Evidence map›Paper›PMID 41185151›Full record

ArticleMedicine and science in sports and exercise2026

Postexertional Symptom Exacerbation after Submaximal Exercise in Individuals with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Postacute Sequelae of COVID-19.

Giovanni Berardi, Adam Janowski, Samuel McNally, Andrew Post, Alpana Garg, Kathleen A Sluka

Abstract read
In one paragraph

Article in Medicine and science in sports and exercise, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Giovanni BerardiDepartment of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, IA.
Adam JanowskiDepartment of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, IA.
Samuel McNallyDepartment of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, IA.
Andrew PostDepartment of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, IA.
Alpana GargDepartment of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA.
Kathleen A SlukaDepartment of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, IA.

Funding

University of Iowa Institute for Clinical and Translational ScienceUM1TR004403 · NCATS · UNIVERSITY OF IOWA · PI Marlan R Hansen, Patricia Winokur · 2023 to 2026
$16.1M
Clinical Coordinating Center for the Acute to Chronic Pain Signatures Program: Administrative SupplementU24NS112873 · NINDS · UNIVERSITY OF IOWA · PI COFFEY, CHRISTOPHER S., FREY LAW, LAURA A · 2019 to 2022
$11.0M
Fibromyalgia TENS in Physical Therapy Study (TIPS): an embedded pragmatic clinical trial: Administrative SupplementUH3AR076387 · NIAMS · UNIVERSITY OF IOWA · PI CROFFORD, LESLIE J, SLUKA, KATHLEEN A · 2020 to 2023
$7.3M
Interdisciplinary Training Program in Pain ResearchT32NS045549 · NINDS · UNIVERSITY OF IOWA · PI KATHLEEN A SLUKA, Yuriy M Usachev · 2004 to 2026
$3.7M
Metabolic Biomarkers for Fibromyalgia: Administrative SupplementR01AR077418 · NIAMS · UNIVERSITY OF IOWA · PI FREY LAW, LAURA A, SCHREPF, ANDREW · 2020 to 2024
$1.8M
NCATS NIH HHS UM1 TR004403NIAMS NIH HHS R01 AR077418NIAMS NIH HHS UH3 AR076387NINDS NIH HHS T32 NS045549NINDS NIH HHS U24 NS112873
6 · The paper itself

Abstract

purposeIn individuals with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and postacute sequelae of SARS-CoV-2 infection (PASC), physical activity can exacerbate symptoms for days to weeks, referred to as postexertional symptom exacerbation (PESE). This study characterized the trajectory of PESE symptoms before and for 7 d after a submaximal exercise task in individuals with ME/CFS or PASC.

methodsIndividuals with ME/CFS ( n = 30) or PASC ( n = 30) and matched controls ( n = 30) were recruited from a university hospital and the community setting. Participants completed a 25-min moderate-intensity exercise on a whole-body cycle ergometer. The trajectory of eight commonly reported PESE symptoms (physical fatigue, mental fatigue, pain, physical function, flu-like symptoms, gastrointestinal symptoms, sleep dysfunction, and anxiety) before and for 7 d after exercise were analyzed.

resultsThere was variability in the proportion of those who experienced increased symptoms, ranging from 46/60 reporting physical fatigue to only 18/30 reporting anxiety. There was no change in any of the symptoms across the 7-d period when analyzed individually. An aggregate score of 4-5 symptoms that includes physical fatigue, mental fatigue, physical function, and flu-like symptoms, with or without pain, was more comprehensive in capturing maximal changes in PESE. Changes were greatest during the 72-h postexercise and for those with ME/CFS. The aggregate score shows that 8/30 of individuals with ME/CFS and 12/30 with PASC show minimal to no increase in PESE, while 6-7/30 show increases greater than 3/10 points.

conclusionsPESE to a clinically relevant exercise task is variable in individuals with ME/CFS and PASC, as submaximal exercise does not exacerbate symptoms for some, while modifications of intensity may be necessary to minimize PESE in others.

Indexed as

COVID-19ExerciseFatigue Syndrome, ChronicSymptom Flare UpAdultAnxietyCase-Control StudiesFatigueFemaleHumansMaleMiddle AgedPost-Acute COVID-19 SyndromeSARS-CoV-2CHRONIC FATIGUE SYNDROMEEXERCISEFATIGUEPAINPOSTACUTE COVID-19 SYNDROME

Identifiers

PMID41185151
PMCPMC13565752

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.