Packer, T L, Sauriol, A, Brouwer, B · Archives of physical medicine and rehabilitation · 1994 · DOI
This study compared fatigue in people with three different chronic illnesses: postpolio syndrome, ME/CFS, and multiple sclerosis. Researchers found that people with all three conditions experienced much higher levels of fatigue than healthy people, and those with ME/CFS and MS also had greater difficulty doing everyday activities. The study highlights how serious and disabling fatigue can be across these different conditions.
This study provides objective evidence that ME/CFS-related fatigue is severe and functionally disabling—comparable to other serious chronic illnesses. It validates the real-world impact of fatigue on patients' ability to perform daily activities, supporting the need for clinical recognition and research into fatigue management strategies.
This study does not establish what causes fatigue in these conditions or whether the mechanisms are similar across diagnostic groups. It is a snapshot comparison and does not prove that fatigue worsens over time or that any specific treatment reduces it. Correlation between fatigue and reduced activity does not clarify whether fatigue causes reduced activity or vice versa.
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
Packer, T L, Sauriol, A, & Brouwer, B (1994). Fatigue secondary to chronic illness: postpolio syndrome, chronic fatigue syndrome, and multiple sclerosis.. Archives of physical medicine and rehabilitation. https://doi.org/10.1016/0003-9993(94)90088-4
BibTeX
@article{mecfsatlas-packer-1994-fatigue-secondary,
author = {Packer, T L and Sauriol, A and Brouwer, B},
title = {Fatigue secondary to chronic illness: postpolio syndrome, chronic fatigue syndrome, and multiple sclerosis.},
journal = {Archives of physical medicine and rehabilitation},
year = {1994},
doi = {10.1016/0003-9993(94)90088-4},
note = {PubMed: 7944918},
url = {https://www.mecfsatlas.com/evidence/packer-1994-fatigue-secondary},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/packer-1994-fatigue-secondary
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