Heart rate monitoring for Post-viral Fatigue Syndrome and Myalgic Encephalomyelitis - Podcast

Introduction: The first episode in a two-part series discussing heart rate monitoring for individuals with Myalgic Encephalomyelitis (ME-CFS) and Post-viral Fatigue Syndrome.
Guests: Includes Todd Davenport from the Workwell Foundation and experts with backgrounds in physiotherapy and sports science.

Cardiopulmonary Exercise Tests (CPET): ME patients show abnormalities in CPET results, with lower VO2 peak and anaerobic threshold levels, indicating a reduced ability to undertake physical exertion.
Unique Approach for ME: Traditional cardiorespiratory monitoring norms don't apply to ME patients, requiring a distinct approach for management.

Definition: A severe worsening of symptoms following physical or emotional exertion, a key symptom in ME.
Symptoms: Includes cognitive difficulties, muscle pain, and flu-like symptoms.
Triggers and Onset: Various triggers and onset times for PEM were discussed, emphasizing its variable nature.

Definition: It is the point during physical activity where the body starts to accumulate Lactate in the blood faster than it can be removed, causing rapid fatigue.
Importance in ME: For individuals with ME, managing activities to stay below this threshold can help in reducing the onset of Post-Exertional Malaise (PEM), a severe worsening of symptoms following exertion.

Methods: The podcast discussed various methods to calculate this threshold, including using percentages of the maximum heart rate. Some people use 60% of the maximum heart rate as a starting point, while others use different percentages based on their individual responses to activity.
Individual Approach: It was emphasized that these methods are not one-size-fits-all and individuals might need to find the most suitable method for themselves through trial and error.

Purpose: To help individuals track their heart rate in real-time and manage their activity levels to stay below their anaerobic threshold.
Benefit: Regular monitoring can potentially reduce the risk of triggering PEM by alerting individuals when they are nearing their threshold, allowing them to modify their activity level accordingly.

Heart Rate Variability (HRV): Discusses HRV as a non-invasive marker of the autonomic nervous system's functioning, and how it can potentially help in managing ME symptoms.
Choosing a Heart Rate Monitor: Suggestions include considering whether it uses a chest strap, its waterproof nature, and battery life.
Applications for Physiotherapists: The podcast suggests that physiotherapists working with ME patients can use heart rate monitors to gauge real-time body responses to various activities, helping in more effective management.

Hosts: Karen and Nikki from "Physios for ME"
Objective: Sharing real-life experiences of people with ME using heart rate monitors to manage their activity levels.
Note: The podcast is informative rather than prescriptive, urging listeners to consult with healthcare professionals if they consider using heart rate monitoring.

Background: Living with ME since 2002, and began using a heart rate monitor in 2011.
Anaerobic Threshold: Discovered her Anaerobic Threshold was 105 beats per minute (bpm), but daily activities often exceeded this, causing post-exertional crashes.
Heart Rate Monitoring Insights:
- Simple activities, like tying shoes, could spike her heart rate over her threshold.
- Even on quiet days at home, she frequently exceeded her anaerobic threshold.
Treatment: Successfully used low-dose extended-release beta blockers to reduce her heart rate and manage her symptoms better, allowing her to gradually improve her fitness level.

Background: A former physiotherapist now living with ME.
Real-Time Monitoring: Stresses the importance of real-time heart rate monitoring to adapt behavior and manage activity levels effectively.
Personal Diagnosis: Through detailed monitoring, she discovered she had multiple health issues that needed attention.
Advice to Healthcare Professionals: Urges them to listen to patients' experiences and approach with caution.

Background: An individual with ME sharing her observations on aerobic capacity and metabolic equivalents.
Metabolic Equivalents:
- Identified activities that exceeded her peak capacity, helping her to manage her daily activities better.
- Could engage in certain exercises without triggering severe Post-Exertional Malaise (PEM) due to a better understanding of her body's responses.
Heart Rate Monitoring: Helped her to stabilize her heart rate and avoid activities that would cause it to spike uncontrollably.

Background: An admin of an international Facebook group for ME sufferers, living with ME for about 35 years.
Negative Experience with Physiotherapy: Describes a rapid deterioration in her condition following an increase in workload prescribed by an uninformed physiotherapist.
Heart Rate Monitoring:
- Started in 2016, helping her to understand her limits better and stabilize her condition.
- Emphasizes that it is a management tool, not a cure, and highlights the importance of avoiding triggers and stresses that can exacerbate symptoms.
Advice for Users: Encourages users to learn their limits, find safe zones, and maintain stability by monitoring their heart rate effectively.

Resources: Encourages listeners to explore further resources on their website.
Appreciation: Thanks the contributors for sharing their experiences and emphasizes learning from people with ME to understand the condition better.

The slides can be found on the physiosforme website:
www.physiosforme.com/heart-rate-monitoring
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