So, Suzanna, Evans, Meredyth, Jason, Leonard A et al. · Journal of prevention & intervention in the community · 2015 · DOI
This study looked at whether fatigue and stamina are opposite sides of the same coin in ME/CFS. The researchers found that some people with ME/CFS have low fatigue but still cannot do much physically, while others have high fatigue that stops them from being active. This suggests that fatigue and stamina may be separate issues, and current diagnostic criteria that focus mainly on fatigue might miss people who have low energy and endurance but don't report severe fatigue.
Current ME/CFS diagnostic criteria emphasize fatigue as a primary symptom, but this study highlights that some patients may be excluded from diagnosis if they manage their activity carefully and report lower fatigue despite severe physical limitation. Understanding that stamina and fatigue are separate constructs could improve diagnostic accuracy and ensure that all people suffering from ME/CFS receive proper recognition and care.
This case study does not prove causation or establish the biological mechanisms underlying the relationship between fatigue and stamina. The small sample size and case-control design limit generalizability to the broader ME/CFS population. The study does not determine whether one construct causes the other or whether they are independent symptoms.
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
So, Suzanna, Evans, Meredyth, Jason, Leonard A, & Brown, Abigail (2015). Are stamina and fatigue polar opposites? A case study.. Journal of prevention & intervention in the community. https://doi.org/10.1080/10852352.2014.973235
BibTeX
@article{mecfsatlas-so-2015-stamina-fatigue,
author = {So, Suzanna and Evans, Meredyth and Jason, Leonard A and Brown, Abigail},
title = {Are stamina and fatigue polar opposites? A case study.},
journal = {Journal of prevention & intervention in the community},
year = {2015},
doi = {10.1080/10852352.2014.973235},
note = {PubMed: 25584526},
url = {https://www.mecfsatlas.com/evidence/so-2015-stamina-fatigue},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/so-2015-stamina-fatigue
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