Exercise Intolerance in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: Guide to Management and Treatment



Document Type

Conference Presentation

Conference Title/Conference Publication

Biennial Meeting of the International Association for Chronic Fatigue Syndrome and Myalgic Encephalomyelitis


International Association for Chronic Fatigue Syndrome and Myalgic Encephalomyelitis


San Francisco, CA

Conference Dates

March 20, 2014- March 23, 2014

Date of Presentation



Post-exertional malaise (PEM) is a defining characteristic of CFS and a difficult problem to manage for persons with CFS. Our research group has utilized a serial graded exercise test protocol while measuring work output and performing cardiopulmonary analysis to more clearly define PEM. Cardiopulmonary analysis helps to identify cardiac, pulmonary, metabolic and workload-related abnormalities that contribute to PEM. These measurements, made across two days, provide objective documentation for changes in pathology associated with the disease and may be useful for clinical trials examining treatments for this illness. We have proposed the paradigm as a biomarker for PEM in CFS as they appear to relate directly to aerobic system impairment, autonomic dysregulation, and immune dysfunction. This session will also provide a case study based approach to the use of a cardiopulmonary test-retest for identification and quantification of PEM, and provide a conceptual framework for rehabilitation using energy conservation education and analeptic exercise therapy.

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