ 6 ] and is a cardinal symptom of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). [ 7 ]
Central nervous system fatigue, or central fatigue, is a form of fatigue that is associated with changes in the synaptic concentration of neurotransmitters within the central nervous system (CNS; including the brain and spinal cord) which affects exercise performance and muscle function and cannot be explained by peripheral factors that affect muscle function.
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