Risbano, Michael G · Experimental physiology · 2026 · DOI
This study examines how a special two-day exercise test can help doctors understand the physical changes that happen in long COVID and ME/CFS patients. Instead of pushing patients to their maximum effort, researchers used a gentler approach to measure heart and lung function, which may be safer and more revealing for people with these conditions. The study aims to create new standard ways of testing that better capture what's happening in patients' bodies.
Developing safe, standardized testing methods is critical for ME/CFS patients who experience worsening symptoms after exertion. This research provides evidence-based alternatives to traditional maximum-effort tests that can be harmful to these patients, potentially enabling better diagnosis and monitoring without causing harm.
This study does not establish that submaximal CPET testing can diagnose ME/CFS or predict individual patient outcomes. The preliminary evidence level means findings are not yet definitive and require confirmation through larger, controlled studies before widespread clinical adoption.
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
Risbano, Michael G (2026). From fatigue to physiology: Submaximal 2-day cardiopulmonary exercise test and emerging standards in long COVID.. Experimental physiology. https://doi.org/10.1113/EP092958
BibTeX
@article{mecfsatlas-risbano-2026-fatigue-physiology,
author = {Risbano, Michael G},
title = {From fatigue to physiology: Submaximal 2-day cardiopulmonary exercise test and emerging standards in long COVID.},
journal = {Experimental physiology},
year = {2026},
doi = {10.1113/EP092958},
note = {PubMed: 40532111},
url = {https://www.mecfsatlas.com/evidence/risbano-2026-fatigue-physiology},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/risbano-2026-fatigue-physiology
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