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Helena Liiran ja toiminnallisten häiriöiden klinikan ohjeistukset ovat nykyisten lääketieteellisten tutkimustulosten vastaisia ja erittäin vaarallisia ME/CFS-potilaille. PEM-oireen sivuuttaminen ja liikunnan lisääminen oireista välittämättä voivat romauttaa ME-potilaan kunnon peruuttamattomasti. Viitteitä: VanNess J. M., Snell C. R., & Stevens S. R. (2007). Diminished cardiopulmonary capacity during post-exertional malaise. Journal of Chronic Fatigue Syndrome, 14(2):77–85. DOI: 10.1300/J092v14n02_07. https://doi.org/10.1300/J092v14n02_07. scholarlycommons.pacific.edu Snell C. R., Stevens S. R., Davenport T. E., & VanNess J. M. (2013). Discriminative validity of metabolic and workload measurements for identifying people with chronic fatigue syndrome. Physical Therapy. 93(11):1484–1492. DOI: 10.2522/ptj.20110368. https://pubmed.ncbi.nlm.nih.gov/23813.... Keller B. A., Pryor J. L., & Giloteaux L. (2014). Inability of myalgic encephalomyelitis/chronic fatigue syndrome patients to reproduce VO₂peak indicates functional impairment. Journal of Translational Medicine, 12:104. DOI: 10.1186/1479-5876-12-104. https://doi.org/10.1186/1479-5876-12-104. Nelson M. J., Buckley J. D., Thomson R. L., Clark D., Kwiatek R., & Davison K. (2019). Diagnostic sensitivity of 2-day cardiopulmonary exercise testing in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Journal of Translational Medicine, 17:80. DOI: 10.1186/s12967-019-1836-0. https://pubmed.ncbi.nlm.nih.gov/30908... täysi teksti: https://doi.org/10.1186/s12967-019-18.... Lim E.-J., Kang E.-B., Jang E.-S., & Son C.-G. (2020). The prospects of the two-day cardiopulmonary exercise test (CPET) in ME/CFS patients: a meta-analysis. Journal of Clinical Medicine, 9(12):4040. DOI: 10.3390/jcm9124040. https://pubmed.ncbi.nlm.nih.gov/33327... — https://www.mdpi.com/2077-0383/9/12/4040. Stevens S. R., Snell C. R., Stevens J. M., Keller B., & VanNess J. M. (2018). Cardiopulmonary exercise test methodology for assessing exertion intolerance in ME/CFS. Frontiers in Pediatrics. DOI/Link: https://pubmed.ncbi.nlm.nih.gov/30234.... Joseph P., Arevalo C., Oliveira R. K. F., Faria-Urbina M., Felsenstein D., Oaklander A. L., Systrom D. M., et al. (2021). Insights from invasive cardiopulmonary exercise testing of patients with myalgic encephalomyelitis/chronic fatigue syndrome. Chest. DOI: 10.1016/j.chest.2021.01.082. https://pubmed.ncbi.nlm.nih.gov/33577... — PDF/preprint: https://journal.chestnet.org/article/.... Singh I., Joseph P., Heerdt P. M., Cullinan M., Lutchmansingh D. D., Gulati M., Possick J. D., Systrom D. M., Waxman A. B. (2022). Persistent exertional intolerance after COVID-19: insights from invasive cardiopulmonary exercise testing. Chest. 161(1):54–63. DOI: 10.1016/j.chest.2021.08.010. (iCPET-työ, relevantti myös PASC/Long COVID https://pubmed.ncbi.nlm.nih.gov/34389... https://doi.org/10.1016/j.chest.2021..... Germain A., Giloteaux L., Moore G. E., et al. (2022). Plasma metabolomics reveals disrupted response and recovery following maximal exercise in myalgic encephalomyelitis/chronic fatigue syndrome. JCI Insight. 7(9):e157621. DOI: 10.1172/jci.insight.157621. https://pubmed.ncbi.nlm.nih.gov/35358... — https://doi.org/10.1172/jci.insight.1.... van Campen C. L. M. C. & Visser F. C. (2020). Two-day cardiopulmonary exercise testing in females with a severe grade of ME/CFS: comparison with mild/moderate disease. Healthcare (Basel). 8(3):192. https://www.ncbi.nlm.nih.gov/pmc/arti.... White A. T., Light A. R., Hughen R. W., et al. (2010). Severity of symptom flare after moderate exercise is linked to cytokine activity in chronic fatigue syndrome. Psychophysiology. https://pubmed.ncbi.nlm.nih.gov/20419.... Jones D. E. J., Hollingsworth K. G., Jakovljevic D. G., Fattakhova G., Pairman J., Blamire A. M., Newton J. L. (2012). Loss of capacity to recover from acidosis on repeat exercise in chronic fatigue syndrome: a case–control study. European Journal of Clinical Investigation. DOI: 10.1111/j.1365-2362.2011.02567.x. https://pubmed.ncbi.nlm.nih.gov/21988.... Workwell Foundation — Two-day CPET protocol, https://www.workwellfoundation.org/wp... ja https://workwellfoundation.org/