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New paper: Inability of ME patients to reproduce VO2 max indicates functional impairment

Discussion in 'Latest ME/CFS Research' started by Countrygirl, Apr 23, 2014.

  1. Countrygirl

    Countrygirl Senior Member

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    I couldn't find this posted elsewhere, and apologies if I have missed it


    http://www.translational-medicine.com/content/pdf/1479-5876-12-104.pdf

    Published 23rd April 2014


    Journal of Translational Medicine 2014, 12:104 doi:10.1186/1479-5876-12-104
    Betsy A Keller (keller@ithaca.edu)
    John Luke Pryor (luke.pryor@uconn.edu)
    Ludovic Giloteaux (ludovicgiloteaux@gmail.com)

     
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  2. taniaaust1

    taniaaust1

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    Have I miss understood? Is that saying that due to this that physical activity should be prescribed? eg as in getting people to be more physical?? **confused**

    What is meant by prescribing physical activity? shouldnt it say prescribe rest periods or something like that?
     
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  3. A.B.

    A.B. Senior Member

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    Yes, I think they haven't learned enough about ME/CFS to realize a normal exercise program is counterproductive. I wouldn't worry about it, it is very good news that this study has been replicated, and they got the key points right.
     
  4. alex3619

    alex3619 Senior Member

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    This is the paper I have been waiting for! Thank you @Countrygirl . This is the independent confirmation of the CPET findings. No longer can anyone argue its one single group, now at the Workwell Foundation, who have made this finding.

    @taniaaust1 , this kind of finding specifies what kind of exercise cannot be undertaken as well as what can. The current discussion at Workwell is about four year exercise programs, very slow, always staying within levels that do not exacerbate our energy production issues. It most specifically is against any form of graded aerobic exercise program.

    I will read the full paper and maybe say some more later.
     
  5. A.B.

    A.B. Senior Member

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  6. Sidereal

    Sidereal Senior Member

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  7. taniaaust1

    taniaaust1

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    I wonder if those doing the IOM stuff going to pay this study any attention as its small..

    We need a large study showing this stuff!
     
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  8. Sean

    Sean Senior Member

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    Just worth repeating. :thumbsup:
     
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  9. Valentijn

    Valentijn Activity Level: 3

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    The CPET results would show that limits need to be placed on exertion, and can be a scientific way to determine what those limitations are. Instead of "add a minute of walking every day even if you feel like cat puke", it can show that exceeding a certain heart rate, etc, must be avoided.

    Hence it's more likely to result in pacing than GET, since it would indicate minimal activity on bad days where sitting up sends your heart rate to 150, etc. But the main difference is using a "physiological" basis to determine activity levels - our bodies would determine the limits, not some quack with a crazy theory.
     
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  10. A.B.

    A.B. Senior Member

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    It makes it possible to determine what really helps and what doesn't. CBT/GET nutters will not like this. They prefer things to be vague and opinion/authority based.
     
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  11. Valentijn

    Valentijn Activity Level: 3

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    It removes all opportunity for them to fabricate a mystical illness framework based on their unverifiable psychosomatic beliefs, and puts us back in the hands of science. The psychobabblers aren't the experts anymore, and anyone leaving them in charge should have a lot to answer for.
     
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  12. chipmunk1

    chipmunk1 Senior Member

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    That is how it was all born.

    The founder of the talking cure Sigmund Freud took loads of cocaine, felt invincible and started to tell stories about his talking "cures". Unfortunately people would believe him. Eventually this all became mainstream despite Freud being nuttier than a fruitcake. Once the idea of "curing" sick people just with brief, frequent talk sessions was in the mind of the public it became fact despite being fiction.

    The modern cognitive approaches like cBS(Cognitive BS), while being different are based one the same 100 year old freudian ideas(or delusions) that sick people can be cured just with a little bit of talking.

    Freud would make an inflation adjusted $500 per session and it is documented that he once told a wealthy patient in analysis that he had the subconscious desire to make Freud rich and asked him to donate to his psychoanalytic fund.

    I read some of the cBS therapists in the UK earn $250 per hour selling their invisible snake oil. If it doesn't work they blame the patient or change the diagnosis and refer them to their buddies for further looting.

    The true history of talk therapy is well documented in "The Freud Files". It's far worse than even most critics would admit.

    http://www.brainpickings.org/index.php/2012/04/23/the-freud-files/
     
    Last edited: Apr 23, 2014
  13. peggy-sue

    peggy-sue

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    One also has to remember that Freud was a blatant misogynist, with a serious "mother fixation" and never, ever forget that he was also a product of his time.
    And that he had supportive buddies, such as Jung, who joined him in his coke-fuelled sessions...
     
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  14. Wildcat

    Wildcat Senior Member

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    Hmm, and his mad mate Fleiss who operated on women's noses because of his theory of 'nasal reflex neurosis', a supposed connection twixt nose and genitals. So Fleiss did nose operations to stop neurological and psychological 'symptoms, operations which had terrible physical results for the patients, notably Emma Eckstein, who was referred to Fleiss by Freud for nose surgery to cure premenstrual symptoms.

    .
    .
     
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  15. alex3619

    alex3619 Senior Member

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    Freud is almost completely discredited. Richard Webster shows how he fabricated at least one of his cases. Yet, sadly, his legacy lives on in conversion disorder and other psychosomatic claims.

    I have been of the opinion for some time that CPET is our big weapon in this fight. The test isn't perfect, its not an ideal diagnostic test of anything as severe patients may not be able to do it, but it shows the reality of things.

    When things like this were discovered for gastric ulcers and MS it became only a matter of time before things changed. However I want to point out that, in peptic ulcers at least, it was active advocacy that really drove things along. I am unsure about advocacy involvement in the change of attitude to MS, but I think it would be a similar story.

    The fuse is lit. The unproven hypotheses psychobabblers have been using are about to be demolished. Yet we also have a potential diagnostic test for the less sick, a treatment outcome biomarker, and a measurement of disability. Darn, somebody kick me, this can only happen in a dream.
     
    Last edited: Apr 23, 2014
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  16. Wildcat

    Wildcat Senior Member

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    .

    Freud's legacy also lives on in the form of Freudian Feminist Literary criticism, most notoriously in the work of the shameless Elaine Showalter and her infamous book 'Hystories: Hysterical Epidemics and Modern Culture'.
    .
     
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  17. alex3619

    alex3619 Senior Member

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    In case anyone is unaware, CPET technology, though not called that, goes back to at least 1949. That's a long time to miss something like this.
     
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  18. alex3619

    alex3619 Senior Member

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    At one time her book was one of the supposed "authoritative" sources that the Wikipedia page on CFS was using to support their line.
     
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  19. PennyIA

    PennyIA Senior Member

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    It does seem like a really long time, doesn't it? I was thinking, well, but since we show normal on the first test, that's why it was dropped.

    BUT if the doctors had TRULY listened to what the patients were saying? Then they would have been able to put two and two together to go - oh, but lets see if the person can function just as well on day two... after all, our worst episodes usually occurred after exertion.

    I get missing it for a few years... but I think this is just another piece to prove that our symptoms were dismissed for far too long. I'm sure some doctors hear "I get really fatigued after excercising" and assume it's because we tried to do too much too fast.... and/or 'everyone gets tired after exercising'.... and didn't connect the dots that it's the extremeness of our reactions.

    I'm just glad that it looks like a great way to finally get a diagnosis and will hopefully start shutting down all the people telling us it's psychological. Maybe then we'll finally get the funds pushed back into studying the diabling disease and see if we can't track down treatments/cures... I'd take anything not to keep getting worse.
     
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  20. alex3619

    alex3619 Senior Member

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    Hi @PennyIA , you are stealing the blog I am writing! ;)The finding about delayed recovery, and worsening etc., was only really obvious after the 1955 Royal Free Hospital epidemic. The Bruce Protocol popularized CPET from about 1963, so most docs should have known about it by about 1970, presuming they followed cardiac research for which it was developed. I still do not know when CPET went back to the original format, where things were measured rather than estimated. I suspect the 1980s. From that point on the medical profession can be considered to have resoundingly failed us.
     
    Last edited: Apr 23, 2014
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