Lessons from Myalgic Encephalomyelitis/Chronic Fatigue Syndrome for Long COVID: Postexertional Symptom Exacerbations is an Abnormal Response to Exercise/Activity Authors: Todd E. Davenport, Staci R. Stevens, Jared Stevens, Christopher R. Snell, J. Mark Van Ness Quote: Prolonged symptoms after infection with the novel coronavirus 2019 (SARS-COV-2) are an emerging challenge to individual patients, society, and clinicians. In a previous post on the JOSPT Blog, we identified several lessons from research and clinical practice in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) that are important lessons for long COVID. The purpose of this post is to discuss the phenomenon of postexertional symptom exacerbation (PESE) and its clinical identification to recognize the potential onset of long COVID.
Oh cool, I missed the part of this being the first of a series. Looking forward to the 3 following blogs.
JOSPT Lessons from Myalgic Encephalomyelitis/Chronic Fatigue Syndrome for Long COVID Part 2: Physiological Characteristics During Acute Exercise Are Abnormal in People With Postexertional Symptoms Excacerbation by Todd E. Davenport, Staci R. Stevens, Jared Stevens, Christopher R. Snell, J. Mark Van Ness Summary This post reviewed evidence from systems-level physiology that indicates important differences in physiological responses to acute exercise between people with deconditioning compared to people with PESE. Clearly, PESE is not deconditioning. Rather, physiological changes may be related to autonomic dysfunction, as well as direct and indirect effects of pathogenic infection, such as the novel coronavirus infection in long COVID. Insights into the physiology of PESE may be used to evaluate and treat people with long COVID and ME/CFS, as well as shape future rehabilitation research and safe clinical practices.
JOSPT Lessons from Myalgic Encephalomyelitis/Chronic Fatigue Syndrome for Long COVID Part 3: "Energy System First Aid" for People With Postexertional Symptom Exacerbation by Todd E. Davenport et al Summary First aid is an important part of rehabilitation. Energy system first aid for people with PESE focuses on helping patients to use the metabolic systems that function well, and to limit the use of the aerobic system that current evidence suggests is functioning abnormally. Working together, patients and clinicians can use widely available tools and simple insights from physiological data to promote improvements in symptoms and functioning.
JOSPT Lessons from Myalgic Encephalomyelitis/Chronic Fatigue Syndrome for Long COVID Part 4: Heart Rate Monitoring to Manage Postexertional Symptom Exacerbation by Todd E. Davenport et al Summary A combination of HRM and symptom journaling will best assist patients and clinicians to track outcomes and adjust the HRM program as needed. The patient and clinician should collaborate to determine the “Key 3” symptoms of PESE that are most functionally limiting to the patient. Symptoms may be assessed using a formalized questionnaire,1,3,9 or they may be qualitatively determined based on discussion with the patient. The presence and severity of Key 3 symptoms can be reassessed over time to determine the effectiveness of the HRM program.
A new course presented by Todd Davenport has its own thread here: Lessons from Myalgic Encephalomyelitis for Long Covid, 2022, Davenport et al
Posts copied from the Long Covid thread. Podcast JOSPT Insights: Ep 77: Less is more - the mindset shift clinicians need for long COVID, ME and other post-viral illness, with Dr. Todd Davenport "How prepared are you to support someone who is living with post-exertion symptom exacerbation? Dr Todd Davenport wants to start a conversation about re-imagining the way most of us have thought about fatigue, physical activity and exercise." ETA: This is the first episode of two with Dr. Todd Davenport. The next will be focusing on pacing.
I'm not the biggest fan of Todd, but I thought his interview was very good! Alternative source: https://podcasts.apple.com/au/podca...eed/id1522929437?i=1000557078368/id1522929437
Video: Todd Davenport Discusses PEM/PESE Blog Series [with David Tuller] Code: https://youtu.be/P_HNEqCtrVA https://www.youtube.com/watch?v=P_HNEqCtrVA https://twitter.com/user/status/1517352347134881793
Thanks, Andy! For some reason, when I paste the URL into a Virology Blog post, I can see the video in the draft version but in the published version it disappears and only the URL appears. So I've unpublished it for now. Does anyone know WordPress and what the issue is?
