MEDREH-11 · Post-COVID and PASC Rehabilitation

Post-COVID and PASC Rehabilitation. Topics: Fatigue, Post-Exertional Malaise, Dysautonomia and POTS, Cognitive Dysfunction, and the Pacing-Versus-Graded-Exercise Branch Point. Part of the Medical Rehabilitation series of the Reflex PM&R Board Review podcast. Audio corrections: (1) In the audio: And if the patient repeatedly triggers these crashes, the damage compounds, lowering their overall functional baseline permanently. — Correct: Repeated PEM triggers compound into a prolonged crash, not a permanent loss of functional baseline. Irreversibility is not an established feature of PEM. (2) In the audio: there is a strict directional rule you must follow. When you do initiate movement, you must start with recumbent exercise. — Correct: Recumbent exercise as the mandatory starting point applies when POTS coexists with PEM, it is not a universal rule for every PEM patient. (3) In the audio: pushing through PEM causes structural metabolic damage to their energy systems. — Correct: Pushing through PEM causes sustained symptom deterioration, per ME/CFS and PASC cohort data. No structural or mitochondrial damage mechanism is established. (4) In the audio: locate and clear out those persistent viral reservoirs that have been driving the chronic inflammation. — Correct: No mechanism for vaccine-associated PASC improvement is established; reservoir clearance is only one hypothesis. Vaccination is "generally recommended," not "strongly recommended." The written chapter is correct. Full correction register: https://www.reflexpmr.com/errata. The full companion chapter and a linked board-style Q-bank set for this topic are at https://www.reflexpmr.com/read/MEDREH-11.