Professor & patients' paper on the solvable biological challenge of ME/CFS: reader-friendly version
Simon McGrath provides a patient-friendly version of a peer-reviewed paper which highlights some of the most promising biomedical research on ME/CFS ...
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Short-Term Effect of Aerobic Exercise on Symptoms in Multiple Sclerosis and Chronic Fatigue Syndrome

Discussion in 'Latest ME/CFS Research' started by Dolphin, Jul 23, 2014.

  1. Dolphin

    Dolphin Senior Member

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    Free full text: http://ijmsc.org/doi/abs/10.7224/1537-2073.2013-005

     
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  2. Dolphin

    Dolphin Senior Member

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    When one sees the results, they are not as clear cut as the authors make out. At 8 patients in each cohort, I think this study was underpowered to find differences.

    ---
    The authors appear to be fans of exercise for CFS. This is annoying as I know people like Lorna Paul and Rebecca Marshall-McKenna have been funded by ME Research UK in the past and should be aware of problems

    Discussion:
     
    Last edited: Jul 23, 2014
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  3. Dolphin

    Dolphin Senior Member

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    Who were the patients:
    So not necessarily a representative group.

    Good that Canadian ME/CFS criteria used.

    So again possibly not representative.
     
  4. Dolphin

    Dolphin Senior Member

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    An example of how underpowered the study appears:
    The pre-treatment pain scores were:
    Mean (SD)
    MS: 3.85 (4.6)
    CFS: 18.9 (17)
    Healthy Controls: 8 (22.6)
    On scale of 0-100.
     
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  5. Dolphin

    Dolphin Senior Member

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    Note that 3 out of 8 of the CFS group didn't perform the required exercise:
    3 out of 8 is 37.5% so a significant percentage.
     
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  6. Dolphin

    Dolphin Senior Member

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    As might be expected, the exercise had a greater effect on perceived exertion in the MS & CFS groups.
     
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  7. Dolphin

    Dolphin Senior Member

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    Here's the table with the main results:
    i1537-2073-16-2-76-t02.gif

    As one can see, there are some changes for fatigue and pain in the CFS group compared to the healthy controls which might reach statistical significance with a bigger sample.

    They did say:
     
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  8. Bob

    Bob

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    With only 8 CFS patients participating, this is a meaningless study. But these look like the sort of results you'd expect for deconditioned/sedentary healthy people, rather than ME patients. I'd like to see the results at 48 hours, but if they are deconditioned/sedentary patients, then I guess the results would be similar.
     
    Last edited: Jul 23, 2014
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  9. osisposis

    osisposis Senior Member

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    [QUOTEI think there are differences in CFS vs. ME/CFS , to me ME/CFS does point to allergy and infection, and menningitis and damage to the menninges. IL-33 involvement points to this. again, I'm here because of exposure in a WDB, aka toxic molds, chemicals,voc's,ect. it was a high moisture/humidity wdb that tore me up. this was 2001, in 2007 I started researching which didn't start so well because of brain dysfunctions but I kept at it. mast cells are major here, and alot of new and very recent studies point to this. I say this because I've done the research, lyme, virus,bacterial, and the secondary poisoning cause by mast cell degranulation and even the release of potents without degranulation is a big deal. to much to try to cover in a few but mainly I wanted to share this as I think I may be seeing some tie in here because I've been looking into IL-6 and IL-10. this first article jumped out at me, you have to look inbetween the lines here but I pulled out some interesting stuff. the other article "mast cell in inflammation" goes into some detail thats very valuable also. ][/QUOTE]
     
  10. osisposis

    osisposis Senior Member

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    IL-6 and IL-10 Anti-Inflammatory Activity Links Exercise to Hypothalamic Insulin and Leptin Sensitivity through IKKβ and ER Stress Inhibition
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2927536/

     
  11. osisposis

    osisposis Senior Member

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  12. lnester7

    lnester7 Seven

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    How is this even valid or relevant when is widely accepted that excercise can cause PEM in cfs after even 72H!!!!! They cannot conclude but tha WITHIN the 24h didn't make a difference, even if you go bed ridden right after that. :bang-head::bang-head:
     
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  13. osisposis

    osisposis Senior Member

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    low IL-10 has also been linked to fibromyalgia.
     
  14. MeSci

    MeSci ME/CFS since 1995; activity level 6?

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    Some of the standard deviations (SDs) are enormous, aren't they? Stats are my weakest point in science :redface: but I know there are some stats whizzes on here.
     
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  15. lnester7

    lnester7 Seven

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    @Dolphin it is legal to comment on paper or use the same data and write another paper??? Could any of us clarify the 24h period and publish something before we get detremental excercise prescribed. This is irresponsible (AND I DO EXCERCISE but I know what my AT is, and even like that I have issues and set backs).
     
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  16. Simon

    Simon

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    Think they are getting well ahead of themselves, as surely the only safe message is to researchers, that this is an interesting finding that needs replication on a bigger scale with representative patients. This ought to come before any messages about appropriate exercise regimes are put out to patients or their clinicians.

    The abstract is a little better
    However, the authors didn't cite a bigger study on MS, CFS patients and controls in response to moderate exercise, which found pain and fatigue increased at 24 hours in the CFS but not the MS group (from the Lights' stable)
    Differences in metabolite-detecting, adrenergic, and immune gene expression following moderate exercise in chronic fatigue syndrome, multiple sclerosis and healthy controls
    Although focusing on gene expression this study - with 22 CFS, 23 MS & 23 controls - found that both pain and fatigue increased significantly over time in response to moderate exercise (c70% max heart rate, similar to the new study) and remained elevated at 48 hours in CFS patients though not in MS or controls [see figure 1]. (The study didn't measure function.)

    Yes, and the unrepresentative nature too, as you pointed out: additionally was 4 men/4women, aged 56 and BMI=29 so older, more male and more overweight than typical clinical samples.
     
    Last edited: Jul 23, 2014
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  17. anciendaze

    anciendaze Senior Member

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    There is considerable clinical recognition about the negative effects of overexertion in MS. What do they say about that? Second, do they offer any way CFS patients can tell if they are approaching anaerobic threshold? It now appears that exercise beyond this threshold is responsible for PEM. If patients have no way to avoid a threshold they cannot perceive, what use is advice?

    For those who expect ME/CFS to show strong markers in terms of cytokines, I'd point out that MS generally does not offer these in a consistent and disease-specific way.

    See,
    Review: cytokines and the pathogenesis of multiple sclerosis
    1. V. Navikas* and
    2. H. Link

    Elsewhere I've commented on the problematic nature of thresholds for laboratory measurements for autoimmune disease in the absence of clinical signs.

    So, what determines a solid diagnosis of MS? We come back to clinical signs which are difficult or impossible to fake, and lesions seen on MRIs or found at autopsy. Is it possible for disease states to fall just short of these? Yes, and the way you tell is to wait for the patient to develop those clinical signs or lesions, or die unexpectedly.
     
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  18. osisposis

    osisposis Senior Member

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  19. osisposis

    osisposis Senior Member

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    2012, Differences in metabolite-detecting, adrenergic, and immune gene expression following moderate exercise in chronic fatigue syndrome, multiple sclerosis and healthy controls


    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3256093/
     
  20. user9876

    user9876 Senior Member

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    With only 8 in each group quoting the mean and SD is very dodgy at they can be very sensitive to an outlier. This may be particularly so when several in 2 groups didn't manage to do the test.
     
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