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Post-exertional malaise
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=== Energy conservation and pacing === Patients often report the feeling of a red line, an [[energy limit]] that if exceeded, will result in a [[crash]] or relapse. As one [[Norway|Norwegian] patient described: <blockquote>β....And suddenly it is just too much. The body turns itself off, as if it has gone on strike. You have pushed too much for too long, it repeats itself, and the body stops functioning.β<ref name="Lauren2011">{{Cite journal | last = Larun | first = Lillebeth | last2 = Malterud | first2 = Kirsti | date = May 2011 | title = Finding the right balance of physical activity: a focus group study about experiences among patients with chronic fatigue syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/20580520|journal=Patient Education and Counseling|volume=83|issue=2|pages=222β226|doi=10.1016/j.pec.2010.05.027|issn=1873-5134|pmid=20580520}}</ref></blockquote>Energy conservation strategies such as [[pacing]] and the [[Energy Envelope Theory|envelope theory]] have been developed to minimize PEM while allowing patients to stay as active as possible.<ref name="Goudsmit2012">{{Cite journal | last = Goudsmit | first=Ellen M. | author-link = Elen Goudsmit | last2 = Nijs | first2 = Jo | authorlink2 = Jo Nijs | last3 = Jason | first3 = Leonard A. | authorlink3 = Leonard Jason | last4 = Wallman | first4 = Karen E.| date = 2012 | title = Pacing as a strategy to improve energy management in myalgic encephalomyelitis/chronic fatigue syndrome: a consensus document|url=https://www.ncbi.nlm.nih.gov/pubmed/22181560|journal=Disability and Rehabilitation|volume=34|issue=13|pages=1140β1147|doi=10.3109/09638288.2011.635746|issn=1464-5165|pmid=22181560}}</ref> These techniques advise patients to balance energy availability and expenditure and to recognize early signs of PEM so they can reduce activity levels before a relapse occurs.
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