Quando sintomas como fadiga ou exaustão incapacitante, dificuldade de pensar, dor, intolerância ao exercício e outros sintomas são agravados pelo esforço, isto é chamado de exacerbação dos sintomas pós-exercício. A exacerbação dos sintomas pós-exercionais (PESE) também pode ser chamada de mal-estar pós-exercional (PEM) ou exaustão neuroimune pós-exercional (PENE).

Post-exertional symptom exacerbation can be triggered by physical, cognitive, mental, social or emotional exertions, and varies among different people. The worsening of symptoms by exertion can happen immediately, or can happen 24-72 hours after exertion. This can make it difficult to predict or manage. It can take days, weeks or even months to recover from post-exertional symptom exacerbation. The exhaustion caused by exertion can be very disabling, as it can affect different symptoms or parts of the body. Post-exertional symptom exacerbation is a feature of the inability to produce sufficient energy on demand and is characteristic among those with Myalgic Encephalomyelitis / Chronic Fatigue Syndrome (ME/CFS).

Post-exertional symptom exacerbation can be triggered by different things, such as usual activities in daily life, changes to sound and light, or activities that could previously be tolerated. It is not the same as “Boom and Bust” cycles of overactivity, because often post-exertional symptom exacerbation is not triggered by overactivity. Showering, getting dressed, walking, loud noises, busy environments, or multi-tasking is not overactivity. Saying post-exertional symptom exacerbation is like a “Boom and Bust” cycle, is patient blaming and unhelpful, and this assumption may be based on ableism.

ME/CFS South Australia Inc provides a comprehensive description of what is post-exertional malaise, assessment, and management. Dialogues ME/CFS provides accessible videos on post-exertion malaise.

Bateman Horne Centre provides a 7-part video series on post-exertional malaise, available below: