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Jo Nijs
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=== Exercise limits === Nijs tested the use of exercise limits as a method to prevent post-exertional setbacks in ME/CFS patients.<ref name="Prevent2008" /> In a 2008 study, patients had to estimate the amount of exercise (walking) they could handle without triggering post-exertional malaise. Because it was assumed patients would overestimate their capacities, this amount was reduced by 25% if the person was having a good day and 50% if she was having a bad day. Another exercise limit involved a maximal heart rate (the heart rate that corresponded with a respiratory exchange ratio of 1 on an exercise test), that patients could not exceed during walking. Despite these precautions, patients still experienced a worsening of their symptoms after exertion. Because this relapse was short-lived, Nijs concluded that the exercise limits had worked and prevented important health status changes. Two years later the Nijs’ research group conducted a similar study. Twenty-two ME/CFS test-subjects had to perform a submaximal exercise test and a paced cycling regime. Patients could only do 75% (on a good day) or 50% (on a bad day) of what they thought they could handle without triggering a relapse, while a maximal heart rate was set at 80% of their anaerobe threshold. Once again, despite these precautions, patients experienced a worsening of their condition after both pacing and the submaximal exercise test, a deterioration that was not seen in healthy controls.<ref name="Unravelling2010" />
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