Exertion

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Exertion is the physical or perceived use of energy. Exertion traditionally connotes a strenuous or costly effort related to physical, muscular, philosophical actions, and work,[1] resulting in the generation of force, initiation of motion, or in the performance of work.[2] It often relates to muscular activity and can be quantified, empirically and by a measurable metabolic response.[3][4]

Exertion in ME/CFS[edit | edit source]

Only a minimal amount of exertion causes a marked increase in symptoms in people with ME/CFS[5], for instance chronic fatigue, chronic pain, cognitive dysfunction (e.g., brain fog), flu-like symptoms, muscle fatigability, unrefreshing sleep, and more, this is known as ME/CFS's hallmark symptom post-exertional malaise (PEM).[5][6][7] Depending on a patient's disease severity exertion capabilities is different and results in varying symptoms and degree of symptom severity.[8][9] Physical or mental exertion can trigger PEM.[10][11]

This post-exertional malaise is not limited to just musculoskeletal pain or fatigue, and does not occur in illnesses like depression, multiple sclerosis, or systemic lupus erthematosus or rheumatoid arthritis.[5]

Intolerance to exertion and exercise was built into the renaming of ME/CFS by the National Academy of Medicine (NAM) in the 2015 Institute of Medicine report (IOM report) where the name Systemic Exertion Intolerance Disease (SEID) was coined.[12][9]

Notable studies[edit | edit source]

2008, Can exercise limits prevent post-exertional malaise in chronic fatigue syndrome? An uncontrolled clinical trial.[5] - (Full text)

2014, The delayed fatigue effect in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)[11] - (Abstract)

2015, "Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome"[12] - IOM report - (Full text)

2018, Deconstructing post-exertional malaise in myalgic encephalomyelitis/ chronic fatigue syndrome: A patient-centered, cross-sectional survey[10] - (Abstract)

See also[edit | edit source]

References[edit | edit source]

  1. "What does exertion mean?". www.definitions.net. Retrieved October 11, 2018.
  2. "Work and energy". physics.bu.edu. Retrieved October 11, 2018.
  3. Arazi, Hamid; Mirzaei, Bahman; Heidari, Naser (2014). "Neuromuscular and Metabolic Responses to Three Different Resistance Exercise Methods". Asian Journal of Sports Medicine. 5 (1): 30–38. ISSN 2008-000X. PMC 4009085. PMID 24868429.
  4. Slentz, Cris A.; Houmard, Joseph A.; Kraus, William E. (2009). "Exercise, Abdominal Obesity, Skeletal Muscle, and Metabolic Risk: Evidence for a Dose Response". Obesity (Silver Spring, Md.). 17 (0 3): S27–S33. doi:10.1038/oby.2009.385. ISSN 1930-7381. PMC 3762482. PMID 19927142.
  5. 5.0 5.1 5.2 5.3 Nijs, Jo; Almond, Freya; De Becker, Pascale; Truijen, Steven; Paul, Lorna (2008). "Can exercise limits prevent post-exertional malaise in chronic fatigue syndrome? An uncontrolled clinical trial". Clinical Rehabilitation. 22 (5): 426–435. doi:10.1177/0269215507084410. ISSN 0269-2155. PMID 18441039. The severe exacerbation of symptoms following exercise, as seen in CFS patients, is not present in other disorders where fatigue is a predominant symptom such as depression, rheumatoid arthritis, systemic lupus erythematosus, or multiple sclerosis. 10,11
  6. "Deciphering Post-Exertional Malaise - Solve ME/CFS Initiative". Solve ME/CFS Initiative. November 21, 2014. Retrieved October 11, 2018.
  7. Dellwo, Adrienne (August 16, 2018). "The Many Faces of Chronic Fatigue Syndrome". Verywell Health. Retrieved October 11, 2018.
  8. "NINDS CDE Project - Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Post Exertional Malaise Subgroup" (PDF). nig.gov.
  9. 9.0 9.1 Dellwo, Adrienne (August 1, 2018). "What is Post-Exertional Malaise? Learn About a Key ME/CFS Symptom". Verywell Health. Retrieved October 11, 2018.
  10. 10.0 10.1 Chu, Lily; Valencia, Ian J.; Garvert, Donn W.; Montoya, Jose G. (2018). "Deconstructing post-exertional malaise in myalgic encephalomyelitis/ chronic fatigue syndrome: A patient-centered, cross-sectional survey". PloS One. 13 (6): e0197811. doi:10.1371/journal.pone.0197811. ISSN 1932-6203. PMC 5983853. PMID 29856774.
  11. 11.0 11.1 Arroll, Megan A.; Attree, Elizabeth A.; O'Leary, John M.; Dancey, Christine P. (April 3, 2014). "The delayed fatigue effect in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)". Fatigue: Biomedicine, Health & Behavior. 2 (2): 57–63. doi:10.1080/21641846.2014.892755. ISSN 2164-1846.
  12. 12.0 12.1 Institute of Medicine (March 16, 2015). Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. nap.edu. The National Academies Press. p. 228. doi:10.17226/19012.