Simon
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Well, glad they got that right, though I would like to see a replication before insisting patients undergo two maximal exertion tests in 24 hours. To me, it seems a bit reckless - I certainly have relapses at way less than one maximal exertion, let alone two.At the CFSAC meeting, they seem to be urging Unger to use day-two 'anaerobic threshold' testing, and not V02 max, so maybe I'm just a bit behind the times..
As for PEM, I do think that's an intersting way to go, eg the VanNess 2010 single maximal exertion study:
Written questionnaires revealed that within 24 hours of the test, 85% of controls indicated full recovery, in contrast to 0 CFS patients. The remaining 15% of controls recovered within 48 hours of the test. In contrast, only 1 CFS patient recovered within 48 hours
While a White (not that one, think Light) 2012 study found a highly significant increase in symptoms in CFS patients after moderate exercise, while there was no increase in either controls or MS patients, though the sample size was very small.