Department of Molecular Biology and Genetics, Cornell University, Ithaca, NY 14853, USA.
Department of Exercise Science & Athletic Training, Ithaca College, Ithaca, NY 14850, USA.
Medicina (Kaunas). 2023 Mar 15;59(3):571. doi: 10.3390/medicina59030571.
: Post-exertional malaise (PEM) is the hallmark of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), but there has been little effort to quantitate the duration of PEM symptoms following a known exertional stressor. Using a Symptom Severity Scale (SSS) that includes nine common symptoms of ME/CFS, we sought to characterize the duration and severity of PEM symptoms following two cardiopulmonary exercise tests separated by 24 h (2-day CPET). : Eighty persons with ME/CFS and 64 controls (CTL) underwent a 2-day CPET. ME/CFS subjects met the Canadian Clinical Criteria for diagnosis of ME/CFS; controls were healthy but not participating in regular physical activity. All subjects who met maximal effort criteria on both CPETs were included. SSS scores were obtained at baseline, immediately prior to both CPETs, the day after the second CPET, and every two days after the CPET-1 for 10 days. : There was a highly significant difference in judged recovery time (ME/CFS = 12.7 ± 1.2 d; CTL = 2.1 ± 0.2 d, mean ± s.e.m., Chi = 90.1, < 0.0001). The range of ME/CFS patient recovery was 1-64 days, while the range in CTL was 1-10 days; one subject with ME/CFS had not recovered after one year and was not included in the analysis. Less than 10% of subjects with ME/CFS took more than three weeks to recover. There was no difference in recovery time based on the level of pre-test symptoms prior to CPET-1 (F = 1.12, = 0.33). Mean SSS scores at baseline were significantly higher than at pre-CPET-1 (5.70 ± 0.16 vs. 4.02 ± 0.18, < 0.0001). Pharmacokinetic models showed an extremely prolonged decay of the PEM response (Chi > 22, < 0.0001) to the 2-day CPET. : ME/CFS subjects took an average of about two weeks to recover from a 2-day CPET, whereas sedentary controls needed only two days. These data quantitate the prolonged recovery time in ME/CFS and improve the ability to obtain well-informed consent prior to doing exercise testing in persons with ME/CFS. Quantitative monitoring of PEM symptoms may provide a method to help manage PEM.
体力活动后不适（PEM）是肌痛性脑脊髓炎/慢性疲劳综合征（ME/CFS）的标志，但很少有人努力量化已知体力应激后 PEM 症状的持续时间。使用包括 ME/CFS 的九种常见症状的症状严重程度量表（SSS），我们试图描述两次心肺运动测试（2 天 CPET）之间 PEM 症状的持续时间和严重程度。
80 名 ME/CFS 患者和 64 名对照（CTL）接受了 2 天 CPET。ME/CFS 患者符合加拿大 ME/CFS 的临床诊断标准；对照组为健康人，但不参加定期体育活动。所有在两次 CPET 中都达到最大努力标准的受试者均被纳入研究。在基线、两次 CPET 前、第二次 CPET 后一天以及 CPET-1 后每两天均获得 SSS 评分，共 10 天。
ME/CFS 患者的自我判断恢复时间有显著差异（ME/CFS = 12.7 ± 1.2 d；CTL = 2.1 ± 0.2 d，均值±标准误，χ = 90.1，<0.0001）。ME/CFS 患者的恢复时间范围为 1-64 天，CTL 为 1-10 天；1 名 ME/CFS 患者在一年后仍未恢复，未纳入分析。不到 10%的 ME/CFS 患者需要超过三周才能恢复。CPET-1 前的预测试症状水平对恢复时间无影响（F = 1.12，= 0.33）。基线时的平均 SSS 评分显著高于 CPET-1 前（5.70 ± 0.16 比 4.02 ± 0.18，<0.0001）。药代动力学模型显示，2 天 CPET 后的 PEM 反应（Chi > 22，<0.0001）呈极度延长衰减。
ME/CFS 患者平均需要大约两周的时间才能从 2 天 CPET 中恢复，而久坐不动的对照组只需要两天。这些数据量化了 ME/CFS 患者从 2 天 CPET 中恢复的时间延长，提高了在 ME/CFS 患者进行运动测试前获得充分知情同意的能力。对 PEM 症状的定量监测可能提供一种帮助管理 PEM 的方法。
