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Journal of Pediatrics 95: 10431046, 1979 Schmidt-Sommerfeld E, Penn D

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Overall, the benefits of aerobic exercise are limited by the functional reserve beyond the mutation load in MM patients, and the magnitude of improvement is largely determined by the underlying genotype ( MM patients experience exercise intolerance and delayed post-exercise recovery as a result of defective oxidative phosphorylation, which limits ATP production ( MM patients typically exhibit elevated oxidative stress due to ETC defects, resulting in excessive ROS production that damages mtDNA

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