Understanding Post-Exertional Malaise (PEM)

The lecture by Dr. Puta dealt with the understanding PEM by analyzing responses to physical stress. Responses to exercise can take place in aerobic and anaerobic metabolism. However, ME/CFS patients quickly become anaerobic and develop PEM. Rehabilitation therapy for ME/CFS and PCS without considering PEM can negatively impact health outcomes. Rehabilitation plans that take PEM into account can, in turn, have positive effects. An undersupply of oxygen to the muscles during exertion can be explained by a disturbed microcirculation and reduced blood flow to the organs. Deformed red blood cells could play a role in this regard, since they are less able to supply tissues with oxygen. Inadequate regeneration after exercise also plays a role: Patients with PCS with ME/CFS showed an increased resting heart rate already during their acute infection.