Vital signs and sensors for post-exertional malaise prevention

ABSTRACT

Introduction Myalgic encephalomyelitis (ME) / chronic fatigue syndrome (CFS) is a disease of the nervous system that leads to profound physical weakness. The number of patients is currently increasing worldwide due to the consequences of chronic COVID-19 syndrome. ME/CFS patients suffer from severe fatigue, autonomic, neurological and immunological symptoms. The core symptom Post-Exertional Malaise (PEM) leads to a general exacerbation after even low levels of exertion. Since there is no approved therapy, patient advocacy groups recommend pacing. This involves monitoring trivial vital signs of the patient to avoid PEM. This paper aims to evaluate the suitability of various vital signs and proposes matching sensors. Methods Via a literature review, different vital signs are compared in terms of their usefulness for PEM prevention. Objective criteria such as the number of publications and the PEM triggers to be covered are included in the evaluation. Recommendations for the use of body-worn sensors are derived from the vital signs and the requirements for real-world use. This takes into account patient needs through an objective evaluation of, among other things, wearer comfort, long-term stability and attachment. Results Even simple pedometers can help to monitor the physical trigger of PEM. Strong emotional reactions can be detected by heart rate monitoring. This can be accomplished using electrocardiography and photoplethysmopgraphy sensors. Smartwatches and chest straps in particular are suitable for easy monitoring of vital signs because they enable long-term measurement without interruption and easy sensor attachment. Conclusion The importance of different vital parameter sensors in the monitoring of PEM is elaborated. In the future, more complex analysis of heart rate variability and respiratory rate could be used to prevent PEM. From this, recommendations for the prevention of PEM and potential Long-Covid consequences can be derived. This may help to mitigate the severity of the disease course.