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Fear of movement and avoidance behaviour toward physical activity in CFS and fibromyalgia-Nijs et al

Discussion in 'Latest ME/CFS Research' started by Dolphin, Dec 5, 2013.

  1. Dolphin

    Dolphin Senior Member

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    There is also this thread:
    But, of the 142 comments, very few were directly on the paper itself so I thought I'd start a specific thread on it. There is an interesting discussion in that thread about "Fear of movement" and "avoidance behaviour".
    Last edited: Dec 5, 2013
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  2. Dolphin

    Dolphin Senior Member

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    Here, the authors justify putting the two together:
    I'm not convinced of the supreme importance of central sensitisation in ME/CFS in particular. But the authors thankfully do keep the two separate a lot of the time.
  3. Dolphin

    Dolphin Senior Member

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    I found a lot of this paper annoying but thought this was interesting:
    Anyone know why this is the case?
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  4. Dolphin

    Dolphin Senior Member

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    The review seemed quite good in mentioning (questionnaire) evidence that contradicted the viewpoint that thinks fear avoidance is very important.

    It also seemed quite good in highlighting weakness in the literature.

    However, it didn't discuss biological findings that I can recall.
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  5. Dolphin

    Dolphin Senior Member

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    It highlights that there can be different types of behaviour, which is good (CBT crowd often don't mention this), although I'm not convinced that either should be seen as necessarily pathological behaviour:

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  6. Dolphin

    Dolphin Senior Member

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    I'm uneasy with the sort of language used (and the view underlying it):
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  7. Dolphin

    Dolphin Senior Member

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    The authors do mention a weakness in the evidence for CBT:

    However, they contrast that with the following study which I don't think really invalidates the finding in Wiborg et al:
    The authors don't made clear that the Deale et al. study didn't measure actual behaviour, just responses (which may not represent actual behaviour) to:
    The participants may simply know/have been taught what are the "right" answers to give.

    --------
    I have some other observations but don't feel inclined at present to put in more time on this paper.
  8. Valentijn

    Valentijn Activity Level: 3

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    Amersfoort, Netherlands
    The mere existence of kinesiophobia seems like a bit of an alternative or quacky belief. There's also an acknowledged rationality to the belief that movement is harmful, in the form of ongoing pain, whereas other phobias are based on distant past experiences or nothing at all.

    A phobia should also involve a strong anxiety or other emotional response, which isn't the case for most ME patients. I think most of us have a very calm response to the thought or experience of over-exertion, even it is very oppositional to what certain experts believe. At least, my own response to a persistent suggestion to exercise might be surly, defiant, and extremely stubborn, but I wouldn't get upset or fearful.

    There's also the problem that people who avoid movement probably pretty much universally want to move - so long as it is without pain or disability resulting. I doubt that is true for people who have a phobia of spiders, or dogs, or heights.

    So I think kinesiophobia suffers from similar problems as pysochosomatic theories. They are simply the beliefs of certain therapists who cannot prove that they actually exist. And in the case of kinesiophobia, there are real phobias which it can easily be compared to, which suggests that it has very little in common with those phobias.
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  9. user9876

    user9876 Senior Member

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    Isn't that something that could be measured. For example measure the physiological signs associated with fear with people with various phobias when confronted with whatever was causing the fear and compare this to this with fear of movement.

    Any experiments would need to separate out movement from fear or anger of doctors causing a relapse through forced exercise programs.
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  10. Ecoclimber

    Ecoclimber Senior Member

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    Rebuttal to Ickmans et al. Association between cognitive performance, physical fitness, and physical activity level in women with chronic fatigue syndrome. J Rehabil Res Dev. 2013;50(6):795–810.

    As argued before, cognitive deficits in ME/CFS can plausibly be explained by neurological abnormalities, e.g., hypoperfusion of and hypometabolism in specific brain regions, impaired cerebral oxygenation during exercise and orthostatic stress, SPECT-scan abnormalities in the cerebral cortex, and a reduction in white and gray matter. A correlation between neurological abnormalities and neurocognitive functioning has been observed repeatedly.

    As substantiated by Meeus et al. , elevated oxidative and nitrosative stress, frequently observed in ME/CFS, can account for mitochondrial dysfunction, a decrease of the aerobic exercise capacity, and increased pain sensitivity.

    Attached Files:

  11. Dolphin

    Dolphin Senior Member

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    Thanks for posting that. However, the letter is replying to a different paper.

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