Balke, Maryam, Garbsch, René, Cormann, Jessica et al. · Frontiers in rehabilitation sciences · 2025 · DOI
Researchers developed a simple daily diary to help post-COVID patients track their energy levels throughout the day. The diary showed that patients had more energy in the morning than evening, and that rest helped restore energy while active therapy temporarily reduced it. Most patients found the diary helpful for understanding how their body responds to different activities and for learning to pace themselves better.
Energy tracking tools could help ME/CFS and post-COVID patients better understand their individual fatigue patterns and practice pacing—a key self-management strategy. This study provides evidence that a simple, patient-centered diary can objectively reflect fatigue changes and may improve patients' awareness of how different types of activity affect their energy, potentially supporting safer rehabilitation planning.
This study does not prove that using the diary improves clinical outcomes or recovery speed in post-COVID patients—only that the tool reliably measures energy changes. It does not establish causation between activity type and energy depletion, nor does it demonstrate that pacing based on diary data prevents post-exertional malaise or improves long-term prognosis. The study is limited to post-COVID syndrome and may not directly apply to ME/CFS populations.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Balke, Maryam, Garbsch, René, Cormann, Jessica, Pape, Pantea, Mooren, Frank C, & Schmitz, Boris (2025). Design and validation of an energy level diary for fatigue management in patients with post-COVID syndrome.. Frontiers in rehabilitation sciences. https://doi.org/10.3389/fresc.2025.1633466
BibTeX
@article{mecfsatlas-balke-2025-design-validation,
author = {Balke, Maryam and Garbsch, René and Cormann, Jessica and Pape, Pantea and Mooren, Frank C and Schmitz, Boris},
title = {Design and validation of an energy level diary for fatigue management in patients with post-COVID syndrome.},
journal = {Frontiers in rehabilitation sciences},
year = {2025},
doi = {10.3389/fresc.2025.1633466},
note = {PubMed: 40761505},
url = {https://www.mecfsatlas.com/evidence/balke-2025-design-validation},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/balke-2025-design-validation
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