Adopting a grounded theory approach, the researchers systematically gathered and analysed data, allowing themes to emerge organically. 

What did they find?

The study identified eight overarching themes, shedding light on various aspects of PEM:

PEM was triggered by three broad categories of events – physical, cognitive and emotional.

The effects of PEM were impacted by baseline pre-exertional symptoms.

PEM had a wide symptom range with few differences between daily PEM and PEM following CPET, with three core symptoms – exhaustion, cognitive difficulties and neuromuscular complaints.

PEM following CPET was more immediate and of longer duration than PEM in daily life.

The manner of onset of PEM symptoms varied.

Complete rest was necessary to gain any relief in PEM symptoms.

Planning and moderation of energy expenditure were seen as essential to avoiding PEM.

The uncertainty and debility of PEM created despair.