Pacing for PEM/PESE

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Patients who have post-exertional malaise (PEM/PESE) generally benefit more from pacing and energy conservation than exercise-focused treatments. Pacing for PEM/PESE involves managing exertion to stay under the threshold that causes increased symptoms or post-exertional malaise. While pacing is not a cure for PEM/PESE, it is an effective management strategy. Pacing and energy conservation approaches need to be individualized for each patient.

This video covers how therapy providers can use biofeedback pacing, task analysis, activity logs, and heart rate variability tracking to assist patients with pacing to reduce their symptoms.

Note to community members: We advise viewers to always speak with their medical care team prior to making any adjustments or changes to their current regimen.

This video was made possible by the OMF-funded Medical Education Resource Center (MERC) at BHC, our generous donors, and viewers like you.
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This can be helpful, but I do not have PEM until around 24 hrs after an activity, so do not get the dizziness, nausea, etc, until then.

FMulholland
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Just standing up puts my heart rate 30 beats above my resting heart rate.
My current crash followed a sudden increase in heart rate variability of 6 on one day followed immediately by a decrease of 10 the next day! No idea what that means.

OrganisedPauper
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If I have to stop at a heart rate of 15bpm above my resting heart rate, I most of the time couldn't even get up from a chair :/ If I set the threshold to (220-age)*0.6, I have to take it easy, but I can get up (and then wait until I start walking).

sebimmbasti
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Maybe one day there will be enough research into ME CFS and other post viral syndrome so we can have better therapeutics than just being recommended to: "don't do anything with you life!" 🙄

cwebbwash
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If anyone has a recommendation for a heart monitoring device that gives information in real time, whether it’s watch watch plus chest monitor or whatever, I would be grateful. All the ones I have tried, have a set number below, which you can’t set your high rate alert. Such as, not below 120, or not below 100. It is not helpful if you’re alert heart rate is 85.

wandajune
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Are there good apps for Apple Watch to monitor HR changes and get alerts?

rancholocotv