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Impact of an Individualized Low-to-Moderate Exercise Task on Post-Exertional Malaise in Post-Acute Sequelae of SARS-CoV-2 Infection and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
Abstract   Peer reviewed

Impact of an Individualized Low-to-Moderate Exercise Task on Post-Exertional Malaise in Post-Acute Sequelae of SARS-CoV-2 Infection and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

Giovanni Berardi, Adam Janowski, Samuel McNally and Kathleen Sluka
The journal of pain, Vol.25(4 Supplement), pp.51-51
04/2024
DOI: 10.1016/j.jpain.2024.01.236

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Abstract

Individuals with post-acute sequelae of SARS-CoV-2 infection (PASC) and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) commonly experience post-exertional malaise following an exercise task. This study examined tolerance to a tailored low-to-moderate intensity exercise task using age-predicted maximal heart rate guided by symptom-based intensity modifications in individuals with PASC and ME/CFS. Thirty individuals with PASC, ME/CFS, and controls completed a bout of whole-body exercise on an upright cycle ergometer for 25-minutes. Aspects of post-exertional malaise, specifically pain and fatigue were assessed prior to, during, and up to 7-days following the exercise bout using 0-10 numerical rating scales. Individuals with PASC and ME/CFS achieved similar target heart rates (118.6±13.3bpm), and changes in perceived exertion (3.8±1.9), fatigue (2.0±1.9), and pain (1.1±1.5) during the 25-minute exercise task. Controls performed the bicycle task with greater revolutions per minute (p<.001) without significant increases in pain or fatigue. Changes in perceived physical fatigue (p<.001), mental fatigue (p<.001), and pain (p<.012) differed by group during the 7-days following exercise with PASC and ME/CFS. The greatest increases in pain (ME/CFS:+1.0, PASC:+0.3), physical fatigue (ME/CFS:+1.2, PASC:+0.7) and mental fatigue (ME/CFS:+1.2, PASC:+0.6) occurred on day 1 and returned to baseline within 7 days. This study demonstrates the impact of an individualized, low-to-moderate exercise task on post-exertional symptoms of pain and fatigue in individuals with PASC and ME/CFS. Further investigation will address the individual variability in symptom responses and the impact of repeated exercise bouts in larger cohorts. Funding: R01AR077418, R01AR077418-S1, U24NS112873-S1.

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