Talk:Exercise

Papers to add

Muscle fibre characteristics and lactate responses to exercise in chronic fatigue syndrome

https://jnnp.bmj.com/content/64/3/362.short

Aerobic work capacity in patients with chronic fatigue syndrome

https://www.bmj.com/content/301/6758/953.short

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The page is getting pretty long. We need to think of a different way to approach quotations, especially opinion. --JenB (talk) 21:46, 21 April 2018 (PDT)

Notable quotations

Mark VanNess

"Our studies clearly show that dynamic exercise like walking or jogging exacerbates symptoms associated with ME/CFS."

Paul Cheney

"The whole idea that you can take a disease like this and exercise your way to health is foolishness. It is insane."

"The most important thing about exercise is not to have (patients with ME/CFS) do aerobic exercise. I believe that even progressive aerobic exercise is counter-productive. If you have a defect in mitochondrial function and you push the mitochondria by exercise, you kill the DNA."

Peter Behan

There is "... general agreement that (ME’s) distinguishing characteristic is severe muscle fatigability, made worse by exercise. It becomes apparent that any kind of muscle exercise can cause patients to be almost incapacitated (and) the patient is usually confined to bed."

M.S. Riley, et al

"The patients with the chronic fatigue syndrome had a reduced exercise capacity compared with that of the other subjects, spending a significantly shorter time on the treadmill. They had a significantly higher heart rate at submaximal levels of exertion and at stage III exertion had significantly higher blood lactate concentrations."

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I wonder if we can come up with an alternative to "Appropriate exercise" It sounds like a value judgment and even though we don't think graded exercise works and a lot of the research on graded exercise has been poor quality, we also don't know that it doesn't work in the sense that there isn't as far as I am aware any peer reviewed literature demonstrating a negative or null result. Or that that the "appropriate" exercise the clinicians are recommending does. The key distinction is exercise that tries to remain within some kind of boundary ("energy envelope," heart rate) versus exercise that doesn't. Is there a name for a school of exercise that marries exercise with pacing? --JenB (talk) 06:37, 18 November 2015 (PST)

We could perhaps add this http://www.jacobspublishers.com/images/Physiology/J_J_Physiology_1_2_007.pdf Olliec (talk) 07:46, 24 November 2015 (PST)

Another study to consider adding is Cochrane, not sure where to put it atm so putting it here for now https://www.ncbi.nlm.nih.gov/pubmed/26852189 Olliec (talk) 05:24, 17 February 2016 (PST)

Another resources is this list of quotations from Williams & Hooper, which contains many about exercise http://www.meactionuk.org.uk/Quotable_Quotes_Updated.pdf Olliec (talk) 07:35, 16 August 2016 (PDT)

I am going to go on record as saying exercise in a clinical setting based on theory not yet thoroughly researched and proven is wrong. The very "thing" that damages the health of patients further should not be employed on a clinical level unless their is PROOF that it will not hurt them; these so called thresholds are not proven in double blind and replicated studies. Exercise, in order to bring on PEM in order to research it OR trying to find if there is a way for a patient to ever exercise and finding a research proven threshold or finding when a patient is in a true remission which probably exists but not for all patients, should only be employed in highly controlled research. It doesn't matter if it is not used as a treatment or cure for the patient, what matters is why it would be used outside of highly controlled research at this time.--DxCFS (talk) 11:57, 22 August 2016 (PDT) --DxCFS (talk) 15:03, 22 August 2016 (PDT) Excellent point! Kmdenmark (talk) 15:34, 22 August 2016 (PDT)

Additionally, I fail to understand how mental exertion which triggers PEM has anything to do with measuring VO2, but I'm stupid like that. I'm sure there is a theory, but we are back to theory and not solid research. Theory should not be implemented on patients in a clinical setting.--DxCFS (talk) 14:54, 22 August 2016 (PDT)

Another excellent point! 15:34, 22 August 2016 (PDT)

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I have moved citations not used in prior text from references section to here. If you can figure out where in the article these citations should be used, please move them back.--Samsara (talk) 08:33, 7 November 2016 (PST)

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This study can probably be added here too https://www.ncbi.nlm.nih.gov/pubmed/28782878 Ollie (talk) 04:46, 10 August 2017 (PDT)

Perhaps <ref name="Riley,1990"> citation can be removed altogether as it is over 30 years old. Kmdenmark(talk) 11:23, 25 April 2018 (EST)

mitochondria Important parts of the biological cell, with each mitochondrion encased within a mitochondrial membrane. Mitochondria are best known for their role in energy production, earning them the nickname "the powerhouse of the cell". Mitochondria also participate in the detection of threats and the response to these threats. One of the responses to threats orchestrated by mitochondria is apoptosis, a cell suicide program used by cells when the threat can not be eliminated.

heart rate (HR) - the number of times the heart beats within a certain time period, usually a minute

Energy Envelope Theory A self-management tool developed and tested by Dr. Leonard Jason to reduce symptom severity and the frequency of post-exertional malaise or relapses for people with ME/CFS. According to this theory, ME/CFS patients should not expend more energy than they perceive they have, as this results in post-exertional malaise and higher disability. Instead patients are advised to stay within their energy envelope, meaning the physical limits the disease has imposed upon them. As the energy envelope theory also cautions about the dangers of under-exertion, its principles are almost identical to ‘pacing’, an activity management strategy for ME patients devised by Ellen Goudsmit in the UK.

double blinded trial A clinical trial is double blinded if neither the participants nor the researchers know which treatment group they are allocated to until after the results are interpreted. This reduces bias. (Learn more: www.nottingham.ac.uk)

post-exertional malaise (PEM) - A notable exacerbation of symptoms brought on by small physical or cognitive exertions. PEM may be referred to as a "crash" or "collapse" and can last for days or weeks. Symptoms can include cognitive impairments, muscle pain, trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, and others.

BMJ The BMJ (previously the British Medical Journal) is a weekly peer-reviewed medical journal.

physiological Concerning living organisms, such as cells or the human body.  Physio logical (as in physio) is not to be confused with psych ological (emotional stress).

muscle strain An injury involving a stretched or torn muscle or tendon (tendons are fibrous cords of tissue that connect muscle to bone).