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, resulting in the generation of force, initiation of motion, or in the performance of work. It often relates to muscular activity and can be quantified, empirically and by a measurable metabolic response.
Exertion in ME/CFS[edit | edit source]
Only a minimal amount of exertion causes a marked increase in symptoms in people with ME/CFS, 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). Depending on a patient's disease severity exertion capabilities is different and results in varying symptoms and degree of symptom severity. Physical or mental exertion can trigger PEM.
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.
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.
Notable studies[edit | edit source]
See also[edit | edit source]
References[edit | edit source]
- "What does exertion mean?". www.definitions.net. Retrieved October 11, 2018.
- "Work and energy". physics.bu.edu. Retrieved October 11, 2018.
- 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.
- 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.
- 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
- "Deciphering Post-Exertional Malaise - Solve ME/CFS Initiative". Solve ME/CFS Initiative. November 21, 2014. Retrieved October 11, 2018.
- Dellwo, Adrienne (August 16, 2018). "The Many Faces of Chronic Fatigue Syndrome". Verywell Health. Retrieved October 11, 2018.
- "NINDS CDE Project - Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Post Exertional Malaise Subgroup" (PDF). nig.gov.
- Dellwo, Adrienne (August 1, 2018). "What is Post-Exertional Malaise? Learn About a Key ME/CFS Symptom". Verywell Health. Retrieved October 11, 2018.
- 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.
- 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.
- Institute of Medicine (March 16, 2015). Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. nap.edu. The National Academies Press. p. 228. doi:10.17226/19012.
post-exertional malaise (PEM) - A notable exacerbation of symptoms brought on by small physical or cognitive exertions. PEM can last for days or weeks. Symptoms can include cognitive impairments, muscle pain (myalgia), trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, among others.
National Academy of Medicine (NAM) - An American non-profit, non-governmental organization which provides expert advice to governmental agencies on issues relating to biomedical science, medicine and health. Formerly known as the Institute of Medicine (IOM).
Institute of Medicine report (IOM report) - A report that was commissioned by the U.S. government and was published by the Institute of Medicine on February 10, 2015. The report was titled "Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness" and proposed the term Systemic Exertion Intolerance Disease (SEID). Among its key findings were that "This disease is characterized by profound fatigue, cognitive dysfunction, sleep abnormalities, autonomic manifestations, pain, and other symptoms that are made worse by exertion of any sort." The report further stated "Between 836,000 and 2.5 million Americans suffer from myalgic encephalomyelitis/chronic fatigue syndrome."
systemic exertion intolerance disease (SEID) - A term for ME/CFS that aims to avoid the stigma associated with the term "chronic fatigue syndrome", while emphasizing the defining characteristic of post-exertional malaise (PEM). SEID was defined as part of the diagnostic criteria put together by the Institute of Medicine (IOM) report of 10 February 2015.
myalgic encephalomyelitis (ME) - A disease often marked by neurological symptoms, but fatigue is sometimes a symptom as well. Some diagnostic criteria distinguish it from chronic fatigue syndrome, while other diagnostic criteria consider it to be a synonym for chronic fatigue syndrome. A defining characteristic of ME is post-exertional malaise (PEM), or post-exertional neuroimmune exhaustion (PENE), which is a notable exacerbation of symptoms brought on by small exertions. PEM can last for days or weeks. Symptoms can include cognitive impairments, muscle pain (myalgia), trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, among others. An estimated 25% of those suffering from ME are housebound or bedbound. The World Health Organization (WHO) classifies ME as a neurological disease.