Loss of muscle tissue in cancer patients is reflected in functional changes of various reflexes arising from them, for example, ergoreflex.
Ergoreflex is a peripheral reflex originating in skeletal muscles.
In patients with CHF, there is evidence of a significant association between peripheral muscle wasting and enhanced ergoreflex. 
The depletion of lean tissue in cancer patients might contribute to the functional changes in skeletal muscles and ergoreflex. The study was undertaken to test the hypothesis that ergoreflex is hyperactive in cancer patients and it contributes to early fatigue, breathlessness, and exercise limitations.
To evaluate ergoreflex in forearm, post-exercise regional circulatory occlusion method was used.
In fact, the stimulation of limb locomotor groups III-IV afferent fibers (ergoreflex activation) clearly has the capability to increase ventilatory response to rhythmic exercise (21,22).
With regard to heart failure syndrome, mechanisms reported for increased ventilatory inefficiency during exercise include: 1) ventilation-perfusion mismatch; 2) early occurrence of metabolic acidosis, and 3) abnormal ergoreflex and chemoreflex control leading to a high ventilatory drive (8,9,42-47).
It should also be noted that afferent feedback linked to receptors in locomotor muscle (ergoreflex activation) originating from groups III and IV (myelinated and unmyelinated, respectively) contributes to altered ventilatory control during exercise in heart failure patients (42,43).
Notably, aerobic exercise training not only improves peak V[O.sub.2] but also promotes a number of significant changes in the exercising limbs, such as increased [O.sub.2] uptake and arteriovenous [O.sub.2] difference, as well as decreased lactate accumulation and ergoreflex activation (50).
Based on these findings, it seems reasonable to speculate that an increase in cardiac output after exercise training programs can improve convective [O.sub.2] transport to the working locomotor muscle, thus reducing both metabolic disturbance and ergoreflex activation during exercise in CHF patients.
As illustrated in Figure 1, after MI, the reduction in cardiac output is associated with an imbalance of the autonomic nervous system in favor of increased sympathetic activity and reduced vagal activity and is usually accompanied by abnormalities in the cardiorespiratory reflex control, that is, impairment of baroreflex sensitivity and function, and increased activation of ergoreflex
and chemoreflex [3, 5, 17, 18].