Fast-witch muscle fibers are used for quick, explosive movements, such as lifing heavy objects or sprinting, while slow-twitch muscle fibers are used for slower, steadier activity, such as walking or endurance running “We know that it i difficult to change fiber types in people, and that it doesn't happen with inactivity,” Wast says. “Something else is changing the fiber types.” Although they don't know what is driving this change, it may help explain some of the fatigue that patients are experiencing. ‘[Fast-twitch muscle fibers] use energy quicker, and therefore they fatigue quicker,” Wast says. Changes to the body's abilty to recover In addition to the changes in the body's ability to use energy, and the composition of muscle fibers, Wast and his collaborators also found evidence of muscle damage. “Often when we see people, they are in a slow rolling crash, it these constant waves of post-exertional malaise,” says Davenport, noting that for many patients with long COVID or MEJ/CFS, overexertion can happen while carrying out their daily activities, whether it's going to the grocery store or brushing their teeth For patients with post-exertional malaise, this study affirms the importance of staying within their energy limits to minimize crashes, a strategy that is commonly referred to as pacing “You want to minimize the severity and duration of post-exertional malaise,” Bateman says.
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