A Brief Questionnaire to Assess Post-Exertional Malaise
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants
2.2. Measures
2.2.1. First-Step DSQ Items
2.2.2. Supplemental DSQ PEM Items
2.3. Statistics
3. Results
Receiver Operating Characteristic
4. Discussion
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Appendix A
Symptoms | Frequency: Throughout the past 6 months, how often have you had this symptom? For each symptom listed below, circle a number from: 0 = none of the time 1 = a little of the time 2 = about half the time 3 = most of the time 4 = all of the time | Severity: Throughout the past 6 months, how much has this symptom bothered you? For each symptom listed below, circle a number from: 0 = symptom not present 1 = mild 2 = moderate 3 = severe 4= very severe |
1. Dead, heavy feeling after starting to exercise | 0 1 2 3 4 | 0 1 2 3 4 |
2. Next day soreness or fatigue after non-strenuous, everyday activities | 0 1 2 3 4 | 0 1 2 3 4 |
3. Mentally tired after the slightest effort | 0 1 2 3 4 | 0 1 2 3 4 |
4. Minimum exercise makes you physically tired | 0 1 2 3 4 | 0 1 2 3 4 |
5. Physically drained or sick after mild activity | 0 1 2 3 4 | 0 1 2 3 4 |
6. If you were to become exhausted after actively participating in extracurricular activities, sports, or outings with friends, would you recover within an hour or two after the activity ended? | Yes | No | ||||
7. Do you experience a worsening of your fatigue/energy related illness after engaging in minimal physical effort? | Yes | No | ||||
8. Do you experience a worsening of your fatigue/energy related illness after engaging in mental effort? | Yes | No | ||||
9. If you feel worse after activities, how long does this last? | <1 h | 2–3 h | 4–10 h | 11–13 h | 14–23 h | ≥ 24 h |
10. If you do not exercise, is it because exercise makes your symptoms worse? | Yes | No |
Appendix B
- DSQ-PEM Scoring
- Scoring Step 1
- Items 1–5: A frequency and severity score of 2, 2 on any items 1–5 is indicative of PEM.
- Scoring Step 2
- Items 7, 8: Either item 7 or 8 must have an answer of yes to indicate an ME and/or CFS dx.
- Item 9: A response of >14 h is needed to indicate an ME and/or CFS dx.
- Items 6, 10: Neither item indicates an ME and/or CFS diagnosis, but provides a description of patient PEM for clinical evaluations.
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Symptom | Tier 1 | Tier 2 | Tier 3 | Tier 4 |
---|---|---|---|---|
PEM duration | 100 | 2 | 10 | 0 |
Mental Exacerbation | 0 | 38 | 17 | 0 |
Exercise Exacerbation | 0 | 19 | 0 | 0 |
Quick Recovery | 0 | 0 | 0 | 2 |
Physical Exacerbation | 0 | 0 | 0 | 0 |
Symptom | MS % (n) | ME and CFS % (n) | PPS % (n) |
---|---|---|---|
Quick Recovery | 42.3 (66) | 1.3 (5) | 38.3 (64) |
Exercise Exacerbation | 10.8 (17) | 47.6 (179) | 34.1 (57) |
Physical Exacerbation | 65.6 (103) | 94.7 (356) | 68.3 (114) |
Mental Exacerbation | 55.4 (87) | 91.4 (342) | 34.9 (58) |
Symptom | MS % (n) | ME and CFS % (n) | PPS % (n) |
---|---|---|---|
No Exacerbation | 21.0 (33) | 2.1 (8) | 12.3 (86) |
≤1 h | 10.8 (17) | 0.8 (3) | 13.2 (22) |
2–3 h | 28.7 (45) | 2.1 (8) | 19.8 (33) |
4–10 h | 17.2 (27) | 6.1 (23) | 11.4 (19) |
11–13 h | 3.2 (5) | 1.3 (5) | 3.6 (6) |
14–23 h | 10.2 (16) | 14.1 (53) | 11.4 (19) |
≥24 h | 8.9 (14) | 73.4 (276) | 13.8 (23) |
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Cotler, J.; Holtzman, C.; Dudun, C.; Jason, L.A. A Brief Questionnaire to Assess Post-Exertional Malaise. Diagnostics 2018, 8, 66. https://doi.org/10.3390/diagnostics8030066
Cotler J, Holtzman C, Dudun C, Jason LA. A Brief Questionnaire to Assess Post-Exertional Malaise. Diagnostics. 2018; 8(3):66. https://doi.org/10.3390/diagnostics8030066
Chicago/Turabian StyleCotler, Joseph, Carly Holtzman, Catherine Dudun, and Leonard A. Jason. 2018. "A Brief Questionnaire to Assess Post-Exertional Malaise" Diagnostics 8, no. 3: 66. https://doi.org/10.3390/diagnostics8030066