Lessons from Myalgic Encephalomyelitis/Chronic Fatigue Syndrome for long COVID: Postexertional Symptom Exacerbation is an abnormal response to exercise/activity, by Todd E Davenport, Staci R Stevens, Jared Stevens, Christopher R Snell, J Mark Van Ness in JOSPT blog, February 2, 2022 [doi.org/10.2519/jospt.blog.20220202]


Researchers from the Workwell Foundation in California offer guidance for physical therapists with understanding and identifying PESE in patients with long COVID, following extensive research with patients with ME.

PESE – postexertional symptom exacerbation – is a constellation of unusual symptom responses to exercise/activity


Blog post extract:

What the Physical Therapist can do

Clinicians may ask evidence-based questions that may suggest PESE (TABLE). These questions may be used to direct clinical reasoning. They also can form the basis for collaborative treatment approaches that consider the patient’s perspective. Variability in PESE symptoms between patients/clients, during exercise/activity recovery, and according to disease staging reinforces there is no one-size-fits-all approach to working with patients who have PESE.

Identification of the patient/client’s top three symptoms, how much activity is necessary to provoke PESE, how long symptoms of PESE last, and how they change over time are critical to inform patient-centered approaches to PESE management.


Read full article

Read Part 2: Physiological characteristics during acute exercise are abnormal in people with PostExertional Symptom Exacerbation

Read Part 3: “Energy System First Aid” for people with Post Exertional Symptom Exacerbation

Read Part 4: Heart Rate Monitoring to manage PostExertional Symptom Exacerbation


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