On 2016 Jun 24, Lily Chu commented:

The limitation with this study is that symptoms were only recorded within a 24-hour period. Many patients with ME/CFS suffer from post-exertional malaise. Post-exertional malaise can start after 24 hours have passed and can endure for longer than 24-hours. Patients are often able to perform activities once or for a short period but the difficulty is when they have to repeat it again the same day or over the next few days. Repeated cardiopulmonary testing shows drops in cardiometabolic parameters not during a first exercise test but during a repeated test the next day. One study, for example,

https://translational-medicine.biomedcentral.com/articles/10.1186/1479-5876-12-20

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4004422/

Similarly, see this study which follows symptoms for more than 24 hours.

http://www.ncbi.nlm.nih.gov/pubmed/20095909

Finally, clinicians should be careful about prescribing aerobic exercise. On average about 50% of patients report worsening of their health if exercise is prescribed without careful consideration of symptoms that flare up. http://www.ncf-net.org/library/Reporting of Harms.pdf

On 2016 Jun 24, Lily Chu commented:

The limitation with this study is that symptoms were only recorded within a 24-hour period. Many patients with ME/CFS suffer from post-exertional malaise. Post-exertional malaise can start after 24 hours have passed and can endure for longer than 24-hours. Patients are often able to perform activities once or for a short period but the difficulty is when they have to repeat it again the same day or over the next few days. Repeated cardiopulmonary testing shows drops in cardiometabolic parameters not during a first exercise test but during a repeated test the next day. One study, for example,

https://translational-medicine.biomedcentral.com/articles/10.1186/1479-5876-12-20

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4004422/

Similarly, see this study which follows symptoms for more than 24 hours.

http://www.ncbi.nlm.nih.gov/pubmed/20095909

Finally, clinicians should be careful about prescribing aerobic exercise. On average about 50% of patients report worsening of their health if exercise is prescribed without careful consideration of symptoms that flare up. http://www.ncf-net.org/library/Reporting of Harms.pdf