The physiological and cognitive effects of a repeated 5-minute exercise challenge on individuals with ME/CFS : a thesis presented in partial fulfilment of the requirements for the degree of Master of Health Science in Sport and Exercise at Massey University, Manawatu, New Zealand

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PURPOSE: Recently exercise prescription has been cast into doubt surrounding the effectiveness of exercise as a treatment for those with ME/CFS. This study investigated the effects of a repeated 5 minute exercise challenge on the physiological and cognitive markers in those with ME/CFS. With the intention of being able to provide recommendations regarding safe and beneficial exercise to aid with the treatment and management of symptoms experienced by those with ME/CFS. METHODS: Eleven participants with ME/CFS completed three testing sessions. On the first visit, each participant completed a battery of neuropsychological tests, resting and standing Heart Rate Variability (HRV), as well as an incremental, maximal cycle test. On the second and third visit, participants completed the same battery of neuropsychological and HRV tests, but also included a steady state exercise challenge at Anaerobic Threshold (AT), determined from the initial maximal exercise test. The second and third visit were separated by 24 hours. RESULTS: From the maximal exercise test, a low mean 𝑉̇O₂ (23.36 and a high blood pressure (BP) (169/97mmHg), relative to mean heart rate (HR) (155bpm) and workload (131W) were found. HR response was low relative to the exercise intensity, with only one participant reaching their precalculated age predicted max heart rate (APMHR). From the repeated 5-minute exercise challenge, there was a reduction in 𝑉̇O₂ ( to BP followed a similar trend to the maximal exercise test, where mean SBP and DBP were high relative to HR and workload. From analysis of 𝑉̇O₂, Respiratory Exchange Ratio (RER) and Rating of Perceived Exertion (RPE), individuals were exercising at Anaerobic Threshold (AT), yet 6 of the 11 participants had an HR and BP response equivalent to greater than 84% of their max. The repeated exercise challenge did not reduce cognition. Results also demonstrated that the exercise challenge reduced the recovery from a mean of 9.18 days with the CPET to 5.23 days from the repeated exercise challenge. CONCLUSIONS: This study identified new information surrounding the BP and HR response to exercise, experienced by those with ME/CFS. The information detailed provides a good opportunity for future research, particularly aiming to provide further understanding of why those with ME/CFS have this physiological response to exercise. The results also provided details about how APMHR is not necessarily a useful prescription tool for those with ME/CFS due to the great variation between individuals.