In een artikel worden de mogelijke oorzaken van post-exertionele "malaise" in kaart gebracht:
- energetische afwijkingen en verminderde zuurstofopname worden versterkt door inspanning;
- spierafwijkingen en de afwijkende fysiologische reactie van spieren op inspanning;
- landurige oxidatieve en nitrosatieve stress na inspanning;
- verhoogde pijngevoeligheid en verlaagde pijndrempel bij inspanning;
- immunologische afwijkingen na een ("kleine") inspanning;
- cardiologische afwijkingen/verstoorde bloedcirculatie en het gevolg van inspanning;
- afwijkende reactie van het autonome zenuwstelsel bij inspanning en orthostatische stress; en
- neurologische afwijkingen in relatie met fysieke en cognitieve stress.
De meeste afwijkingen komen niet voor bij inactieve mensen met of mensen met psychische klachten
en kunnen derhalve niet verklaard worden door "deconditionering" of "psychogene" oorzaken.
Deviant cellular and physiological responses to exercise
in Myalgic Encephalomyelitis and chronic fatigue syndrome.
J J Physiology. 2015,1(2): 007.
Twisk FNM, Geraghty KJ.
Abstract
Post-exertional "malaise" is a hallmark symptom of
Myalgic Encephalomyelitis (ME) and Chronic Fatigue Syndrome (CFS).
Various abnormalities,
including abnormal physiological responses to exertion,
can account for post-exertional "malaise” and "exercise avoidance".
Since these abnormalities are not observed in sedentary healthy controls,
the abnormalities and deviant responses cannot be explained by
"exercise avoidance" and subsequent deconditioning, nor by psychogenic factors.
Keywords:
Myalgic Encephalomyelitis; chronic fatigue syndrome; exercise physiology;
energetics; immune system; oxidative and nitrosative stress.
Conclusion
Post-exertional "malaise" and "exercise intolerance" are hallmark symptoms [80] of
Myalgic Encephalomyelitis (ME) [1-3] and Chronic Fatigue Syndrome (CFS) [4].
This article reviews observations which support the position that
post-exertional "malaise" in ME/CFS may be linked to
a number of observable deviant physiological responses to exercise,
including muscle weakness and myalgia, a substantial fall of oxygen uptake after exercise,
an increase in metabolite-detecting (pain) receptors, increased acidosis,
abnormal immune responses, and orthostatic intolerance.
Such findings go some way to explain why many ME/CFS sufferers
either avoid exercise or
report negative effects of exercised-based rehabilitation protocols,
such as graded exercise therapy (GET).
The physiological abnormalities induced by ME/CFS
cannot be simply explained by
a sedentary life style and deconditioning [81],
or psychogenic factors [82].
While we acknowledge the importance of physical activity in illness rehabilitation,
our findings cast doubt on the efficacy of exercise protocols as a therapeutic approach.
More research into exercise-induced cellular and physiological abnormalities
in ME/CFS is needed
to better understanding the illness and its impact on patients, and
to develop appropriate treatments.
http://www.jacobspublishers.com/images/Physiology/J_J_Physiology_1_2_007.pdf
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