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tomkindlon ,
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"Why does physical activity exacerbate symptoms in ME/CFS and long Covid patients?"

A second interesting article from Science Norway, this time including info on two-day CPETs & how deconditioning does not explain the findings.

https://www.sciencenorway.no/chronic-fatigue-syndrome-me-physical-activity/why-does-physical-activity-exacerbate-symptoms-in-me/cfs-and-long-covid-patients/2382080

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Photo of a woman in bed with her eyes closed “All activity, whether physical, cognitive, or emotional, depletes the little energy I have,” says Kari Cotton, 61, who has had ME for eight years. If it’s too much, she gets PEM. Then she can be bedridden for several days, with chills, tremors, pain, and sleep problems. You can read more about this in this article. (Photo: Private) Why does physical activity exacerbate symptoms in ME/CFS and long Covid patients? “It can resemble overtraining in athletes,” says Professor Nina Vøllestad.
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    • tomkindlon OP ,
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    Extract on post-exertional malaise from article


    @mecfs @longcovid

    Post-exertional malaise (PEM) Exercise-induced worsening of symptoms is a characteristic feature of ME/CFS. It has also been reported among some long Covid patients and people with fibromyalgia. The phenomenon is often referred to as PEM (post-exertional malaise). Some also call it PESE (post-exertional symptom exacerbation) or PENE (post-exertional neuroimmune exhaustion). PEM involves a worsening of symptoms after physical, mental, or emotional exertion that would not have caused problems before the illness. PEM can be triggered by cognitive, physical, emotional, or social activity. PEM can cause a wide range of symptoms. The most common are extreme fatigue, feeling like you have the flu, body aches, sleep disturbances, and cognitive problems like brain fog. The symptoms are often delayed and are typically worst 12 to 48 hours after the activity. They can last for days or even weeks. In the worst case, PEM can lead to long-term worsening of the illness.
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    • tomkindlon OP ,
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    Extract:
    “There is little evidence to suggest that poor fitness is the explanation for PEM – the characteristic worsening of symptoms following exertion – which in many cases does not involve physical
    activity at all …”

    @mecfs @longcovid

    All in all, there is little evidence to suggest that poor fitness is the explanation for PEM – the characteristic worsening of symptoms following exertion – which in many cases does not involve physical activity at all. Not a result of poor fitness “Physical inactivity itself does not cause PEM,” Wüst and his colleagues wrote about the patients they examined in their study. “PEM is a unique symptom in these diseases and is not the result of deconditioning,” David Systrom from Harvard Medical School said to the American radio channel National Public Radio (NPR). In a summary from 2023, Systrom and his colleagues write that poor fitness does not lead to the physical changes that they see in the bodies of ME/CFS and long Covid patients with PEM. Neither do the researchers that sciencenorway.no has spoken with believe that PEM can be explained by poor fitness. “This probably has nothing to do with deconditioning. It appears to be something the patients react to neuroendocrinologically, which makes the body respond differently after physical activity,” says Vøllestad. Kristian Sommerfelt is a paediatrician and senior physician at the Østfold Hospital Trust Kalnes and professor emeritus at the University of Bergen. (Photo: University of Bergen) Sommerfelt suggests that the illness' progression often indicates that PEM is not related to poor fitness due to long-term inactivity.
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