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1/ The problem with Myalgic Encephalomyeltis/Chronic Fatigue Syndrome #MECFS is that it seems so ridiculous that exercise could actually make patients worse
How can exercise be so bad for #pwME but so good for almost every other serious illness?
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How can exercise be so bad for #pwME but so good for almost every other serious illness?
THREAD
2/ New study by @4WorkWell @sunsopeningband et al shows that #MECFS patients have metabolic defects that cannot be explained by exercise phobias, deconditioning or 'illness beliefs'
#pwME have reduced oxygen consumption during exercise tests
https://buff.ly/2CXH6Hj
#pwME have reduced oxygen consumption during exercise tests
https://buff.ly/2CXH6Hj
3/ #pwME have an impaired ability to increase their oxygen consumption during exercise
This is entirely different to every other disease we know including cardiovascular disease, lung disease, end-stage renal disease, hypertension & cystic fibrosis …https://translational-medicine.biomedcentral.com/articles/10.1186/1479-5876-12-104
This is entirely different to every other disease we know including cardiovascular disease, lung disease, end-stage renal disease, hypertension & cystic fibrosis …https://translational-medicine.biomedcentral.com/articles/10.1186/1479-5876-12-104
4/ And #MECFS patients also show impaired oxygen consumption and reduced anaerobic threshold compared to Multiple Sclerosis
#MECFS are #SickNotDeconditioned, #SickNotTired, #SickNotWeak https://onlinelibrary.wiley.com/doi/abs/10.1111/cpf.12460#.W82IGKs6x4g.twitter
#MECFS are #SickNotDeconditioned, #SickNotTired, #SickNotWeak https://onlinelibrary.wiley.com/doi/abs/10.1111/cpf.12460#.W82IGKs6x4g.twitter
5/ Exercise testing provides an explanation for why #MECFS patients can crash even after modest exertion
The reduced aerobic capacity of #pwME results in a switch to anaerobic #metabolism that likely impacts their ability to do simple daily activities https://frontiersin.org/article/10.3389/fped.2019.00082
The reduced aerobic capacity of #pwME results in a switch to anaerobic #metabolism that likely impacts their ability to do simple daily activities https://frontiersin.org/article/10.3389/fped.2019.00082
6/ And #MECFS patients can 'crash' if they over-exert resulting in a post-exertional malaise #PEM
Triggering #PEM reduces the threshold at which anaerobic #metabolism accelerates which impairs the ability of patients to do non-strenuous tasks …https://translational-medicine.biomedcentral.com/articles/10.1186/1479-5876-12-104
Triggering #PEM reduces the threshold at which anaerobic #metabolism accelerates which impairs the ability of patients to do non-strenuous tasks …https://translational-medicine.biomedcentral.com/articles/10.1186/1479-5876-12-104
7/ And exercise that triggers #PEM in #MECFS patients leads to a sustained #immune inflammatory response that is distinct from that in sedentary or deconditioned people
@PLOSONE #MedEd #SickNotTired https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0197811
@PLOSONE #MedEd #SickNotTired https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0197811
8/ Humans use aerobic metabolism for the majority of daily activities such as walking and seated tasks
But a reduced aerobic capacity of #MECFS patients likely forces a switch to less efficient anaerobic metabolism leading to premature fatigue and #PEM https://www.frontiersin.org/article/10.3389/fped.2018.00242
But a reduced aerobic capacity of #MECFS patients likely forces a switch to less efficient anaerobic metabolism leading to premature fatigue and #PEM https://www.frontiersin.org/article/10.3389/fped.2018.00242
9/ Exercise studies also show that the increased reliance on anaerobic #metabolism in #MECFS patients results in increased metabolites such as lactic acid which likely leads to an inability to maintain work and a reduction in activity https://academic.oup.com/ptj/article/93/11/1484/2735315#.XvwQSPj6eMh.twitter
10/ Physical therapists should be aware that post-exertional malaise #PEM in #pwME is due to objectively measurable deficits in metabolism
So yes, exercise is beneficial for nearly every illness...
..but the science shows that #MECFS is the exception https://academic.oup.com/ptj/article/93/11/1484/2735315#.XvwQSPj6eMh.twitter
So yes, exercise is beneficial for nearly every illness...
..but the science shows that #MECFS is the exception https://academic.oup.com/ptj/article/93/11/1484/2735315#.XvwQSPj6eMh.twitter
This @FrontiersIn review by @4WorkWell discusses how cardiopulmonary exercise testing #CPET can be used to help diagnose & research #MECFS
This table provides a helpful list definitions for patients and doctors to investigate #MECFS
#MedEd #MedTwitter
https://www.frontiersin.org/article/10.3389/fped.2018.00242
This table provides a helpful list definitions for patients and doctors to investigate #MECFS
#MedEd #MedTwitter
https://www.frontiersin.org/article/10.3389/fped.2018.00242
