Keech, Andrew, Sandler, Carolina X, Vollmer-Conna, Ute et al. · Journal of psychosomatic research · 2015 · DOI
This study developed a new questionnaire called the Fatigue and Energy Scale (FES) to measure the specific type of exhaustion that ME/CFS patients experience after physical or mental activity. Researchers talked with 19 patients to understand what their fatigue feels like, then tested the questionnaire with patients doing exercise, driving simulation, and everyday tasks. The results showed that the FES successfully captured both the physical tiredness and mental fog that worsens after activity in ME/CFS.
Reliable measurement tools for post-exertional malaise—a hallmark ME/CFS symptom—are critically needed for both clinical practice and research. This study provides a validated instrument that captures the patient-experienced reality of fatigue worsening after activity, which could enable better monitoring of disease severity and more accurate assessment of treatment responses in clinical trials and patient care.
This study does not establish the biological mechanisms underlying post-exertional malaise or explain what causes the fatigue to worsen after activity. It also does not prove the FES is superior to or better than other fatigue measurement tools, as no direct comparison with existing instruments was performed. The small sample sizes mean findings may not apply equally to all ME/CFS patients or different disease severity levels.
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
Keech, Andrew, Sandler, Carolina X, Vollmer-Conna, Ute, Cvejic, Erin, Lloyd, Andrew R, & Barry, Benjamin K (2015). Capturing the post-exertional exacerbation of fatigue following physical and cognitive challenge in patients with chronic fatigue syndrome.. Journal of psychosomatic research. https://doi.org/10.1016/j.jpsychores.2015.08.008
BibTeX
@article{mecfsatlas-keech-2015-capturing-post,
author = {Keech, Andrew and Sandler, Carolina X and Vollmer-Conna, Ute and Cvejic, Erin and Lloyd, Andrew R and Barry, Benjamin K},
title = {Capturing the post-exertional exacerbation of fatigue following physical and cognitive challenge in patients with chronic fatigue syndrome.},
journal = {Journal of psychosomatic research},
year = {2015},
doi = {10.1016/j.jpsychores.2015.08.008},
note = {PubMed: 26359713},
url = {https://www.mecfsatlas.com/evidence/keech-2015-capturing-post},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/keech-2015-capturing-post
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