Outcomes of Research or Clinical Trials Activity Levels Acute Flaccid Paralysis Ageing Anaerobic Threshold Anaesthesia Assistive Technology Brain Cardiorespiratory Cardiovascular Clinical Evaluation Cold Intolerance Complementary Therapies Continence Coping Styles and Strategies Cultural Context Diagnosis and Management Differential Diagnosis Drugs Dysphagia Dysphonia Epidemiology Exercise Falls Fatigue Fractures Gender Differences Immune Response Inflammation Late Effects of Polio Muscle Strength Muscular Atrophy Orthoses Pain Polio Immunisation Post-Polio Motor Unit Psychology Quality of Life Renal Complications Respiratory Complications and Management Restless Legs Syndrome Sleep Analaysis Surgery Vitality Vocational Implications

Title order Author order Journal order Date order
Category: Ageing, Late Effects of Polio

Title: A Review of Secondary Health Conditions in Post-Polio Syndrome: Prevalence and Effects of Aging
Author: Thomas E. McNalley, MD, MA, Kathryn M. Yorkston, PhD1, Mark P. Jensen, PhD1, Anjali R. Truitt, MPH1, Katherine G. Schomer, MA1, Carolyn Baylor, PhD1, and Ivan R. Molton, PhD1
Affiliation: Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
Journal: American Journal of Physical Medicine & Rehabilitation
Citation: 94(2): 139–145. doi:10.1097/PHM.0000000000000166
Publication Year and Month: 2015 02

Abstract: Objective—This study seeks to better understand the prevalence and severity of secondary health conditions in individuals with post-polio syndrome (PPS), and the association between these conditions and aging.

Design—A scoping literature review was conducted searching electronic databases for studies published from 1986 – 2011. The scoping review provided information regarding the prevalence and associations of secondary health conditions in PPS with age or other duration-related variables.

Results—The findings indicate that: (1) individuals with PPS experience a number of serious secondary health conditions; (2) the most common conditions or symptoms are fatigue, pain, respiratory and sleep complaints, and increased risk of falls; (3) reports of the associations between the frequency or severity of conditions and age-related factors are variable, perhaps because of methodological inconsistencies between studies; and (4) there is a marked lack of longitudinal research examining the natural course of health conditions in people aging with PPS.

Conclusions—Longitudinal research is needed to understand the course of health conditions and the impact of multiple secondary conditions in people aging with PPS. Efforts are also needed to develop and test the efficacy of interventions to prevent these health secondary conditions or reduce their negative impact.

Keywords
Post-Polio Syndrome; Secondary Conditions; Aging; Scoping Review

Conclusions: The key findings from this scoping review include the following: (1) people with PPS experience a large number of serious secondary health conditions, including fatigue, pain, depression, muscle weakness, pulmonary and sleep disorders, and falls; (2) although comparisons with normative samples are rare, one study suggests that depression has a greater impact on the lives of people with PPS than on the general population; and (3) a number of methodological issues limit our ability to interpret the findings related to the associations between secondary conditions and aging.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Assistive Technology, Late Effects of Polio

Title: Coping with a Second Disability: Implications of the Late Effects of Poliomyelitis for Occupational Therapists
Author: Mary Westbrook, Lynette McDowell
Affiliation: Macquarie University, Sydney. Australia
Journal: Australian Occupational Therapy Journal
Citation: 38(2):83 - 91
Publication Year and Month: 2010 08

Abstract: The long term effects of many physical disabilities have only recently begun to be appreciated. For people who have lived for years with what they thought to be stable conditions, the onset of secondary disabilities may be associated with considerable problems and distress. A questionnaire survey of 324 people with poliomyelitis revealed the occurrence of late effects in 94% of respondents. The majority reported increased weakness, pain and fatigue, problems in carrying out daily living activities and difficulties in obtaining appropriate health care. Although occupational therapists were less likely to be consulted than other professionals, they received one of the highest satisfaction ratings from clients.

Conclusions: Discussion of case studies indicates ways in which occupational therapists can provide symptom relief and enable clients to maintain valued roles. As the survival rates of people with disabilities increase there is a need for greater awareness of, and research into, the late effects of disability.

Outcome of Research: More research required

Availability of Paper:

Comments (if any):

Link to Paper (if available): Click here for preview


Category: Pain, Late Effects of Polio

Title: Effectiveness of Intravenous Immunoglobulin for Management of Pain in Patients with Postpolio Syndrome
Author: Min Cheol Chang (1), Jin-Sung Park (2), Jong-moon Hwang (3), and Donghwi Park (4)
Affiliation: (1) Department of Rehabilitation Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea

(2) Department of Neurology, School of Medicine, Kyungpook National University,
Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea

(3) Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea

(4) Department of Physical Medicine and Rehabilitation, Ulsan University Hospital, University of Ulsan College of Medicine,
Ulsan, Republic of Korea
Journal: Pain Research and Management
Citation: Volume 2021, Article ID 6637705, 4 pages
https://doi.org/10.1155/2021/6637705
Publication Year and Month: 2021 03

Abstract: Objective.
Many patients with postpolio syndrome (PPS) experience pain. In this study, we aimed to review previous studies to investigate the effectiveness of intravenous immunoglobulin (IVIG) for managing pain in patients with PPS. We performed a narrative review.

Methods.
In PubMed, we searched for the keywords ((Immunoglobulin OR IVIG) AND (poliomyelitis OR poliomyelitis syndrome)). We included articles in which IVIG was infused in patients with PPS and pain severity was measured before and after treatment.

Results.
In the results, five articles (4 randomized controlled trials and 1 prospective observational study) were included in this review. Four of the studies reported that IVIG had a positive pain-reducing effect in patients with PPS. In addition, 4 studies evaluated the outcomes related to muscle strength and function. Of these studies, 3 showed some improvement in measurements for muscle strength and function.

Conclusion.
In conclusion, IVIG might be one of the beneficial options for managing pain in PPS. Pain reduction might be responsible for the improvement of muscle strength or function. To confirm the benefits of IVIG in reducing pain, more high-quality studies are required.

Conclusions: In conclusion, this review shows that IVIG administration might be useful for managing pain in patients with PPS. In the 5 articles reviewed, no major adverse effects were reported. Owing to the small number of studies and inconsistent results between the studies, we cannot make a definite conclusion on the effect of IVIG on pain in PPS. However, we think that the previous studies showed a possibility that IVIG can safely manage pain in patients with PPS. To confirm the benefits of IVIG in reducing pain in patients with PPS, more high-quality studies are required. Moreover, the protocols for IVIG infusion used in each study were heterogeneous; therefore, the most effective protocol for IVIG infusion for controlling pain should be evaluated in the future.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Cardiovascular, Exercise, Late Effects of Polio, Muscle Strength

Title: Effects of muscle strengthening and cardiovascular fitness activities for poliomyelitis survivors: A systematic review and meta-anaylsis.
Author: Akhilesh Kumar RAMACHANDRAN, MSc, BEng (1), Stephen P. J. GOODMAN, PhD, Hon BEXSc (2), Michael J. JACKSON, MPT, BEd, BACH (1) and Timothy J. H. LATHLEAN, PhD, MClinRehab, Hon BSc, BBehSc (2,3)
Affiliation: 1) Polio Australia Incorporated

2) Discipline of Exercise and Sports Science, School of Science and Technology, University of New England

3) Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide.
Journal: Journal of Rehabilitation Medicine (JRM) - formerly Scandanavian Journal of Rehabilitation Medicine
Citation: J Rehabil Med 2021; 53: jrm00184, doi: 10.2340/16501977-2832
Publication Year and Month: 2021 04

Abstract: Objective:
To evaluate and assess the effectiveness of muscle strengthening and cardiovascular interventions in improving outcomes in poliomyelitis (polio) survivors.

Data sources:
A systematic literature search was conducted in Medline, PubMed, CINAHL, PsychINFO, Web of Science, and Google Scholar for experimental and observational studies.

Study selection and extraction:
Screening, data-extraction, risk of bias and quality assessment were carried out independently by the authors. The quality appraisal and risk of bias were assessed using the Downs and Black Checklist. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was followed to increase clarity of reporting.

Data synthesis:
A total of 21 studies that met all the inclusion criteria were subjected to statistical analyses according to intervention (muscle strengthening or cardiovascular fitness). A random-effects metaanalysis showed a statistically significant effect for the exercise interventions favouring improvement in outcomes according to the International Classification of Functioning, Disability and Health (ICF).

Conclusion:
This review provides further insight into the effects associated with muscle strengthening and cardiovascular interventions among polio survivors, and helps to further identify the current state of research in this area. Future research is needed, focusing on individualized approaches to exercise with polio survivors and specific exercise prescription recommendations, based on established frameworks, such as the ICF.

Conclusions: The findings of this review and analysis provide “very low level evidence” (according to the Grading of Recommendations Assessment, Development and Evaluate; GRADE) to polio survivors, clinicians and researchers. The main findings of this review relate specifically to changes in body function, and activity and participation, and include evidence of effect on improved functioning without furthering debility in polio survivors. This systematic review and meta-analysis provides additional insights into effects associated with exercise, across various types of interventions, in polio survivors, and advances the level of methodological quality of research in this area. Although there was evidence demonstrating effect across domains, due to inherent biases within the literature to date, further and high-quality primary exercise-focused research is required in order to strengthen the certainty of evidence regarding important research questions about the ongoing health of polio survivors.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any): Polio Australia staff co-authored this article.

Link to Paper (if available): Click here to view full text or to download


Category: Epidemiology, Late Effects of Polio

Title: Epidemic poliomyelitis, post-poliomyelitis sequelae and the eradication program
Author: Margaret Peel
Affiliation: University of Melbourne - Department of Microbiology and Immunology Melbourne, Australia
Position: Principal Microbiologist
Description: Retired
Journal: Microbiology Australia
Citation: 41(4):196 DOI: 10.1071/MA20053
Publication Year and Month: 2020 11

Abstract: Epidemics of paralytic poliomyelitis (polio) first emerged in the late 19th and early 20th centuries in the United States and the Scandinavian countries. They continued through the first half of the 20th century becoming global. A major epidemic occurred in Australia in 1951 but significant outbreaks were reported from the late 1930s to 1954. The poliovirus is an enterovirus that is usually transmitted by the faecal–oral route but only one in about 150 infections results in paralysis when the central nervous system is invaded. The Salk inactivated polio vaccine (IPV) became available in Australia in 1956 and the Sabin live attenuated oral polio vaccine (OPV) was introduced in 1966. After decades of stability, many survivors of the earlier epidemics experience late-onset sequelae including post-polio syndrome. The World Health Organization launched the global polio eradication initiative (GPEI) in 1988 based on the easily administered OPV. The GPEI has resulted in a dramatic decrease in cases of wild polio so that only Pakistan and Afghanistan report such cases in 2020. However, a major challenge to eradication is the reversion of OPV to neurovirulent mutants resulting in circulating vaccine-derived poliovirus (cVDPV). A novel, genetically stabilised OPV has been developed recently to stop the emergence and spread of cVDPV and OPV is being replaced by IPV in immunisation programs worldwide. Eradication of poliomyelitis is near to achievement and the expectation is that poliomyelitis will join smallpox as dreaded epidemic diseases of the past that will be consigned to history.

Conclusions: Eradication of poliomyelitis is near to achievement and the expectation is that poliomyelitis will join smallpox as dreaded epidemic diseases of the past that will be consigned to history.

Outcome of Research: Effective

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio

Title: Experiences and perspectives of patients with post-polio syndrome and therapists with exercise and cognitive behavioural therapy
Author: Minne Bakker, Karen Schipper, Fieke S. Koopman, Frans Nollet and Tineke A. Abma
Affiliation: Department of Medical Humanities, EMGO+ Institute, VU Medical Center
(VUmc), Amsterdam, The Netherlands
Journal: BioMed Central Neurology
Citation: BMC Neurology (2016) 16:23
Publication Year and Month: 2016

Abstract: Background: Many persons affected with poliomyelitis develop post-polio syndrome (PPS) later in their life.
Recently, the effectiveness of Exercise Therapy (ET) and Cognitive Behavioural Therapy (CBT) for PPS has been evaluated in a randomized controlled trial, but did not show a decrease in fatigue or improvement in secondary endpoints like Quality of Life and self-perceived activity limitations. The aim of this explorative study was to gain insight in the perceived effects and experiences of the interventions from the perspectives of the patients and
therapists.
Methods: Qualitative data were collected through semi-structured interviews with 17 patients and 7 therapists. All participants were involved in the trial. A thematic analysis of the data was performed.
Results: Some patients experienced a short term enhanced endurance and a better use of energy during the day. However, in general patients did not experience a long lasting reduction of fatigue from the CBT or ET. Mainly patients of the CBT, but also some patients of the ET described an increase of self-esteem and self-acceptance. As a result, patients were sometimes better able to perform physical activities during the day. In contrast to the CBT, the
ET was in general perceived by the patients as an intensive therapy, which was difficult to fit into their daily routine. Therapists of both the CBT and the ET struggled with a low intrinsic motivation of the patients in the study.
This made it sometimes difficult for the therapists to follow the protocol.

Conclusions: Conclusion: Confirming the negative quantitative study outcome, the qualitative results did not demonstrate lasting effects on fatigue. Patients did, however, experience some benefits on self-esteem and acceptance of the disease. This study showed that it is of great importance to work with feasible interventions; they should fit the patients’ needs on a practical (fit into their daily routine) and mental (fit their need for support) level.

Outcome of Research: More research required

Availability of Paper:

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Falls, Late Effects of Polio

Title: Fall-Related Activity Avoidance among Persons with Late Effects of Polio and Its Influence on Daily Life: A Mixed-Methods Study
Author: Christina Brogårdh (1,2), Jan Lexell (1,2) and Catharina Sjödahl Hammarlund (1,3)

Affiliation: 1) Department of Health Sciences, Lund University, 221 00 Lund, Sweden

2) Department of Neurology, Rehabilitation Medicine, Memory Disorders and Geriatrics, Skåne University Hospital, 222 41 Lund, Sweden

3) The PRO-CARE Group, School of Health and Society, Kristianstad University, 291 39 Kristianstad, Sweden

Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Int. J. Environ. Res. Public Health 2021, 18(13), 7202; https://doi.org/10.3390/ijerph18137202
Publication Year and Month: 2021 07

Abstract: Falls are common among persons with late effects of polio (LEoP), which may lead to fear of falling and activity avoidance in everyday life. Here, we assessed the occurrence of fall-related activity avoidance among persons with LEoP and explored how these experiences influenced daily life. Fourteen ambulatory persons (seven women; mean age 70 years) with LEoP participated. They responded to the modified Survey of Activities and Fear of Falling in the Elderly (mSAFFE) and participated in individual interviews, which were analysed by systematic text condensation. Each quotation was deductively analysed from its representation with regard to mSAFFE. We found that many persons often avoided activities related to standing and walking, for example, taking a bath, performing household chores, walking outdoors, attending social events if there were stairs in the building and travelling by public transport, due to fear of falling, increased pain and fatigability. To facilitate the performance of daily activities participants expressed that strategic thinking and aids were important to use. In conclusion, fall-related activity avoidance is common in persons with LEoP, which negatively influence daily life and social participation. To increase daily functioning in this population, fall-related activity avoidance should be included in a multifaceted fall management program.

Keywords: activities of daily living; fear of falling; postpoliomyelitis syndrome; qualitative research

Conclusions: Fall-related activity avoidance is common in persons with LEoP, which negatively influence daily life and social participation. To increase daily functioning in this population, fall-related activity avoidance should be included in a multifaceted fall management program.

Outcome of Research: Effective

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Activity Levels, Late Effects of Polio, Muscle Strength, Psychology, Quality of Life

Title: Health-related quality of life, self-reported impairments and activities of daily living in relation to muscle function in post-polio syndrome
Author: Vanya Gocheva,corresponding author1 Patricia Hafner,1 Anna-Lena Orsini,1,2 Simone Schmidt,1,3 Sabine Schaedelin,4 Nicole Rueedi,1 Daniela Rubino-Nacht,1 Peter Weber,1 and Dirk Fischer1
Affiliation: 1Division of Neuropediatrics and Developmental Medicine, University Children’s Hospital of Basel (UKBB),University of Basel, Spitalstrasse 33, Postfach, 4056 Basel, Switzerland
2Division of Neurology, University Hospital Basel, Basel, Switzerland
3Department of Neurology, General Hospital Hietzing with Neurological Center Rosenhügel, Vienna, Austria
4Department of Clinical Research, Clinical Trial Unit, University Hospital Basel, Basel, Switzerland
Vanya Gocheva, Email: [email protected]
corresponding author.
Journal: Journal of Patient-Reported Outcomes
Citation: 4(1), 59. https://doi.org/10.1186/s41687-020-00226-5
Publication Year and Month: 2020 12

Abstract: Background
The symptoms of post-polio syndrome (PPS) and its resulting disabilities can affect quality of life and the ability to perform daily activities. No study has comprehensively analysed how various patient-reported outcome measures (PROMs) are associated with objectively assessed physical function in patients with PPS.

Aim
To investigate health-related quality of life (HRQOL), self-reported impairments and activities of daily living during 6 months and evaluate their association with clinical muscle function outcomes in individuals with PPS.

Methods
Twenty-seven patients with PPS were included in the study. At baseline and 6 months, patients were administered PROMs measuring HRQOL (WHOQOL-BREF), self-reported impairments related to PPS (SIPP-RS) and activities of daily living (IBM-FRS). Clinical muscle function outcomes included 6 min walking distance (6MWD) and motor function measure (MFM).

Results
There were no changes in self-reported impairments (25.52 to 24.93, p = 0.40), activities of daily living (33.89 to 33.30, p = 0.20), 6MWD (391.52 to 401.85, p = 0.30) and MFM (83.87 to 85.46, p = 0.14) during 6 months, while the HRQOL psychological health decreased during this period (76.85 to 72.38, p = 0.05). A strong association was found between activities of daily living and clinical muscle function outcomes (6MWD: ß = 0.02, 95% CI: 0.02;0.03, t = 6.88, p < 0.01; MFM: ß = 0.25, 95% CI: 0.17;0.33, t = 6.69, p < 0.01). Self-reported impairments and HRQOL domains were not associated with the clinical muscle outcomes.

Conclusions
Study findings indicate that objectively measured walking and motor abilities do not reflect patient’s perspectives of their HRQOL and impairment due to PPS. More research is needed to assess changes over time and capture clinically meaningful changes in individuals with PPS and to increase the understanding of how the patient’s perspective of disability measured by PROMs is related to objectively measured walking and motor abilities.

Conclusions: Self-reported impairments, HRQOL domains, activities of daily living and muscle function outcomes remained stable during 6 months in patients with PPS, except for the HRQOL psychological health domain which declined during this period. Clinical muscle outcomes had no statistically significant relationship with HRQOL and self-reported impairments of PPS patients while a significant relationship was observed with the activities of daily living. More research is needed to assess changes over time and capture clinically meaningful changes in individuals with PPS and to increase the understanding of how the patient’s perspective of disability measured by PROMs is related to objectively measured walking and motor abilities.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio

Title: Late functional deterioration following paralytic poliomyelitis
Author: D. Kidd, R.S. Howard, A.J. Williams, F.W. Heatley, C.P. Panayiotopoulos and G.T. Spencer
Affiliation: Departments of Neurology, Respiratory Medicine and Orthopaedics, the Lane-Fox Unit, St Thomas' Hospital, London, UK
Journal: Post-Polio Network (NSW) Inc
Citation: QJ Med 1997; 90: 189 - 196
Publication Year and Month: 1997 01

Abstract: Many patients with previous poliomyelitis develop 'post-polio syndrome' (PPS) in which late functional deterioration follows a period of relative stability. The frequency with which PPS can be attributed to clearly defined causes remains uncertain. We reviewed 283 newly-referred patients with previous poliomyelitis seen consecutively over a 4-year period; 239 patients developed symptoms of functional deterioration at a mean of 35 (5-65) years after the paralytic illness. Functional deterioration was associated with orthopaedic disorders in 170 cases, neurological disorders in 35, respiratory disorders in 19 and other disorders in 15. Progressive post-polio muscular atrophy was not observed. Functional deterioration following paralytic poliomyelitis is common, and associated with orthopaedic, neurological, respiratory and general medical factors which are potentially treatable.

Conclusions:

Outcome of Research: Not applicable

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio, Quality of Life

Title: Life Satisfaction in Persons With Late Effects of Polio: A Test‐Retest Reliability Study
Author: Elisabeth Ekstrand RPT, PhD; Jan Lexell MD, PhD, DPhil h.c.; Christina Brogårdh RPT, PhD
Affiliation: E.E. - Department of Health Sciences, Lund University, Lund, Sweden; andDepartmentof Hand Surgery, Skåne University Hospital, Malmö, Sweden. Address correspondenceto: E.E., Department of Health Sciences,Physiotherapy Research Group, Lund Univer-sity, Box 157, SE-221 00 Lund, Sweden; e-mail: [email protected]
Disclosure: nothing to disclose.

J.L. and C.B. - Department of Health Sciences, Lund University, Lund, Sweden; andDepartment of Neurology, Rehabilitation Medicine, Memory Disorders and Geriatrics,Skåne University Hospital, Lund, Sweden
Disclosure: nothing to disclose.
Journal: PM&R: The Journal of Injury, Function, and Rehabilitation
Citation: Volume 12, Issue 10 p.997-1002
https://doi.org/10.1002/pmrj.12325
Publication Year and Month: 2020 01

Abstract:
Background
The Life Satisfaction Questionnaire (LiSat‐11), including one global item and 10 domain‐specific items, is used to evaluate life satisfaction in persons with the late effects of polio (LEoPs). However, there is a lack of knowledge about its psychometric properties.

Objective
To evaluate the test‐retest reliability of the LiSat‐11 and the associations between the global and domain‐specific items in persons with LEoPs.

Design
A test‐retest design, where data were collected by a postal survey.

Setting
University Hospital, Outpatient Clinic.

Participants
A cross‐sectional sample of persons (20 women and 31 men; mean age 72 years) with LEoPs.

Main Outcome Measurements
LiSat‐11, assessing how satisfied a person is with different aspects of life, such as life as a whole, vocation, economy, leisure, contacts with friends and acquaintances, sexual life, activities of daily living (ADLs), family life, partner relationship, somatic health, and psychological health.

Methods
LiSat‐11 was administered on two occasions, 2 weeks apart. The test‐retest reliability was evaluated by Kappa statistics, the percent agreement (PA), and the Svensson rank‐invariant method. The association between the items was evaluated with the Spearman rank correlation coefficient (rho).

Results
The Kappa coefficients showed good to excellent agreement (0.64‐0.90) and the PA ≤1 point was high (>92%) for all items. No items showed any systematic or random disagreements according to the Svensson method. All domain‐specific items correlated significantly with the global item “Life as a whole” (P < .01; rhos 0.41 to 0.75).

Conclusions
LiSat‐11 is reliable for assessing life satisfaction in persons with LEoPs. The global item “Life as a whole” is useful as an overall measure but cannot fully replace the information obtained from the domain‐specific items of LiSat‐11.

Conclusions: LiSat‐11 is a reliable outcome measure to assess life satisfaction in persons with LEoPs. The association between the global item “Life as a whole” and the domain‐specific items indicates that LiSat‐11 measures various aspects that can affect a personʼs life satisfaction. The global question “Life as a whole” is useful as an overall measure but cannot fully replace the information obtained from the domain‐specific questions of LiSat‐11.

Outcome of Research: Effective

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio

Title: Living with polio and postpolio syndrome in the United Kingdom
Author: Atwal A (1), Giles A, Spiliotopoulou G, Plastow N, Wilson L
Affiliation: (1) School of Health Science and Social Care, Brunel University, Kingston Lane, Uxbridge, Middlesex, London, UK - [email protected]

Journal: Scandinavian Journal of Caring Sciences
Citation: Scand J Caring Sci. 2013 Jun;27(2):238-45. doi: 10.1111/j.1471-6712.2012.01029.x
Publication Year and Month: 2013 06

Abstract: The term Postpolio Syndrome (PPS) is used to describe new and late manifestations of poliomyelitis that occur later in life in polio survivors. Polio had been eradicated in the United Kingdom (UK) and most of Europe, although this is not the case in all countries. Research in this area has tended to focus upon the impact of polio and PPS on health status and functional health rather than its overall effect on people's lives. This study's two main aims were to explore the ways in which polio and PPS in the UK has affected the respondents' lives and to ascertain their views about how the quality of life could be improved. The two questions were as follows: (1) How has the health of people with polio and PPS affected their quality of life? (2) What would people with polio and PPS change to improve their quality of life? Deductive content analysis using existing qualitative data from a cross-sectional survey of 336 returned questionnaires from persons with polio and PPS was carried out. The average age of the participants was 54 years. Our research found that polio survivors valued social occupations and participation in family life. Our research has also shown that healthcare professionals still do not understand polio and PPS and this lack of understanding influences their clients' quality of life. Finances and accessibility of environments also influence participation in chosen occupations. Rehabilitation programmes for people with polio and PPS need to be targeted towards maintaining and improving accessible environments and participation in chosen occupations, and healthcare professionals need to ensure that persons with polio and PPS are referred to persons with specific expertise in this area.

Conclusions:

Outcome of Research: Not applicable

Availability of Paper: Paid subscription required to view or download full text.

Comments (if any):

Link to Paper (if available): Click here to view Abstract


Category: Late Effects of Polio

Title: Long-term follow-up of patients with prior polio over a 17-year period.
Author: Vreede KS, Broman L, Borg K.
Affiliation: Department of Rehabilitation Medicine, Danderyd University Hospital, Building 39, Floor 3, SE-182 88 Stockholm, Sweden, [email protected]
Journal: Journal of Rehabilitation Medicine
Citation: 2016 Apr;48(4):359-64
Publication Year and Month: 2016 04

Abstract: OBJECTIVE:
Follow-up of the health of patients with prior polio over a 17-year period.

DESIGN:
Follow-up study.

PATIENTS:
Patients with prior polio.

METHODS:
The study questionnaire was answered in 1995 by 270 patients. In 2012 the questionnaire was sent again to the surviving patients.

RESULTS:
Of the patients who answered the questionnaire in 1995, 116 (40%) were still alive in 2012. The group of patients who had died was older, and had a mean age of 70 years in 1995. A total of 60 patients participated in the study by answering the questionnaire in both 1995 and 2012. Most of these patients (84%) reported that they felt progressively worse, with poor mobility and increased muscle weakness in 2012 compared with 1995, and more than half reported a lower quality of life in 2012. The number of wheelchair users had increased significantly. Furthermore, the patients experienced increasing problems with activities of daily living (ADL) function.

Conclusions: More than half of the patients with prior polio had died between 1995 and 2012. These patients were, on average, older than patients surviving in 2012. When interviewed in 2012 most of the patients felt progressively worse, with poor mobility and increased muscle weakness.

Outcome of Research: More research required

Availability of Paper:

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio

Title: New problems in old polio patients: results of a survey of 539 polio survivors
Author: Halstead LS, Rossi CD
Affiliation: Not stated
Journal: Orthopedics
Citation: Orthopedics. 1985 Jul; 8(7):845-50
Publication Year and Month: 1985 07

Abstract: Presented are the results of a questionnaire survey on new health problems in 539 polio survivors. The most common new problems were fatigue, weakness in previously affected and unaffected muscles, muscle pain, and joint pain. The median time from polio to the onset of these problems ranged from 30 to 40 years. Factors at onset of polio most strongly associated with developing these new health problems were: being hospitalized, being over 10 years old, being on a ventilator, and having paralytic involvement of all four limbs. The differential diagnoses of these new problems, implications for treatment and areas for future research are discussed.

Conclusions:

Outcome of Research:

Availability of Paper:

Comments (if any):

Link to Paper (if available):


Category: Cardiorespiratory, Late Effects of Polio, Respiratory Complications and Management

Title: Obesity and Pulmonary Function in Polio Survivors
Author: Soo Jeong Han, MD, PhD (1), Jae-Young Lim, MD, PhD(2), Jee Hyun Suh, MD(1)
Affiliation: 1. Department of Rehabilitation Medicine, Ewha Womans University School of Medicine, Seoul;

2. Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Korea
Journal: Annals of Rehabilitation Medicine
Citation: 2015;39(6):888-896
pISSN: 2234-0645 • eISSN: 2234-0653
http://dx.doi.org/10.5535/arm.2015.39.6.888
Publication Year and Month: 2015 06

Abstract: OBJECTIVE
To examine the correlation between obesity and pulmonary function in polio survivors.

METHODS
This study was conducted based on a questionnaire survey and physical examination. The questionnaire included gender, age, paralyzed regions, physical activity levels, and accompanying diseases. The physical examination included measuring body mass index, waist circumference, muscle power, total fat amount, body fat percentage, and lean body mass. In addition, pulmonary function was tested based on forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), ratio of FEV1 to FVC, and chest circumference. Five university hospitals and a local health clinic participated in this study.

RESULTS
Pearson and partial correlation coefficients that used data collected from 73 polio survivors showed that obesity had a negative correlation with pulmonary function.

CONCLUSION
This study found that pulmonary function has a negative correlation with obesity for polio survivors. Therefore, it is necessary to develop specialized exercise programs to help polio survivors reduce their weight and strengthen their respiratory muscles.

Conclusions: This study found that pulmonary function has a negative correlation with obesity for polio survivors. Therefore, it is necessary to develop specialized exercise programs to help polio survivors reduce their weight and strengthen their respiratory muscles.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any): Keywords: Poliomyelitis, Obesity, Pulmonary function

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio

Title: People living with post-polio syndrome must not be forgotten
Author: Hill T
Affiliation: British Polio Fellowship
Journal: Nursing Standard
Citation: Nurs Stand. 2015 Nov 4;30(10):30-1. doi: 10.7748/ns.30.10.30.s38
Publication Year and Month: 2015 11

Abstract: As research conducted by YouGov reveals, only 7% of people in Britain are aware of the neurological condition post-polio syndrome (PPS). The British Polio Fellowship is keen to highlight what is now an urgent need for more support for those living with PPS, from both the public and the nursing and medical community.

Conclusions:

Outcome of Research: Not applicable

Availability of Paper: Paid subscription required to view or download full text.

Comments (if any):

Link to Paper (if available): Click here to view Abstract


Category: Dysphagia, Dysphonia, Late Effects of Polio

Title: Pharyngolaryngeal manifestations of post-polio syndrome (Manifestações faringo-laríngeas da síndrome pós-poliomielite)
Author: Noemi Grigoletto De Biase (1), Bruno Teixeira de Moraes (2), Mariana Dantas Aumond Leb (3), Gustavo Polacow Korn (4), Marina Padovani (5), Miriam Moraes (6), Glaucya Madazio (7).
Affiliation: Departament of Laryngology and Voice of the Discipline of Otorhinolaryngology of Federal University of São Paulo - Medical School Paulista (UNIFESP-EPM). São Paulo / SP - Brazil

1) Prof. Doc. Associate of Departament of Fundamentals of Phonoaudiology of Pontifical Catholic University of São Paulo. Advisor of Masters Degree of UNIFESP-EPM.

2) Fellow in Larynx and Voice by the Departament of Otorhinolaryngology and Surgery of Head and Kneck by Federal University of São Paulo - Medical School Paulista (UNIFESP-EPM). Doctor Otorhinolaryngologist.

3) Master in Medicine by UNIFESP-EPM. Doctor Otorhinolaryngologist.

4) PhD in Science by the Departament of Otorhinolaryngology and Surgery of Head and Kneck by Federal University of São Paulo - Medical School Paulista (UNIFESPEPM). Doctor Otorhinolaryngologist.

5) PhD in Science of Human Communication by UNIFESP. Clinical Audiologist.

6) Master in Science of Human Communication by UNIFESP - Clinical Audiologist.

7) PhD in Science of Human Communication by UNIFESP. Clinical Audiologist.
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Intl. Arch. Otorhinolaryngol., São Paulo - Brasil, v.15, n.4, p. 529-533, Oct/Nov/December - 2011.
Publication Year and Month: 2010 04

Abstract: INTRODUCTION: The post-polio syndrome (PPS) is characterized by a new episod of atrophy or muscle weakness in individuals previously affected by poliomyelitis. The symptoms start from an extended period of clinical stability ranging from 20 to 40 years, after the initial chart of polio. Among the pathophysiological mechanisms, the most likely is that the syndrome represents a process of attrition and neuronal metabolic exhaustion due to a continuous process of denervation reinnervation which begins after the initial acute.

OBJECTIVE: Review the clinical characteristics and pathophysiological of PPS,as well as present the approach in cases with pharyngolaryngeal manifestations.

CASE REPORT: We present the clinical case of a male patient with 48 years old, with main complaints of dysphonia, dysphagia and previous history of polio. The patient underwent a diagnostic investigation, in which the voice psychoacoustic findings are described. Laringoscopic, electromyographic and the videoendoscopy of swallowing compatible with PPS. The treatment consisted in phonotherapy in a total of 11 weekly sessions and guidelines for swallowing, with satisfactory improvement of the symptoms.

FINAL COMMENTS: The pharyngolaryngeal manifestations of PPS are susceptible to treatment, obtaining satisfactory results, with improvement of life quality of the patients.

KEYWORDS: poliomyelitis, post-polio syndrome, neuromuscular diseases, larynx diseases, voice disorders.

Conclusions: The diagnosis of PPS depends of the high rate of suspicion and a good anamnesis, in which the patient reports previous history of poliomyelitis. As in the most of the cases these patients present other commemorative resulting of the syndrome, voice alterations become less evident before the whole picture. Active searches in services of references in treatment of PPS can show that the frequency of dysphonia and dysphagia maybe is bigger than the ones described in the literature. Considering that the laryngeal-pharyngeal manifestations of PPS are suitable for treatment with improvement of life quality of the patients, is evident the importance of the diagnosis.

Outcome of Research: Not applicable

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio, Surgery

Title: Physical Therapist Management Following Rotator Cuff Repair for a Patient With Postpolio Syndrome
Author: Mary Carlson, Tana Hadlock
Affiliation: M Carlson, PT, PhD, is Associate Professor, Physical Therapy Program,
University of Texas at El Paso, 1101 N Campbell, El Paso, TX 79902 (USA).

T Hadlock, MA, OTR, is Instructor, Occupational Therapy Program, Yamaguchi Health and Welfare College, Ube City, Yamaguchi Prefecture, Japan.
Journal: PTJ: Physical Therapy & Rehabilitation Journal (Prior to 2021, was titled Physical Therapy)
Citation: Phys Ther. 2007;87:179–192.
https://doi.org/10.2522/ptj.20050200
Publication Year and Month: 2007 02

Abstract: Background and Purpose
Postpoliomyelitis sequelae, such as gait instability and progressive weakness, predispose people with postpolio syndrome to secondary disabilities. With aging, people who depend on their upper extremities to accommodate lower-extremity deficits may anticipate overuse injuries. The purpose of this case report is to describe the use of mobilization and exercise in postoperative rehabilitation of rotator cuff surgery on a patient with postpolio syndrome.

Case Description
A 48-year-old woman with postpolio syndrome had rotator cuff surgical repair followed by physical therapy intervention. Maitland mobilization and mild functional exercises were chosen to avoid triggering fatigue.

Outcomes
Measurements taken preoperatively, before and after physical therapy intervention, and 2 years after intervention showed return to independent status with excellent retention.

Discussion
No fatigue or overuse weakness was encountered. This is the first case report to document physical therapy following rotator cuff repair in a patient with postpolio syndrome.

Conclusions: In summary, this is the first case report to document the effects of physical therapy in a patient with PPS who had a rotator cuff tear resulting from extended use due to postpolio sequelae. The physical therapist used a Maitland technique with functional active exercises for the patient. The physical therapist additionally emphasized communication and used the patient responses to adjust treatment. The patient was knowledgeable about her condition and was able to be an active partner of the rehabilitation team, monitor fatigue, and modify her exercises and activities as needed. Additionally, the change between her status immediately following rehabilitation and 2 years later showed continued progress in strength and ROM. We believe that the combination of good practitioner/patient communication, use of the Maitland technique to increase joint ROM without patient effort, and careful selection of a few functionally important active and resistive exercises contributed to the success of this patient’s rehabilitation.

Future research might use a single-subject research design for multiple individuals with PPS who have rehabilitation following orthopedic surgery. A standardized functional survey would strengthen the design, and a handheld dynamometer could be used to quantify muscle strength in lieu of the BTE device. The single-subject design is stronger than the case report and can infer an effect of the intervention on the outcome.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Falls, Late Effects of Polio

Title: Polio survivors have poorer walking adaptability than healthy individuals
Author: Jana Tuijtelaars (1), Melvyn Roerdink (2), Bart Gerardus Hendricus Raijmakers (1), Frans Nollet (1), Merel-Anne Brehm (1)
Affiliation: (1) Amsterdam UMC, University of Amsterdam, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, the Netherlands

(2) Department of Human Movement Sciences, Faculty of Behavioural and Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Van der Boechorststraat 7, Amsterdam, the Netherlands
Journal: Gait & Posture
Citation: https://doi.org/10.1016/j.gaitpost.2021.04.031
Publication Year and Month: 2021 04

Abstract: Background:
Falling is a major health problem in polio survivors, often occurring as a result of tripping, slipping or misplaced steps. Therefore, reduced walking adaptability possibly plays an important role.

Research question:
Does walking adaptability, assessed on an interactive treadmill, differ between polio survivors and healthy individuals?

Methods:
In this cross-sectional study, 48 polio survivors with at least one reported fall in the past year and/or fear of falling and 25 healthy individuals of similar age walked at self-selected comfortable fixed speed on an instrumented treadmill. Walking adaptability was measured as i) target-stepping accuracy (determined as variable error [VE] in mm independent of speed) in three conditions; 0%, 20% and 30% variation in step length and width, and ii) anticipatory and reactive obstacle avoidance (ObA and ObR, in percentage successfully avoided). All trials were checked for valid step detection.

Results:
46 polio survivors (mean ± SD age: 63.2 ± 8.7 years) and 25 healthy individuals (64.3 ± 6.6 years, p = 0.585) showed valid step detection. Compared to healthy individuals (mean±SE VE: 30.6±1.2mm), polio survivors stepped less accurately onto targets (36.4±0.9mm, p = 0.001), especially with their least-affected leg. Polio survivors avoided fewer obstacles successfully (mean±SE ObA: 83±3%, ObR: 59±4%) than healthy individuals (100±0.3%, p < 0.001 and 94±3%, p < 0.001, respectively), with a stronger decline in success rates from anticipatory to reactive obstacle avoidance for polio survivors (p < 0.001).

Significance:
Polio survivors reporting falls and/or fear of falling had a demonstrably reduced walking adaptability, especially so for reactive obstacle avoidance which requires step adjustments under high time-pressure demands. Future research should study the merit of walking-adaptability assessment to currently used clinical methods of fall-risk assessment within this population.

Abbreviations:
CoP: Center of Pressure

CWS: Comfortable Walking Speed

ObA: Obstacle Avoidance Anticipatory

ObR: Obstacle Avoidance Reactive

ST0: Stepping Targets, 0% variation in step length and width relative to normal walking

ST20: Stepping Targets, 20% variation in step length and width relative to normal walking

ST30: Stepping Targets, 30% variation in step length and width relative to normal walking

VE: Variable stepping Error

%GDS: Percentage successful goal-directed steps

Keywords:
Poliomyelitis, walking adaptability, falling, fall, risk, C-Mill, muscle, weakness

Conclusions: Polio survivors had a demonstrable limited ability to adapt walking to environmental circumstances compared to community-dwelling healthy individuals of similar age. They had fewer successful goal-directed steps, stepped less consistently on stepping targets and, despite walking slower, had lower obstacle-avoidance success rates, especially under high time-pressure demands. This diminished walking adaptability could place them at higher risk of falling, especially in everyday life, where walking often needs to be adapted to expected and unexpected circumstances. Future research should study the validity and reproducibility of walking-adaptability assessment in polio survivors to determine its added value to the currently used methods of fall-risk assessment in clinical practice.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio

Title: Polio: long-term problems
Author: Perry J, Fleming C
Affiliation: Not stated
Journal: Orthopedics
Citation: Orthopedics. 1985 Jul; 8(7):877-81
Publication Year and Month: 1985 07

Abstract: The most common long-term problems seen in polio are brace problems, knee recurvatum, increasing weakness due to overuse and ankle equinus. A definite increased incidence of problems is seen after the patient is more than 30 years post-polio. The basis for most of these problems is chronic mechanical strain of weak musculature and substituting ligaments. Overuse can cause increasing weakness resulting in pain and decreasing function. It is therefore important to follow polio patients closely, especially those that are more than 30 years post-polio. If signs of overuse or chronic mechanical strain are noted, treatment should not be delayed.

Conclusions:

Outcome of Research:

Availability of Paper:

Comments (if any):

Link to Paper (if available):


Category: Late Effects of Polio

Title: Post-polio syndrome and risk factors in Korean polio survivors: a baseline survey by telephone interview
Author: Bang H (1), Suh JH (2), Lee SY (3), Kim K (1), Yang EJ (1), Jung SH (1), Jang SN (4), Han SJ (2), Kim WH (5), Oh MG (6), Kim JH (5), Lee SG (7), Lim JY (1)
Affiliation: (1) Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Korea; (2) Department of Rehabilitation Medicine, Ewha Womans University Medical Center, Seoul, Korea; (3) Department of Physical Medicine and Rehabilitation, Soonchunhyang University Bucheon Hospital, Bucheon, Korea; (4) Red Cross College of Nursing, Chung-Ang University, Seoul, Korea; (5) Department of Rehabilitation Medicine, National Rehabilitation Center, Seoul, Korea; (6) Department of Rehabilitation Medicine and Institute of Health Science, Gyeongsang National University College of Medicine, Jinju, Korea; (7) Department of Physical Medicine and Rehabilitation, Research Institute of Medical Sciences, Chonnam National University College of Medical School, Gwangju, Korea
Journal: Annals of Rehabilitation Medicine
Citation: Ann Rehabil Med. 2014 Oct;38(5):637-47. doi: 10.5535/arm.2014.38.5.637
Publication Year and Month: 2014 10

Abstract: OBJECTIVE: To obtain information on the socioeconomic, medical, and functional status of polio survivors, and to use these results as the preliminary data for establishing the middle-aged cohort of polio survivors.

METHODS: The subjects were recruited based on the medical records of multiple hospitals and centers. They were assessed through a structured questionnaire over the phone. Post-poliomyelitis syndrome (PPS) was identified according to the specified diagnostic criteria. Differences between polio survivors with or without PPS were evaluated, and the risk factors for PPS were analyzed by the odds ratio (OR).

RESULTS: Majority of polio survivors were middle-aged and mean age was 51.2±8.3 years. A total of 188 out of 313 polio survivors met the adopted criteria for PPS based on the symptoms, yielding a prevalence of 61.6%. Mean interval between acute poliomyelitis and the development of PPS was 38.5±11.6 years. Female gender (OR 1.82; confidence interval [CI] 1.09-3.06), the age at onset of poliomyelitis (OR 1.75; CI 1.05-2.94), the use of orthoses or walking aids (OR 2.46; CI 1.44-4.20), and the history of medical treatment for paralysis, pain or gait disturbance (OR 2.62; CI 1.52-4.51) represented independent risk factors for PPS.

Conclusions: We found that the majority of Korean polio survivors entered middle age with many medical, functional, and social problems. Female gender, early age of onset of poliomyelitis, the use of orthoses or walking aids, and the history of medical treatment for paralysis, pain or gait disturbance were identified as the significant risk factors for PPS. A comprehensive and multidisciplinary plan should be prepared to manage polio survivors considering their need for health care services and the risk factors for late effects, such as PPS.

Outcome of Research: Not applicable

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio, Respiratory Complications and Management

Title: Post-Polio Syndrome Causing Late Onset Respiratory
Failure

Author: Sharon Enghelberg MD, Itamar Y. Love MD and Micha Rapoport MD
Affiliation: Department of Internal Medicine C, Shamir Medical Center, Zerifin, Israel
Journal: Israel Medical Association Journal (IMAJ)
Citation: 2020; 22: 395–396
Publication Year and Month: 2020

Abstract: CASE STUDY:
We present a patient with thoracic cage deformity and chronic progressive hypoventilation due to late onset PPS.

Conclusions: PPS can be a significant cause for respiratory deterioration in patients with
previous history of poliomyelitis. Physicians should be aware of this potential
diagnosis, as early diagnosis can facilitate individualized treatment plan and
prevent unnecessary examinations and mistreatment.

Outcome of Research: Not applicable

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any): KEY WORDS: dyspnea, polio, post-polio syndrome
(PPS), respiratory failure, restrictive
lung disease

Link to Paper (if available): Click here to view full text or to download


Category: Clinical Evaluation, Diagnosis and Management, Late Effects of Polio

Title: Post-polio Syndrome: More Than Just a Lower Motor Neuron Disease
Author: Stacey Li Hi Shing, Rangariroyashe H. Chipika, Eoin Finegan, Deirdre Murray, Orla Hardiman, and Peter Bede
Affiliation: Computational Neuroimaging Group, Academic Unit of Neurology, Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
Edited by: Francesca Trojsi, University of Campania, Luigi Vanvitelli Caserta, Italy
Reviewed by: Andrea Romigi, Mediterranean Neurological Institute (IRCCS), Italy; Louisa Ng, The University of Melbourne, Australia
*Correspondence: Peter Bede [email protected]b
Journal: Frontiers in Neurology
Citation: 10, 773. https://doi.org/10.3389/fneur.2019.00773
Publication Year and Month: 2019 07

Abstract: Post-polio syndrome (PPS) is a neurological condition that affects polio survivors decades after their initial infection. Despite its high prevalence, the etiology of PPS remains elusive, mechanisms of progression are poorly understood, and the condition is notoriously under-researched. While motor dysfunction is a hallmark feature of the condition, generalized fatigue, sleep disturbance, decreased endurance, neuropsychological deficits, sensory symptoms, and chronic pain are also often reported and have considerable quality of life implications in PPS. The non-motor aspects of PPS are particularly challenging to evaluate, quantify, and treat. Generalized fatigue is one of the most distressing symptoms of PPS and is likely to be multifactorial due to weight-gain, respiratory compromise, poor sleep, and polypharmacy. No validated diagnostic, monitoring, or prognostic markers have been developed in PPS to date and the mainstay of therapy centers on symptomatic relief and individualized rehabilitation strategies such as energy conservation and muscle strengthening exercise regimes. Despite a number of large clinical trials in PPS, no effective disease-modifying pharmacological treatments are currently available.

Conclusions: Despite being one of the most devastating neurodegenerative conditions in the world, surprisingly limited research is undertaken in post-polio syndrome. Its pathogenesis remains elusive, no sensitive diagnostic tools have been developed, and validated prognostic and monitoring markers are lacking. Non-motor symptoms of PPS have considerable quality of life implications and are notoriously challenging to manage. The etiology of fatigue in PPS is yet to be elucidated and successful individualized management strategies are needed to maintain mobility, independence, and patient autonomy. There is striking a paucity of neuroimaging studies in PPS that could provide anatomical insights into the substrate of extra-motor symptoms. Ultimately, the characterization of PPS-associated pathology may help research efforts in other motor neuron diseases.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any): This is a good overview of Post-Polio conditions particularly for clinicians new to the topic.

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio

Title: Post-polio Syndrome: More Than Just a Lower Motor Neuron Disease
Author: Stacey Li Hi Shing, Rangariroyashe H. Chipika, Eoin Finegan, Deirdre Murray, Orla Hardiman and Peter Bede*
Affiliation: Computational Neuroimaging Group, Academic Unit of Neurology, Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
Journal: Frontiers in Neurology
Citation: Front. Neurol., 16 July 2019 | https://doi.org/10.3389/fneur.2019.00773
Publication Year and Month: 2019 07

Abstract: Post-polio syndrome (PPS) is a neurological condition that affects polio survivors decades after their initial infection. Despite its high prevalence, the etiology of PPS remains elusive, mechanisms of progression are poorly understood, and the condition is notoriously under-researched. While motor dysfunction is a hallmark feature of the condition, generalized fatigue, sleep disturbance, decreased endurance, neuropsychological deficits, sensory symptoms, and chronic pain are also often reported and have considerable quality of life implications in PPS. The non-motor aspects of PPS are particularly challenging to evaluate, quantify, and treat. Generalized fatigue is one of the most distressing symptoms of PPS and is likely to be multifactorial due to weight-gain, respiratory compromise, poor sleep, and polypharmacy. No validated diagnostic, monitoring, or prognostic markers have been developed in PPS to date and the mainstay of therapy centers on symptomatic relief and individualized rehabilitation strategies such as energy conservation and muscle strengthening exercise regimes. Despite a number of large clinical trials in PPS, no effective disease-modifying pharmacological treatments are currently available.

Keywords: postpolio syndrome, PPS, polio, poliomyelitis, neuroimaging, biomarker, clinical trials, motor neuron disease

Conclusions: Despite being one of the most devastating neurodegenerative conditions in the world, surprisingly limited research is undertaken in post-polio syndrome. Its pathogenesis remains elusive, no sensitive diagnostic tools have been developed, and validated prognostic and monitoring markers are lacking. Non-motor symptoms of PPS have considerable quality of life implications and are notoriously challenging to manage. The etiology of fatigue in PPS is yet to be elucidated and successful individualized management strategies are needed to maintain mobility, independence, and patient autonomy. There is striking a paucity of neuroimaging studies in PPS that could provide anatomical insights into the substrate of extra-motor symptoms. Ultimately, the characterization of PPS-associated pathology may help research efforts in other motor neuron diseases.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Diagnosis and Management, Late Effects of Polio

Title: Post-poliomyelitis syndrome (2019)
Author: Eric Chun Pu Chu1 and Kary Ka Wai Lam2
Affiliation: 1New York Chiropractic and Physiotherapy Center, New York Medical Group, Hong Kong, People’s Republic of China
2Downtown Chiropractic Limited, Hong Kong, People’s Republic of China
Correspondence: Eric Chun Pu ChuNew York Chiropractic and Physiotherapy Centre, New York Medical Group, 41/F Langham Place Office Tower, 8 Argyle Street, Mongkok, Hong Kong, People’s Republic of China, Phone: Tel +852 3 594 7844, Fax: Fax +852 3 594 6193, Email [email protected]
Journal: International Medical Case Reports Journal
Citation: 12, 261–264. https://doi.org/10.2147/IMCRJ.S219481

Publication Year and Month: 2019 08

Abstract: Most developed countries eliminated paralytic poliomyelitis (polio) in the 1970s to 1980s. It was believed that after recovery from acute paralytic poliomyelitis, the physical condition of survivors would remain stable for the rest of their lives. However, the elimination of polio does not equate the end of medical management of polio. Hundreds of thousands of polio survivors worldwide are still at risk of developing the late effects of the disease. Here, we report a case of post-polio syndrome who attended our clinic for the presence of new weakness and neuromuscular problems six decades after recovery from paralytic polio. It is essential that health professionals be aware of these conditions and have an understanding of the underlying pathophysiology of the symptoms.

Conclusions: Post-polio syndrome is related to the exhaustion of the motor units that form decades after the polio attack. This case report describes the effectiveness of manual interventions in assisting our patient in restoring the level of function and alleviating pain. The limitation of the current report is that it is just a single case. Further comparison with more existing therapeutic regimens is warranted to clarify these issues.

Outcome of Research: Not applicable

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Diagnosis and Management, Differential Diagnosis, Gender Differences, Late Effects of Polio

Title: Postpolio Syndrome: A Review of Lived Experiences of Patients
Author: Oluwaseyi Jacob Oluwasanmi, Devaunna Andrene Mckenzie, Idowu Oluwasegun Adewole, Christian O Aluka, James Iyasse, Esther Olunu, and Adegbenro Omotuyi Fakoya1
Affiliation: Department of Microbiology, All Saints University School of Medicine, Commonwealth of Dominica, Roseau, Dominica
1Department of Anatomical Sciences, University of Medicine and Health Sciences, Basseterre, St. Kitts and Nevis
Address for correspondence: Dr. Adegbenro Omotuyi Fakoya, University of Medicine and Health Sciences, Basseterre, St. Kitts and Nevis. E-mail: gbenrofako[email protected]
Journal: International Journal of Applied & Basic Medical Research
Citation: 9(3), 129–134. https://doi.org/10.4103/ijabmr.IJABMR_333_18
Publication Year and Month: 2019 07

Abstract: Postpolio syndrome (PPS) refers to a group of conditions that are present in patients, years after recovery from initial acute paralytic poliomyelitis. About 15%–80% of 20 million polio survivors worldwide will experience exacerbation of symptoms which typically appear 15–30 years after the resolution of initial poliomyelitis. Symptoms include new muscle weakness, fatigue, myalgia, joint pain, dysphagia, and difficulty breathing. Other reported symptoms include cold intolerance, sleep disorder, dysphonia, loss of stamina, musculoskeletal deformities, cardiovascular disorders, psychosocial problems, and restless legs syndrome. These symptoms are attributed to the superimposed neuronal loss of aging with inflammatory mechanisms, but without any convincing evidence of viral reactivation. Risk factors include female gender, respiratory symptoms, normal aging, permanent disability caused by motor neuron damage, muscle overuse and disuse, aging, and immunologic mechanisms. Hypothyroidism-induced myopathy and fibromyalgia are a differential diagnosis for PPS, and exclusion diagnosis is required as confirmatory criteria for PPS. The symptoms of PPS presented determine the course of management.

Keywords: Fatigue, muscle weakness, myalgia, poliomyelitis, postpolio syndrome

Conclusions: PPS is a sequela of acute poliomyelitis which occurs decades after resolution of the initial paralytic or nonparalytic polio. Fatigue, muscle weakness, myalgia, and joint pain are the major symptoms of PPS. Diagnosis of PPS is made based on the exclusion of other conditions that can cause similar symptoms. The quality of life of patients with PPS is significantly affected by the reoccurrence of the constellations of symptoms they experience. Proper assessment and treatment should be performed to prevent severe impairment of function in patients.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio

Title: Prevalence and risk factors of post-polio syndrome in a cohort of polio survivors.
Author: Paolo Ragonese, Brigida Fierro, Giuseppe Salemi, Giovanna Randisi, Daniela Buffa, Marco D'Amelio, Antonella Aloisio, Giovanni Savettieri
Affiliation: Dipartimento di Neurologia, Oftalmologia, Otorinolaringoiatria e Psichiatria, Università di Palermo, Italy.
Journal: Journal of the Neurological Sciences
Citation: 2005 Sep 15;236(1-2):31-5.
Publication Year and Month: 2005 09

Abstract: OBJECTIVE:
To investigate frequency and associated factors of post polio syndrome (PPS) in an Italian cohort of people with prior poliomyelitis.

METHODS:
We screened subjects admitted for poliomyelitis at the paediatric hospital of the University of Palermo during the time frame 1945-1960. Patients who developed PPS were identified through a structured questionnaire and a neurologic examination. PPS diagnosis was made according to specified diagnostic criteria. Frequency of PPS was calculated in the selected cohort of polio survivors. The association with the investigated risk factors (sex, age at onset of polio, extension and severity of polio, education, associated diseases, cigarette smoking, trauma, polio vaccination) was analysed by the calculation of the odds ratio.

RESULTS:
Forty-eight participants met the adopted diagnostic criteria for PPS, giving a prevalence of 31.0%. The prevalence rate was significantly higher in women than in men (p=0.02). Logistic regression analyses revealed a significant inverse association with onset of poliomyelitis at over 12 months of age (OR 0.33; CI 0.14-0.79) a higher degree of education (OR 0.20; CI 0.07-0.79), and a significant association with the presence of other diseases (OR 9.86; CI 3.69-26.34).

Conclusions: CONCLUSIONS:
In our survey one-third of patients with prior poliomyelitis had PPS. Higher age at onset of poliomyelitis is inversely associated with PPS. The association with other diseases may indicate that a chronic physical stress, particularly in already weak motor units, can contribute to the development of signs and symptoms of PPS. Our results also suggest the impact of socio-economic conditions on the risk of PPS.

Outcome of Research: More research required

Availability of Paper:

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio

Title: Psoriasis sparing the lower limb with postpoliomyelitis residual paralysis
Author: Wang TS (1), Tsai TF
Affiliation: (1) Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
Journal: British Journal of Dermatology
Citation: Br J Dermatol. 2014 Aug;171(2):429-31. doi: 10.1111/bjd.12854
Publication Year and Month: 2014 08

Abstract: This paper does not have an abstract.

Conclusions:

Outcome of Research: Not applicable

Availability of Paper: Paid subscription required to view or download full text.

Comments (if any):

Link to Paper (if available): Click here for preview


Category: Late Effects of Polio, Quality of Life

Title: Quality of life assessment scales in polio survivors: a scoping review
Author: Surajo Kamilu Sulaiman (1), Heather Michelle Aldersey (1), Nora Fayed (1), Bashir Kaka (2) & Christiana Okyere (1)
Affiliation: (1) School of Rehabilitation Therapy, Queen’s University, Louise D. Acton Building, 31 George Street, Kingston, ON, K7L 3N6, Canada

(2) Department of Physiotherapy, Faculty of Allied Health Sciences, College of Health Sciences, Bayero University, PMB 3011, Kano, Nigeria
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Quality of Life Research volume 28, pages 2341–2357 (2019)
https://doi.org/10.1007/s11136-019-02185-x
Publication Year and Month: 2019 04

Abstract: Background
Quality of life evaluation is essential to explore the effect of paralytic polio on the daily life experience of the polio survivor. Researchers have employed a range of assessment instruments to evaluate quality of life among polio survivors. Hence, to select the appropriate scale, it is crucial to compare the contents and psychometric properties of these instruments.

Purpose
This scoping review explores quality of life instruments that are used in polio literature and analyzes their contents and psychometric properties using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) criteria.

Method
Using the Arksey and O’Malley framework, we conducted a literature search in the following electronic databases Medline, CINAHL, Web of Science, Embase, and Google Scholar to identify relevant studies that focused on quality of life of polio survivors. Of the 88 articles that qualify for full-text screening, 34 studies met our inclusion criteria. Two independent reviewers extracted data from the selected studies via Covidence, a reference manager that allows for blinding of reviews.

Results
Most of the instruments included in this review are generic, self-reported, and multidimensional. Despite having mostly adequate psychometric properties, these properties were not evaluated in polio survivors.

Conclusion
The information provided in this review could be used to guide instrument selection and identify the need to develop a new tool or to adapt a pre-existing scale for measuring quality of life among polio survivors.

Conclusions: The information provided in this review could be used to guide instrument selection and identify the need to develop a new tool or to adapt a pre-existing scale for measuring quality of life among polio survivors.

Outcome of Research: More research required

Availability of Paper: Paid subscription required to view or download full text.

Comments (if any):

Link to Paper (if available): Click here to view Abstract


Category: Late Effects of Polio, Quality of Life

Title: Relationship between participation in life situations and life satisfaction in persons with late effects of polio
Author: Maria Larsson Lund & Jan Lexell
Affiliation: Maria Larsson Lund - Department of Community Medicine and Rehabilitation, Occupational Therapy, Umeå University, Umeå, Sweden Correspondence: [email protected]

Jan Lexell - Department of Rehabilitation Medicine, Lund University Hospital, Lund, Sweden; Division of Rehabilitation Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden; Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
Journal: Disability and Rehabilitation
Citation: 31(19), 1592–1597. https://doi.org/10.1080/09638280802638881
Publication Year and Month: 2009 09

Abstract:
Purpose. To assess the relationship between participation and problems with participation in life situations, and life satisfaction in persons with late effects of polio.

Methods. One hundred fifty-eight persons with late effects of polio responded to a postal questionnaire including the Swedish versions of the Impact on Participation and Autonomy Questionnaire (IPA-S) and Life Satisfaction Questionnaire (LiSat-11).

Results. The persons' perceived participation in the five domains of participation in the IPA-S was significantly correlated with their satisfaction with life as a whole and with most of the 10 domains of life satisfaction. Significant differences in satisfaction with life as a whole and with eight of the 10 domains in LiSat-11 were found between groups of increasing severe problems with participation. Greater number of reports of severe problems with participation corresponded with gradually decreased satisfaction with life as a whole and with satisfaction in the eight domains in LiSat-11.

Keywords: Activities of daily living, disability evaluation, disabled persons, personal autonomy, postpoliomyelitis syndrome, rehabilitation, quality of life

Conclusions: Perceived participation and problems with participation in life situations are determinants of life satisfaction in persons with late effects of polio. This implies that addressing participation and problems with participation in the rehabilitation of persons with late effects of polio may lead to an enhanced life satisfaction.

Outcome of Research: More research required

Availability of Paper: Paid subscription required to view or download full text.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio

Title: Risk of symptoms related to late effects of poliomyelitis
Author: Rekand T, Albrektsen G, Langeland N, Aarli JA
Affiliation: Department of Neurology, Haukeland Hospital, Bergen, Norway
Journal: Acta Neurologica Scandinavica
Citation: Acta Neurol Scand. 2000 Mar;101(3):153-8
Publication Year and Month: 2000 03

Abstract: OBJECTIVE: To compare the risk of developing symptoms related to late effects of poliomyelitis between polio patients and persons of similar age and sex without history of poliomyelitis.

MATERIAL AND METHODS: The study comprised information on 148 patients with prior poliomyelitis and 115 persons with no history of poliomyelitis. Information was obtained by questionnaire and analyzed by multiple logistic regression method.

RESULTS: The risk of experiencing two or more symptoms was significantly higher among the polio patients than among the persons without history of poliomyelitis. The elevation in risk was less pronounced in the nonparalytic group (OR = 2.35; 95% CI = 0.92-5.97) than the group with permanent muscular weakness (OR = 8.84; 95% CI =4.32-18.09).

Conclusions: Although symptoms defined in the PPS are unspecific and may occur in the general population, the risk for developing such symptoms are higher among the polio victims. The difference in risk among nonparalytic and paralytic patients may depend on the extent of motor neuron damage in the acute stage.

Outcome of Research: Not applicable

Availability of Paper: Paid subscription required to view or download full text.

Comments (if any):

Link to Paper (if available): Click here to view Abstract


Category: Late Effects of Polio, Psychology, Quality of Life

Title: The value of a post-polio syndrome self-management programme
Author: Alexandra Curtis,corresponding author1,# Jeong Su Lee,1,# Georgios Kaltsakas,1,2 Vivian Auyeung,2 Simon Shaw,1 Nicholas Hart,1,2 and Joerg Steier1,2
Affiliation: 1Guy’s and St Thomas’ NHS Foundation Trust, London, UK;
2Faculty of Life Sciences and Medicine, King’s College, London, UK
corresponding authorCorresponding author.
Contributions: (I) Conception and design: A Curtis, JS Lee, N Hart, J Steier, V Auyeung; (II) Administrative support: A Curtis, JS Lee, N Hart, J Steier; (III) Provision of study materials or patients: A Curtis, JS Lee, J Steier, S Shaw, V Auyeung; (IV) Collection and assembly of data: A Curtis, JS Lee; (V) Data analysis and interpretation: A Curtis, JS Lee, J Steier, V Auyeung, G Kaltsakas; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors.
#These authors contributed equally to this work.
Correspondence to: Ms. Alexandra Curtis, MRes, BSc. Guy’s and St Thomas’ NHS Foundation Trust, Lane Fox Unit, Westminster Bridge Road, London SE1 7EH, UK. Email: [email protected]
Journal: Journal of Thoracic Disease
Citation: 12(Suppl 2), S153–S162. https://doi.org/10.21037/jtd-cus-2020-009
Publication Year and Month: 2020 10

Abstract: Background
Post-polio syndrome is characterised by symptoms of fatigue, pain and new-onset neuromuscular weakness, and emerges decades after the initial poliovirus infection. We sought to evaluate the only post-polio syndrome specific self-management programme in the United Kingdom.

Methods
This was a retrospective study of patients who had completed a residential self-management programme led by a multi-disciplinary clinical team. Following a confirmed diagnosis of post-polio syndrome by rehabilitation and neurology specialists, patients were offered to participate in the programme. Although group-based, patients also received individually tailored support on physical exercise and fatigue management. Physical effects, physical function, psychosocial well-being measures were assessed at baseline and 6 months follow-up. Knowledge was tested at baseline and immediately following the programme. Statistical comparisons were made using paired t-test and Wilcoxon signed rank test according to the data distribution.

Results
Over a period of 17 years, 214 participants (median age 61.3 years old, 63% female) attended 31 programmes. At 6 months the following post-polio syndrome specific symptoms improved significantly: fatigue, as measured by the Multidimensional Assessment of Fatigue scale [37.6 (7.1) vs. 34.2 (9.3), P=0.005]; and pain [15.0 (6.1) vs. 13.1 (6.7), P=0.001], atrophy [10.0 (8.0–12.0) vs. 9.0 (7.0–11.0), P=0.002] and bulbar symptoms [3.0 (1.0–5.0) vs. 2.0 (0–4.0), P=0.003] as measured by the Index of Post-polio Sequelae scale. Knowledge related to post-polio syndrome also significantly increased [14.0 (11.0–16.0) vs. 17.0 (16.0–19.0), P=0.001]. Participants were able to walk at a faster speed over 10 meters [0.77 (0.59–1.00) vs. 0.83 (0.67–1.10) m/s, P=0.003] and walked longer distances during the 2-minute walk test [76.9 (31.7) vs. 82.0 (38.4) m, P=0.029]. Depression and anxiety scores did not change over time [PHQ-9, 2.0 (0.3–10.8) vs. 2.0 (0.3–6.8), P=0.450; GAD-7, 2.0 (0–7.0) vs. 1.0 (0–3.0), P=0.460] nor was there change in self-reported quality of life {60 [50–70] vs. 60 [55–70], P=0.200}.

Conclusions
This study suggests that a post-polio syndrome self-management programme led to improvement in symptoms, knowledge and walking speed, but not quality of life. Anxiety and depression scores remained low.

Keywords: Rehabilitation, post-polio syndrome (PPS), fatigue, quality of life (QoL)

Conclusions: A self-management programme for PPS can improve fatigue, the severity to which pain, atrophy and bulbar function issues are experienced and the overall knowledge of PPS, as well as physical function over a 6-month period. Despite some limitations the study results are important to a wider audience given the difficulties in collecting systematic data in this cohort and the relatively sparse evidence for the current approach to PPS management. Experiences from PPS management might prove valuable at a time when a new viral pandemic requires us to design future rehabilitation and self-management programmes for many more survivors of a devastating viral condition.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio

Title: Three case studies of late diagnoses of polio in Australian adults
Author: C.Formby, D.Currie
Affiliation: St Vincent's Hospital Melbourne, Polio Services Victoria, Fitzroy, Australia
Journal: Annals of Physical and Rehabilitation Medicine
Citation: Volume 61, Supplement, July 2018, Page e272
Publication Year and Month: 2018 07

Abstract: Introduction/Background
Polio Services Victoria (PSV) is a publicly funded organization; anyone with a history of polio residing in Australia may be seen by the service. The majority of patients referred to the service were diagnosed with polio shortly after they were infected with the virus, for most this was in early childhood and ranges from two to eight decades ago. In the past 18 months three patients were referred to PSV with untypically late diagnoses of polio, two of which were sisters. All were born in Australia between 1930 and 1950 and are considered to have acquired their infection in Australia during their early childhood. The three were able to live relatively uneventful lives however their verbal histories indicate suspicion of polio during their childhood medical examinations in school, but ultimately no formal diagnosis was made at that time. In later life, symptoms characteristic of the late effects of polio emerged. In combination with imaging and nerve conduction studies these symptoms were diagnosed as being the result of a likely childhood infection of polio. Their current and future management plans are typical of that seen regularly within the service with the patients reporting their main problems as being:

–pain;

–fatigue;

–increasing muscle atrophy and associated weakness.

These three cases highlight that although Australia, like most of the world, holds polio free status there may still be further undiagnosed cases. Polio should be considered as a differential diagnosis for patients presenting with any of the cardinal signs and symptoms of late effects of polio who have resided in a country during a time prior to polio eradication. Special consideration should be given where a sibling or close relative was diagnosed with polio.

Conclusions:

Outcome of Research: More research required

Availability of Paper:

Comments (if any):

Link to Paper (if available): Click here for preview


Category: Late Effects of Polio, Surgery

Title: Total hip arthroplasty in patients affected by poliomyelitis
Author: C. M. DeDeugd, K. I. Perry, W. H. Trousdale, M. J. Taunton, D. G. Lewallen, M. P. Abdel
Affiliation: Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: The Bone & Joint Journal

Bone Joint J 2018;100-B:733–9
Doi: https://doi.org/10.1302/0301-620X.100B6.BJJ-2018-0127.R1
Publication Year and Month: 2018 06

Abstract: Aims
The aims of this study were to determine the clinical and radiographic outcomes, implant survivorship, and complications of patients with a history of poliomyelitis undergoing total hip arthroplasty (THA) in affected limbs and unaffected limbs of this same population.

Patients and Methods
A retrospective review identified 51 patients (27 male and 24 female, 59 hips) with a mean age of 66 years (38 to 88) and with the history of poliomyelitis who underwent THA for degenerative arthritis between 1970 and 2012. Immigrant status, clinical outcomes, radiographic results, implant survival, and complications were recorded.

Results
In all, 32 THAs (63%) were performed on an affected limb, while 27 (37%) were performed on an unaffected limb. The overall ten-year survivorship free from aseptic loosening, any revision, or any reoperation were 91% (95% CI 0.76 to 0.99), 91% (95% CI 0.64 to 0.97) and 87% (95% CI 0.61 to 0.95), respectively. There were no revisions for prosthetic joint infection. There were no significant differences in any of the above parameters if THA was on the affected or unaffected control limbs.

Conclusion
Patients with a history of poliomyelitis who undergo THA on the affected or unaffected limbs have similar results with overall survivorship and complication rates to those reported results in patients undergoing THA for osteoarthritis. At long-term follow-up, previous clinical concerns about increased hip instability due to post-polio abductor weakness were not observed.

Conclusions: Patients with a history of poliomyelitis who undergo THA on the affected or unaffected limbs have similar results with overall survivorship and complication rates to those reported results in patients undergoing THA for osteoarthritis. At long-term follow-up, previous clinical concerns about increased hip instability due to post-polio abductor weakness were not observed.

Outcome of Research: Not applicable

Availability of Paper: Paid subscription required to view or download full text.

Comments (if any):

Link to Paper (if available): Click here to view Abstract


Category: Cultural Context, Disability Rights, Late Effects of Polio, Quality of Life, Vocational Implications

Title: “The car is my extra legs” – Experiences of outdoor mobility amongst immigrants in Sweden with late effects of polio
Author: Helena Selander, Conceptualization, Data curation, Formal analysis, Methodology, Project administration, Supervision, Validation, Visualization, Writing – original draft, Writing – review & editing,1,2,* Iolanda Santos Tavares Silva, Formal analysis, Methodology, Supervision, Validation, Writing – original draft, Writing – review & editing,1,3 Felicia Kjellgren, Conceptualization, Investigation, Methodology, Writing – review & editing,1 and Katharina S. Sunnerhagen, Conceptualization, Data curation, Funding acquisition, Investigation, Methodology, Project administration, Resources, Supervision, Validation, Writing – review & editing1
Wen-Jun Tu, Editor
Affiliation: 1 Rehabilitation Medicine, Department of Clinical Neuroscience, Sahlgrenska Academy, University of Gothenburg, Sweden
2 The Swedish National Road and Transport Research Institute (VTI), Gothenburg, Sweden
3 Department of Occupational Therapy and Physiotherapy, The Sahlgrenska University Hospital, Gothenburg, Sweden
Chinese Academy of Medical Sciences and Peking Union Medical College, CHINA
Competing Interests: The authors have declared that no competing interests exist.
* E-mail: [email protected]
Journal: PLoS One
Citation: 14(10), e0224685. https://doi.org/10.1371/journal.pone.0224685
Publication Year and Month: 2019 10

Abstract: Background
The aim of the study was to describe the experience of outdoor mobility among immigrants with late effects of polio living in Sweden. There is a need to understand more about this young group of persons since they often have problems with mobility and gait, but they may also face participation restrictions due to issues associated with integration into a new community and culture.

Method
A total of 14 young immigrants with late effects of polio participated and were interviewed individually. The study used a qualitative method to explore personal experiences and the interviews were analyzed through an inductive approach, using qualitative content analysis.

Results
The analysis led to a major theme; self-image and acceptance, that comprised a changeable process and experiences of cultural, social, and gender-specific barriers, but also of environmental and personal factors that impacted their outdoor mobility. By using a car, the participants felt they could come across as normal which also increased their self-esteem.

Conclusions
Independent mobility is a major enabler for ongoing employment and being able to use a car increases the chances for integration into society for young immigrants with late effects of polio. Public transport is not considered to be adequate or efficient enough due to the participants’ mobility impairments, but driving can prevent involuntary isolation and facilitate participation. A car can increase quality of life but may also be a facilitator for work and reduce the demand for societal support.

Conclusions: More work is needed on young immigrants with late effects of polio to identify their mobility needs and find solutions that could minimize barriers and help them to be more independent outdoors. This group in Sweden has often been overlooked in clinical settings and in society generally. It is important to consider the need of care and support for persons with late effects polio as the need for care has been questioned and decision makers (such as health commissioners) believe persons with late effects of polio no longer exist in Sweden. Moreover, they are not prioritized despite needing rehabilitation interventions that could increase their outdoor mobility. Independent mobility is a major enabler for ongoing employment and the ability to access a car can increase their chances for social integration. According to participants in this study, public transport is not adequate or efficient enough for their needs. For young immigrants with late effects of polio, driving can prevent involuntary isolation and facilitate participation. A car may increase quality of life and reduce the demand for societal support.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


There are currently 34 papers in this category.

Category: Cardiovascular, Exercise, Late Effects of Polio, Muscle Strength

Title: Effects of muscle strengthening and cardiovascular fitness activities for poliomyelitis survivors: A systematic review and meta-anaylsis.
Author: Akhilesh Kumar RAMACHANDRAN, MSc, BEng (1), Stephen P. J. GOODMAN, PhD, Hon BEXSc (2), Michael J. JACKSON, MPT, BEd, BACH (1) and Timothy J. H. LATHLEAN, PhD, MClinRehab, Hon BSc, BBehSc (2,3)
Affiliation: 1) Polio Australia Incorporated

2) Discipline of Exercise and Sports Science, School of Science and Technology, University of New England

3) Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide.
Journal: Journal of Rehabilitation Medicine (JRM) - formerly Scandanavian Journal of Rehabilitation Medicine
Citation: J Rehabil Med 2021; 53: jrm00184, doi: 10.2340/16501977-2832
Publication Year and Month: 2021 04

Abstract: Objective:
To evaluate and assess the effectiveness of muscle strengthening and cardiovascular interventions in improving outcomes in poliomyelitis (polio) survivors.

Data sources:
A systematic literature search was conducted in Medline, PubMed, CINAHL, PsychINFO, Web of Science, and Google Scholar for experimental and observational studies.

Study selection and extraction:
Screening, data-extraction, risk of bias and quality assessment were carried out independently by the authors. The quality appraisal and risk of bias were assessed using the Downs and Black Checklist. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was followed to increase clarity of reporting.

Data synthesis:
A total of 21 studies that met all the inclusion criteria were subjected to statistical analyses according to intervention (muscle strengthening or cardiovascular fitness). A random-effects metaanalysis showed a statistically significant effect for the exercise interventions favouring improvement in outcomes according to the International Classification of Functioning, Disability and Health (ICF).

Conclusion:
This review provides further insight into the effects associated with muscle strengthening and cardiovascular interventions among polio survivors, and helps to further identify the current state of research in this area. Future research is needed, focusing on individualized approaches to exercise with polio survivors and specific exercise prescription recommendations, based on established frameworks, such as the ICF.

Conclusions: The findings of this review and analysis provide “very low level evidence” (according to the Grading of Recommendations Assessment, Development and Evaluate; GRADE) to polio survivors, clinicians and researchers. The main findings of this review relate specifically to changes in body function, and activity and participation, and include evidence of effect on improved functioning without furthering debility in polio survivors. This systematic review and meta-analysis provides additional insights into effects associated with exercise, across various types of interventions, in polio survivors, and advances the level of methodological quality of research in this area. Although there was evidence demonstrating effect across domains, due to inherent biases within the literature to date, further and high-quality primary exercise-focused research is required in order to strengthen the certainty of evidence regarding important research questions about the ongoing health of polio survivors.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any): Polio Australia staff co-authored this article.

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio, Psychology, Quality of Life

Title: The value of a post-polio syndrome self-management programme
Author: Alexandra Curtis,corresponding author1,# Jeong Su Lee,1,# Georgios Kaltsakas,1,2 Vivian Auyeung,2 Simon Shaw,1 Nicholas Hart,1,2 and Joerg Steier1,2
Affiliation: 1Guy’s and St Thomas’ NHS Foundation Trust, London, UK;
2Faculty of Life Sciences and Medicine, King’s College, London, UK
corresponding authorCorresponding author.
Contributions: (I) Conception and design: A Curtis, JS Lee, N Hart, J Steier, V Auyeung; (II) Administrative support: A Curtis, JS Lee, N Hart, J Steier; (III) Provision of study materials or patients: A Curtis, JS Lee, J Steier, S Shaw, V Auyeung; (IV) Collection and assembly of data: A Curtis, JS Lee; (V) Data analysis and interpretation: A Curtis, JS Lee, J Steier, V Auyeung, G Kaltsakas; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors.
#These authors contributed equally to this work.
Correspondence to: Ms. Alexandra Curtis, MRes, BSc. Guy’s and St Thomas’ NHS Foundation Trust, Lane Fox Unit, Westminster Bridge Road, London SE1 7EH, UK. Email: [email protected]
Journal: Journal of Thoracic Disease
Citation: 12(Suppl 2), S153–S162. https://doi.org/10.21037/jtd-cus-2020-009
Publication Year and Month: 2020 10

Abstract: Background
Post-polio syndrome is characterised by symptoms of fatigue, pain and new-onset neuromuscular weakness, and emerges decades after the initial poliovirus infection. We sought to evaluate the only post-polio syndrome specific self-management programme in the United Kingdom.

Methods
This was a retrospective study of patients who had completed a residential self-management programme led by a multi-disciplinary clinical team. Following a confirmed diagnosis of post-polio syndrome by rehabilitation and neurology specialists, patients were offered to participate in the programme. Although group-based, patients also received individually tailored support on physical exercise and fatigue management. Physical effects, physical function, psychosocial well-being measures were assessed at baseline and 6 months follow-up. Knowledge was tested at baseline and immediately following the programme. Statistical comparisons were made using paired t-test and Wilcoxon signed rank test according to the data distribution.

Results
Over a period of 17 years, 214 participants (median age 61.3 years old, 63% female) attended 31 programmes. At 6 months the following post-polio syndrome specific symptoms improved significantly: fatigue, as measured by the Multidimensional Assessment of Fatigue scale [37.6 (7.1) vs. 34.2 (9.3), P=0.005]; and pain [15.0 (6.1) vs. 13.1 (6.7), P=0.001], atrophy [10.0 (8.0–12.0) vs. 9.0 (7.0–11.0), P=0.002] and bulbar symptoms [3.0 (1.0–5.0) vs. 2.0 (0–4.0), P=0.003] as measured by the Index of Post-polio Sequelae scale. Knowledge related to post-polio syndrome also significantly increased [14.0 (11.0–16.0) vs. 17.0 (16.0–19.0), P=0.001]. Participants were able to walk at a faster speed over 10 meters [0.77 (0.59–1.00) vs. 0.83 (0.67–1.10) m/s, P=0.003] and walked longer distances during the 2-minute walk test [76.9 (31.7) vs. 82.0 (38.4) m, P=0.029]. Depression and anxiety scores did not change over time [PHQ-9, 2.0 (0.3–10.8) vs. 2.0 (0.3–6.8), P=0.450; GAD-7, 2.0 (0–7.0) vs. 1.0 (0–3.0), P=0.460] nor was there change in self-reported quality of life {60 [50–70] vs. 60 [55–70], P=0.200}.

Conclusions
This study suggests that a post-polio syndrome self-management programme led to improvement in symptoms, knowledge and walking speed, but not quality of life. Anxiety and depression scores remained low.

Keywords: Rehabilitation, post-polio syndrome (PPS), fatigue, quality of life (QoL)

Conclusions: A self-management programme for PPS can improve fatigue, the severity to which pain, atrophy and bulbar function issues are experienced and the overall knowledge of PPS, as well as physical function over a 6-month period. Despite some limitations the study results are important to a wider audience given the difficulties in collecting systematic data in this cohort and the relatively sparse evidence for the current approach to PPS management. Experiences from PPS management might prove valuable at a time when a new viral pandemic requires us to design future rehabilitation and self-management programmes for many more survivors of a devastating viral condition.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio

Title: Living with polio and postpolio syndrome in the United Kingdom
Author: Atwal A (1), Giles A, Spiliotopoulou G, Plastow N, Wilson L
Affiliation: (1) School of Health Science and Social Care, Brunel University, Kingston Lane, Uxbridge, Middlesex, London, UK - [email protected]

Journal: Scandinavian Journal of Caring Sciences
Citation: Scand J Caring Sci. 2013 Jun;27(2):238-45. doi: 10.1111/j.1471-6712.2012.01029.x
Publication Year and Month: 2013 06

Abstract: The term Postpolio Syndrome (PPS) is used to describe new and late manifestations of poliomyelitis that occur later in life in polio survivors. Polio had been eradicated in the United Kingdom (UK) and most of Europe, although this is not the case in all countries. Research in this area has tended to focus upon the impact of polio and PPS on health status and functional health rather than its overall effect on people's lives. This study's two main aims were to explore the ways in which polio and PPS in the UK has affected the respondents' lives and to ascertain their views about how the quality of life could be improved. The two questions were as follows: (1) How has the health of people with polio and PPS affected their quality of life? (2) What would people with polio and PPS change to improve their quality of life? Deductive content analysis using existing qualitative data from a cross-sectional survey of 336 returned questionnaires from persons with polio and PPS was carried out. The average age of the participants was 54 years. Our research found that polio survivors valued social occupations and participation in family life. Our research has also shown that healthcare professionals still do not understand polio and PPS and this lack of understanding influences their clients' quality of life. Finances and accessibility of environments also influence participation in chosen occupations. Rehabilitation programmes for people with polio and PPS need to be targeted towards maintaining and improving accessible environments and participation in chosen occupations, and healthcare professionals need to ensure that persons with polio and PPS are referred to persons with specific expertise in this area.

Conclusions:

Outcome of Research: Not applicable

Availability of Paper: Paid subscription required to view or download full text.

Comments (if any):

Link to Paper (if available): Click here to view Abstract


Category: Late Effects of Polio

Title: Post-polio syndrome and risk factors in Korean polio survivors: a baseline survey by telephone interview
Author: Bang H (1), Suh JH (2), Lee SY (3), Kim K (1), Yang EJ (1), Jung SH (1), Jang SN (4), Han SJ (2), Kim WH (5), Oh MG (6), Kim JH (5), Lee SG (7), Lim JY (1)
Affiliation: (1) Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Korea; (2) Department of Rehabilitation Medicine, Ewha Womans University Medical Center, Seoul, Korea; (3) Department of Physical Medicine and Rehabilitation, Soonchunhyang University Bucheon Hospital, Bucheon, Korea; (4) Red Cross College of Nursing, Chung-Ang University, Seoul, Korea; (5) Department of Rehabilitation Medicine, National Rehabilitation Center, Seoul, Korea; (6) Department of Rehabilitation Medicine and Institute of Health Science, Gyeongsang National University College of Medicine, Jinju, Korea; (7) Department of Physical Medicine and Rehabilitation, Research Institute of Medical Sciences, Chonnam National University College of Medical School, Gwangju, Korea
Journal: Annals of Rehabilitation Medicine
Citation: Ann Rehabil Med. 2014 Oct;38(5):637-47. doi: 10.5535/arm.2014.38.5.637
Publication Year and Month: 2014 10

Abstract: OBJECTIVE: To obtain information on the socioeconomic, medical, and functional status of polio survivors, and to use these results as the preliminary data for establishing the middle-aged cohort of polio survivors.

METHODS: The subjects were recruited based on the medical records of multiple hospitals and centers. They were assessed through a structured questionnaire over the phone. Post-poliomyelitis syndrome (PPS) was identified according to the specified diagnostic criteria. Differences between polio survivors with or without PPS were evaluated, and the risk factors for PPS were analyzed by the odds ratio (OR).

RESULTS: Majority of polio survivors were middle-aged and mean age was 51.2±8.3 years. A total of 188 out of 313 polio survivors met the adopted criteria for PPS based on the symptoms, yielding a prevalence of 61.6%. Mean interval between acute poliomyelitis and the development of PPS was 38.5±11.6 years. Female gender (OR 1.82; confidence interval [CI] 1.09-3.06), the age at onset of poliomyelitis (OR 1.75; CI 1.05-2.94), the use of orthoses or walking aids (OR 2.46; CI 1.44-4.20), and the history of medical treatment for paralysis, pain or gait disturbance (OR 2.62; CI 1.52-4.51) represented independent risk factors for PPS.

Conclusions: We found that the majority of Korean polio survivors entered middle age with many medical, functional, and social problems. Female gender, early age of onset of poliomyelitis, the use of orthoses or walking aids, and the history of medical treatment for paralysis, pain or gait disturbance were identified as the significant risk factors for PPS. A comprehensive and multidisciplinary plan should be prepared to manage polio survivors considering their need for health care services and the risk factors for late effects, such as PPS.

Outcome of Research: Not applicable

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio, Surgery

Title: Total hip arthroplasty in patients affected by poliomyelitis
Author: C. M. DeDeugd, K. I. Perry, W. H. Trousdale, M. J. Taunton, D. G. Lewallen, M. P. Abdel
Affiliation: Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: The Bone & Joint Journal

Bone Joint J 2018;100-B:733–9
Doi: https://doi.org/10.1302/0301-620X.100B6.BJJ-2018-0127.R1
Publication Year and Month: 2018 06

Abstract: Aims
The aims of this study were to determine the clinical and radiographic outcomes, implant survivorship, and complications of patients with a history of poliomyelitis undergoing total hip arthroplasty (THA) in affected limbs and unaffected limbs of this same population.

Patients and Methods
A retrospective review identified 51 patients (27 male and 24 female, 59 hips) with a mean age of 66 years (38 to 88) and with the history of poliomyelitis who underwent THA for degenerative arthritis between 1970 and 2012. Immigrant status, clinical outcomes, radiographic results, implant survival, and complications were recorded.

Results
In all, 32 THAs (63%) were performed on an affected limb, while 27 (37%) were performed on an unaffected limb. The overall ten-year survivorship free from aseptic loosening, any revision, or any reoperation were 91% (95% CI 0.76 to 0.99), 91% (95% CI 0.64 to 0.97) and 87% (95% CI 0.61 to 0.95), respectively. There were no revisions for prosthetic joint infection. There were no significant differences in any of the above parameters if THA was on the affected or unaffected control limbs.

Conclusion
Patients with a history of poliomyelitis who undergo THA on the affected or unaffected limbs have similar results with overall survivorship and complication rates to those reported results in patients undergoing THA for osteoarthritis. At long-term follow-up, previous clinical concerns about increased hip instability due to post-polio abductor weakness were not observed.

Conclusions: Patients with a history of poliomyelitis who undergo THA on the affected or unaffected limbs have similar results with overall survivorship and complication rates to those reported results in patients undergoing THA for osteoarthritis. At long-term follow-up, previous clinical concerns about increased hip instability due to post-polio abductor weakness were not observed.

Outcome of Research: Not applicable

Availability of Paper: Paid subscription required to view or download full text.

Comments (if any):

Link to Paper (if available): Click here to view Abstract


Category: Late Effects of Polio

Title: Three case studies of late diagnoses of polio in Australian adults
Author: C.Formby, D.Currie
Affiliation: St Vincent's Hospital Melbourne, Polio Services Victoria, Fitzroy, Australia
Journal: Annals of Physical and Rehabilitation Medicine
Citation: Volume 61, Supplement, July 2018, Page e272
Publication Year and Month: 2018 07

Abstract: Introduction/Background
Polio Services Victoria (PSV) is a publicly funded organization; anyone with a history of polio residing in Australia may be seen by the service. The majority of patients referred to the service were diagnosed with polio shortly after they were infected with the virus, for most this was in early childhood and ranges from two to eight decades ago. In the past 18 months three patients were referred to PSV with untypically late diagnoses of polio, two of which were sisters. All were born in Australia between 1930 and 1950 and are considered to have acquired their infection in Australia during their early childhood. The three were able to live relatively uneventful lives however their verbal histories indicate suspicion of polio during their childhood medical examinations in school, but ultimately no formal diagnosis was made at that time. In later life, symptoms characteristic of the late effects of polio emerged. In combination with imaging and nerve conduction studies these symptoms were diagnosed as being the result of a likely childhood infection of polio. Their current and future management plans are typical of that seen regularly within the service with the patients reporting their main problems as being:

–pain;

–fatigue;

–increasing muscle atrophy and associated weakness.

These three cases highlight that although Australia, like most of the world, holds polio free status there may still be further undiagnosed cases. Polio should be considered as a differential diagnosis for patients presenting with any of the cardinal signs and symptoms of late effects of polio who have resided in a country during a time prior to polio eradication. Special consideration should be given where a sibling or close relative was diagnosed with polio.

Conclusions:

Outcome of Research: More research required

Availability of Paper:

Comments (if any):

Link to Paper (if available): Click here for preview


Category: Falls, Late Effects of Polio

Title: Fall-Related Activity Avoidance among Persons with Late Effects of Polio and Its Influence on Daily Life: A Mixed-Methods Study
Author: Christina Brogårdh (1,2), Jan Lexell (1,2) and Catharina Sjödahl Hammarlund (1,3)

Affiliation: 1) Department of Health Sciences, Lund University, 221 00 Lund, Sweden

2) Department of Neurology, Rehabilitation Medicine, Memory Disorders and Geriatrics, Skåne University Hospital, 222 41 Lund, Sweden

3) The PRO-CARE Group, School of Health and Society, Kristianstad University, 291 39 Kristianstad, Sweden

Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Int. J. Environ. Res. Public Health 2021, 18(13), 7202; https://doi.org/10.3390/ijerph18137202
Publication Year and Month: 2021 07

Abstract: Falls are common among persons with late effects of polio (LEoP), which may lead to fear of falling and activity avoidance in everyday life. Here, we assessed the occurrence of fall-related activity avoidance among persons with LEoP and explored how these experiences influenced daily life. Fourteen ambulatory persons (seven women; mean age 70 years) with LEoP participated. They responded to the modified Survey of Activities and Fear of Falling in the Elderly (mSAFFE) and participated in individual interviews, which were analysed by systematic text condensation. Each quotation was deductively analysed from its representation with regard to mSAFFE. We found that many persons often avoided activities related to standing and walking, for example, taking a bath, performing household chores, walking outdoors, attending social events if there were stairs in the building and travelling by public transport, due to fear of falling, increased pain and fatigability. To facilitate the performance of daily activities participants expressed that strategic thinking and aids were important to use. In conclusion, fall-related activity avoidance is common in persons with LEoP, which negatively influence daily life and social participation. To increase daily functioning in this population, fall-related activity avoidance should be included in a multifaceted fall management program.

Keywords: activities of daily living; fear of falling; postpoliomyelitis syndrome; qualitative research

Conclusions: Fall-related activity avoidance is common in persons with LEoP, which negatively influence daily life and social participation. To increase daily functioning in this population, fall-related activity avoidance should be included in a multifaceted fall management program.

Outcome of Research: Effective

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio

Title: Late functional deterioration following paralytic poliomyelitis
Author: D. Kidd, R.S. Howard, A.J. Williams, F.W. Heatley, C.P. Panayiotopoulos and G.T. Spencer
Affiliation: Departments of Neurology, Respiratory Medicine and Orthopaedics, the Lane-Fox Unit, St Thomas' Hospital, London, UK
Journal: Post-Polio Network (NSW) Inc
Citation: QJ Med 1997; 90: 189 - 196
Publication Year and Month: 1997 01

Abstract: Many patients with previous poliomyelitis develop 'post-polio syndrome' (PPS) in which late functional deterioration follows a period of relative stability. The frequency with which PPS can be attributed to clearly defined causes remains uncertain. We reviewed 283 newly-referred patients with previous poliomyelitis seen consecutively over a 4-year period; 239 patients developed symptoms of functional deterioration at a mean of 35 (5-65) years after the paralytic illness. Functional deterioration was associated with orthopaedic disorders in 170 cases, neurological disorders in 35, respiratory disorders in 19 and other disorders in 15. Progressive post-polio muscular atrophy was not observed. Functional deterioration following paralytic poliomyelitis is common, and associated with orthopaedic, neurological, respiratory and general medical factors which are potentially treatable.

Conclusions:

Outcome of Research: Not applicable

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio, Quality of Life

Title: Life Satisfaction in Persons With Late Effects of Polio: A Test‐Retest Reliability Study
Author: Elisabeth Ekstrand RPT, PhD; Jan Lexell MD, PhD, DPhil h.c.; Christina Brogårdh RPT, PhD
Affiliation: E.E. - Department of Health Sciences, Lund University, Lund, Sweden; andDepartmentof Hand Surgery, Skåne University Hospital, Malmö, Sweden. Address correspondenceto: E.E., Department of Health Sciences,Physiotherapy Research Group, Lund Univer-sity, Box 157, SE-221 00 Lund, Sweden; e-mail: [email protected]
Disclosure: nothing to disclose.

J.L. and C.B. - Department of Health Sciences, Lund University, Lund, Sweden; andDepartment of Neurology, Rehabilitation Medicine, Memory Disorders and Geriatrics,Skåne University Hospital, Lund, Sweden
Disclosure: nothing to disclose.
Journal: PM&R: The Journal of Injury, Function, and Rehabilitation
Citation: Volume 12, Issue 10 p.997-1002
https://doi.org/10.1002/pmrj.12325
Publication Year and Month: 2020 01

Abstract:
Background
The Life Satisfaction Questionnaire (LiSat‐11), including one global item and 10 domain‐specific items, is used to evaluate life satisfaction in persons with the late effects of polio (LEoPs). However, there is a lack of knowledge about its psychometric properties.

Objective
To evaluate the test‐retest reliability of the LiSat‐11 and the associations between the global and domain‐specific items in persons with LEoPs.

Design
A test‐retest design, where data were collected by a postal survey.

Setting
University Hospital, Outpatient Clinic.

Participants
A cross‐sectional sample of persons (20 women and 31 men; mean age 72 years) with LEoPs.

Main Outcome Measurements
LiSat‐11, assessing how satisfied a person is with different aspects of life, such as life as a whole, vocation, economy, leisure, contacts with friends and acquaintances, sexual life, activities of daily living (ADLs), family life, partner relationship, somatic health, and psychological health.

Methods
LiSat‐11 was administered on two occasions, 2 weeks apart. The test‐retest reliability was evaluated by Kappa statistics, the percent agreement (PA), and the Svensson rank‐invariant method. The association between the items was evaluated with the Spearman rank correlation coefficient (rho).

Results
The Kappa coefficients showed good to excellent agreement (0.64‐0.90) and the PA ≤1 point was high (>92%) for all items. No items showed any systematic or random disagreements according to the Svensson method. All domain‐specific items correlated significantly with the global item “Life as a whole” (P < .01; rhos 0.41 to 0.75).

Conclusions
LiSat‐11 is reliable for assessing life satisfaction in persons with LEoPs. The global item “Life as a whole” is useful as an overall measure but cannot fully replace the information obtained from the domain‐specific items of LiSat‐11.

Conclusions: LiSat‐11 is a reliable outcome measure to assess life satisfaction in persons with LEoPs. The association between the global item “Life as a whole” and the domain‐specific items indicates that LiSat‐11 measures various aspects that can affect a personʼs life satisfaction. The global question “Life as a whole” is useful as an overall measure but cannot fully replace the information obtained from the domain‐specific questions of LiSat‐11.

Outcome of Research: Effective

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Diagnosis and Management, Late Effects of Polio

Title: Post-poliomyelitis syndrome (2019)
Author: Eric Chun Pu Chu1 and Kary Ka Wai Lam2
Affiliation: 1New York Chiropractic and Physiotherapy Center, New York Medical Group, Hong Kong, People’s Republic of China
2Downtown Chiropractic Limited, Hong Kong, People’s Republic of China
Correspondence: Eric Chun Pu ChuNew York Chiropractic and Physiotherapy Centre, New York Medical Group, 41/F Langham Place Office Tower, 8 Argyle Street, Mongkok, Hong Kong, People’s Republic of China, Phone: Tel +852 3 594 7844, Fax: Fax +852 3 594 6193, Email [email protected]
Journal: International Medical Case Reports Journal
Citation: 12, 261–264. https://doi.org/10.2147/IMCRJ.S219481

Publication Year and Month: 2019 08

Abstract: Most developed countries eliminated paralytic poliomyelitis (polio) in the 1970s to 1980s. It was believed that after recovery from acute paralytic poliomyelitis, the physical condition of survivors would remain stable for the rest of their lives. However, the elimination of polio does not equate the end of medical management of polio. Hundreds of thousands of polio survivors worldwide are still at risk of developing the late effects of the disease. Here, we report a case of post-polio syndrome who attended our clinic for the presence of new weakness and neuromuscular problems six decades after recovery from paralytic polio. It is essential that health professionals be aware of these conditions and have an understanding of the underlying pathophysiology of the symptoms.

Conclusions: Post-polio syndrome is related to the exhaustion of the motor units that form decades after the polio attack. This case report describes the effectiveness of manual interventions in assisting our patient in restoring the level of function and alleviating pain. The limitation of the current report is that it is just a single case. Further comparison with more existing therapeutic regimens is warranted to clarify these issues.

Outcome of Research: Not applicable

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio

Title: New problems in old polio patients: results of a survey of 539 polio survivors
Author: Halstead LS, Rossi CD
Affiliation: Not stated
Journal: Orthopedics
Citation: Orthopedics. 1985 Jul; 8(7):845-50
Publication Year and Month: 1985 07

Abstract: Presented are the results of a questionnaire survey on new health problems in 539 polio survivors. The most common new problems were fatigue, weakness in previously affected and unaffected muscles, muscle pain, and joint pain. The median time from polio to the onset of these problems ranged from 30 to 40 years. Factors at onset of polio most strongly associated with developing these new health problems were: being hospitalized, being over 10 years old, being on a ventilator, and having paralytic involvement of all four limbs. The differential diagnoses of these new problems, implications for treatment and areas for future research are discussed.

Conclusions:

Outcome of Research:

Availability of Paper:

Comments (if any):

Link to Paper (if available):


Category: Cultural Context, Disability Rights, Late Effects of Polio, Quality of Life, Vocational Implications

Title: “The car is my extra legs” – Experiences of outdoor mobility amongst immigrants in Sweden with late effects of polio
Author: Helena Selander, Conceptualization, Data curation, Formal analysis, Methodology, Project administration, Supervision, Validation, Visualization, Writing – original draft, Writing – review & editing,1,2,* Iolanda Santos Tavares Silva, Formal analysis, Methodology, Supervision, Validation, Writing – original draft, Writing – review & editing,1,3 Felicia Kjellgren, Conceptualization, Investigation, Methodology, Writing – review & editing,1 and Katharina S. Sunnerhagen, Conceptualization, Data curation, Funding acquisition, Investigation, Methodology, Project administration, Resources, Supervision, Validation, Writing – review & editing1
Wen-Jun Tu, Editor

Affiliation: 1 Rehabilitation Medicine, Department of Clinical Neuroscience, Sahlgrenska Academy, University of Gothenburg, Sweden
2 The Swedish National Road and Transport Research Institute (VTI), Gothenburg, Sweden
3 Department of Occupational Therapy and Physiotherapy, The Sahlgrenska University Hospital, Gothenburg, Sweden
Chinese Academy of Medical Sciences and Peking Union Medical College, CHINA
Competing Interests: The authors have declared that no competing interests exist.
* E-mail: [email protected]
Journal: PLoS One
Citation: 14(10), e0224685. https://doi.org/10.1371/journal.pone.0224685
Publication Year and Month: 2019 10

Abstract: Background
The aim of the study was to describe the experience of outdoor mobility among immigrants with late effects of polio living in Sweden. There is a need to understand more about this young group of persons since they often have problems with mobility and gait, but they may also face participation restrictions due to issues associated with integration into a new community and culture.

Method
A total of 14 young immigrants with late effects of polio participated and were interviewed individually. The study used a qualitative method to explore personal experiences and the interviews were analyzed through an inductive approach, using qualitative content analysis.

Results
The analysis led to a major theme; self-image and acceptance, that comprised a changeable process and experiences of cultural, social, and gender-specific barriers, but also of environmental and personal factors that impacted their outdoor mobility. By using a car, the participants felt they could come across as normal which also increased their self-esteem.

Conclusions
Independent mobility is a major enabler for ongoing employment and being able to use a car increases the chances for integration into society for young immigrants with late effects of polio. Public transport is not considered to be adequate or efficient enough due to the participants’ mobility impairments, but driving can prevent involuntary isolation and facilitate participation. A car can increase quality of life but may also be a facilitator for work and reduce the demand for societal support.

Conclusions: More work is needed on young immigrants with late effects of polio to identify their mobility needs and find solutions that could minimize barriers and help them to be more independent outdoors. This group in Sweden has often been overlooked in clinical settings and in society generally. It is important to consider the need of care and support for persons with late effects polio as the need for care has been questioned and decision makers (such as health commissioners) believe persons with late effects of polio no longer exist in Sweden. Moreover, they are not prioritized despite needing rehabilitation interventions that could increase their outdoor mobility. Independent mobility is a major enabler for ongoing employment and the ability to access a car can increase their chances for social integration. According to participants in this study, public transport is not adequate or efficient enough for their needs. For young immigrants with late effects of polio, driving can prevent involuntary isolation and facilitate participation. A car may increase quality of life and reduce the demand for societal support.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio

Title: People living with post-polio syndrome must not be forgotten
Author: Hill T
Affiliation: British Polio Fellowship
Journal: Nursing Standard
Citation: Nurs Stand. 2015 Nov 4;30(10):30-1. doi: 10.7748/ns.30.10.30.s38
Publication Year and Month: 2015 11

Abstract: As research conducted by YouGov reveals, only 7% of people in Britain are aware of the neurological condition post-polio syndrome (PPS). The British Polio Fellowship is keen to highlight what is now an urgent need for more support for those living with PPS, from both the public and the nursing and medical community.

Conclusions:

Outcome of Research: Not applicable

Availability of Paper: Paid subscription required to view or download full text.

Comments (if any):

Link to Paper (if available): Click here to view Abstract


Category: Falls, Late Effects of Polio

Title: Polio survivors have poorer walking adaptability than healthy individuals
Author: Jana Tuijtelaars (1), Melvyn Roerdink (2), Bart Gerardus Hendricus Raijmakers (1), Frans Nollet (1), Merel-Anne Brehm (1)
Affiliation: (1) Amsterdam UMC, University of Amsterdam, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, the Netherlands

(2) Department of Human Movement Sciences, Faculty of Behavioural and Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Van der Boechorststraat 7, Amsterdam, the Netherlands
Journal: Gait & Posture
Citation: https://doi.org/10.1016/j.gaitpost.2021.04.031
Publication Year and Month: 2021 04

Abstract: Background:
Falling is a major health problem in polio survivors, often occurring as a result of tripping, slipping or misplaced steps. Therefore, reduced walking adaptability possibly plays an important role.

Research question:
Does walking adaptability, assessed on an interactive treadmill, differ between polio survivors and healthy individuals?

Methods:
In this cross-sectional study, 48 polio survivors with at least one reported fall in the past year and/or fear of falling and 25 healthy individuals of similar age walked at self-selected comfortable fixed speed on an instrumented treadmill. Walking adaptability was measured as i) target-stepping accuracy (determined as variable error [VE] in mm independent of speed) in three conditions; 0%, 20% and 30% variation in step length and width, and ii) anticipatory and reactive obstacle avoidance (ObA and ObR, in percentage successfully avoided). All trials were checked for valid step detection.

Results:
46 polio survivors (mean ± SD age: 63.2 ± 8.7 years) and 25 healthy individuals (64.3 ± 6.6 years, p = 0.585) showed valid step detection. Compared to healthy individuals (mean±SE VE: 30.6±1.2mm), polio survivors stepped less accurately onto targets (36.4±0.9mm, p = 0.001), especially with their least-affected leg. Polio survivors avoided fewer obstacles successfully (mean±SE ObA: 83±3%, ObR: 59±4%) than healthy individuals (100±0.3%, p < 0.001 and 94±3%, p < 0.001, respectively), with a stronger decline in success rates from anticipatory to reactive obstacle avoidance for polio survivors (p < 0.001).

Significance:
Polio survivors reporting falls and/or fear of falling had a demonstrably reduced walking adaptability, especially so for reactive obstacle avoidance which requires step adjustments under high time-pressure demands. Future research should study the merit of walking-adaptability assessment to currently used clinical methods of fall-risk assessment within this population.

Abbreviations:
CoP: Center of Pressure

CWS: Comfortable Walking Speed

ObA: Obstacle Avoidance Anticipatory

ObR: Obstacle Avoidance Reactive

ST0: Stepping Targets, 0% variation in step length and width relative to normal walking

ST20: Stepping Targets, 20% variation in step length and width relative to normal walking

ST30: Stepping Targets, 30% variation in step length and width relative to normal walking

VE: Variable stepping Error

%GDS: Percentage successful goal-directed steps

Keywords:
Poliomyelitis, walking adaptability, falling, fall, risk, C-Mill, muscle, weakness

Conclusions: Polio survivors had a demonstrable limited ability to adapt walking to environmental circumstances compared to community-dwelling healthy individuals of similar age. They had fewer successful goal-directed steps, stepped less consistently on stepping targets and, despite walking slower, had lower obstacle-avoidance success rates, especially under high time-pressure demands. This diminished walking adaptability could place them at higher risk of falling, especially in everyday life, where walking often needs to be adapted to expected and unexpected circumstances. Future research should study the validity and reproducibility of walking-adaptability assessment in polio survivors to determine its added value to the currently used methods of fall-risk assessment in clinical practice.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Epidemiology, Late Effects of Polio

Title: Epidemic poliomyelitis, post-poliomyelitis sequelae and the eradication program
Author: Margaret Peel
Affiliation: University of Melbourne - Department of Microbiology and Immunology Melbourne, Australia
Position: Principal Microbiologist
Description: Retired
Journal: Microbiology Australia
Citation: 41(4):196 DOI: 10.1071/MA20053
Publication Year and Month: 2020 11

Abstract: Epidemics of paralytic poliomyelitis (polio) first emerged in the late 19th and early 20th centuries in the United States and the Scandinavian countries. They continued through the first half of the 20th century becoming global. A major epidemic occurred in Australia in 1951 but significant outbreaks were reported from the late 1930s to 1954. The poliovirus is an enterovirus that is usually transmitted by the faecal–oral route but only one in about 150 infections results in paralysis when the central nervous system is invaded. The Salk inactivated polio vaccine (IPV) became available in Australia in 1956 and the Sabin live attenuated oral polio vaccine (OPV) was introduced in 1966. After decades of stability, many survivors of the earlier epidemics experience late-onset sequelae including post-polio syndrome. The World Health Organization launched the global polio eradication initiative (GPEI) in 1988 based on the easily administered OPV. The GPEI has resulted in a dramatic decrease in cases of wild polio so that only Pakistan and Afghanistan report such cases in 2020. However, a major challenge to eradication is the reversion of OPV to neurovirulent mutants resulting in circulating vaccine-derived poliovirus (cVDPV). A novel, genetically stabilised OPV has been developed recently to stop the emergence and spread of cVDPV and OPV is being replaced by IPV in immunisation programs worldwide. Eradication of poliomyelitis is near to achievement and the expectation is that poliomyelitis will join smallpox as dreaded epidemic diseases of the past that will be consigned to history.

Conclusions: Eradication of poliomyelitis is near to achievement and the expectation is that poliomyelitis will join smallpox as dreaded epidemic diseases of the past that will be consigned to history.

Outcome of Research: Effective

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio, Quality of Life

Title: Relationship between participation in life situations and life satisfaction in persons with late effects of polio
Author: Maria Larsson Lund & Jan Lexell
Affiliation: Maria Larsson Lund - Department of Community Medicine and Rehabilitation, Occupational Therapy, Umeå University, Umeå, Sweden Correspondence: [email protected]

Jan Lexell - Department of Rehabilitation Medicine, Lund University Hospital, Lund, Sweden; Division of Rehabilitation Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden; Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
Journal: Disability and Rehabilitation
Citation: 31(19), 1592–1597. https://doi.org/10.1080/09638280802638881
Publication Year and Month: 2009 09

Abstract:
Purpose. To assess the relationship between participation and problems with participation in life situations, and life satisfaction in persons with late effects of polio.

Methods. One hundred fifty-eight persons with late effects of polio responded to a postal questionnaire including the Swedish versions of the Impact on Participation and Autonomy Questionnaire (IPA-S) and Life Satisfaction Questionnaire (LiSat-11).

Results. The persons' perceived participation in the five domains of participation in the IPA-S was significantly correlated with their satisfaction with life as a whole and with most of the 10 domains of life satisfaction. Significant differences in satisfaction with life as a whole and with eight of the 10 domains in LiSat-11 were found between groups of increasing severe problems with participation. Greater number of reports of severe problems with participation corresponded with gradually decreased satisfaction with life as a whole and with satisfaction in the eight domains in LiSat-11.

Keywords: Activities of daily living, disability evaluation, disabled persons, personal autonomy, postpoliomyelitis syndrome, rehabilitation, quality of life

Conclusions: Perceived participation and problems with participation in life situations are determinants of life satisfaction in persons with late effects of polio. This implies that addressing participation and problems with participation in the rehabilitation of persons with late effects of polio may lead to an enhanced life satisfaction.

Outcome of Research: More research required

Availability of Paper: Paid subscription required to view or download full text.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio, Surgery

Title: Physical Therapist Management Following Rotator Cuff Repair for a Patient With Postpolio Syndrome
Author: Mary Carlson, Tana Hadlock
Affiliation: M Carlson, PT, PhD, is Associate Professor, Physical Therapy Program,
University of Texas at El Paso, 1101 N Campbell, El Paso, TX 79902 (USA).

T Hadlock, MA, OTR, is Instructor, Occupational Therapy Program, Yamaguchi Health and Welfare College, Ube City, Yamaguchi Prefecture, Japan.
Journal: PTJ: Physical Therapy & Rehabilitation Journal (Prior to 2021, was titled Physical Therapy)
Citation: Phys Ther. 2007;87:179–192.
https://doi.org/10.2522/ptj.20050200
Publication Year and Month: 2007 02

Abstract: Background and Purpose
Postpoliomyelitis sequelae, such as gait instability and progressive weakness, predispose people with postpolio syndrome to secondary disabilities. With aging, people who depend on their upper extremities to accommodate lower-extremity deficits may anticipate overuse injuries. The purpose of this case report is to describe the use of mobilization and exercise in postoperative rehabilitation of rotator cuff surgery on a patient with postpolio syndrome.

Case Description
A 48-year-old woman with postpolio syndrome had rotator cuff surgical repair followed by physical therapy intervention. Maitland mobilization and mild functional exercises were chosen to avoid triggering fatigue.

Outcomes
Measurements taken preoperatively, before and after physical therapy intervention, and 2 years after intervention showed return to independent status with excellent retention.

Discussion
No fatigue or overuse weakness was encountered. This is the first case report to document physical therapy following rotator cuff repair in a patient with postpolio syndrome.

Conclusions: In summary, this is the first case report to document the effects of physical therapy in a patient with PPS who had a rotator cuff tear resulting from extended use due to postpolio sequelae. The physical therapist used a Maitland technique with functional active exercises for the patient. The physical therapist additionally emphasized communication and used the patient responses to adjust treatment. The patient was knowledgeable about her condition and was able to be an active partner of the rehabilitation team, monitor fatigue, and modify her exercises and activities as needed. Additionally, the change between her status immediately following rehabilitation and 2 years later showed continued progress in strength and ROM. We believe that the combination of good practitioner/patient communication, use of the Maitland technique to increase joint ROM without patient effort, and careful selection of a few functionally important active and resistive exercises contributed to the success of this patient’s rehabilitation.

Future research might use a single-subject research design for multiple individuals with PPS who have rehabilitation following orthopedic surgery. A standardized functional survey would strengthen the design, and a handheld dynamometer could be used to quantify muscle strength in lieu of the BTE device. The single-subject design is stronger than the case report and can infer an effect of the intervention on the outcome.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Assistive Technology, Late Effects of Polio

Title: Coping with a Second Disability: Implications of the Late Effects of Poliomyelitis for Occupational Therapists
Author: Mary Westbrook, Lynette McDowell
Affiliation: Macquarie University, Sydney. Australia
Journal: Australian Occupational Therapy Journal
Citation: 38(2):83 - 91
Publication Year and Month: 2010 08

Abstract: The long term effects of many physical disabilities have only recently begun to be appreciated. For people who have lived for years with what they thought to be stable conditions, the onset of secondary disabilities may be associated with considerable problems and distress. A questionnaire survey of 324 people with poliomyelitis revealed the occurrence of late effects in 94% of respondents. The majority reported increased weakness, pain and fatigue, problems in carrying out daily living activities and difficulties in obtaining appropriate health care. Although occupational therapists were less likely to be consulted than other professionals, they received one of the highest satisfaction ratings from clients.

Conclusions: Discussion of case studies indicates ways in which occupational therapists can provide symptom relief and enable clients to maintain valued roles. As the survival rates of people with disabilities increase there is a need for greater awareness of, and research into, the late effects of disability.

Outcome of Research: More research required

Availability of Paper:

Comments (if any):

Link to Paper (if available): Click here for preview


Category: Pain, Late Effects of Polio

Title: Effectiveness of Intravenous Immunoglobulin for Management of Pain in Patients with Postpolio Syndrome
Author: Min Cheol Chang (1), Jin-Sung Park (2), Jong-moon Hwang (3), and Donghwi Park (4)
Affiliation: (1) Department of Rehabilitation Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea

(2) Department of Neurology, School of Medicine, Kyungpook National University,
Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea

(3) Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea

(4) Department of Physical Medicine and Rehabilitation, Ulsan University Hospital, University of Ulsan College of Medicine,
Ulsan, Republic of Korea
Journal: Pain Research and Management
Citation: Volume 2021, Article ID 6637705, 4 pages
https://doi.org/10.1155/2021/6637705
Publication Year and Month: 2021 03

Abstract: Objective.
Many patients with postpolio syndrome (PPS) experience pain. In this study, we aimed to review previous studies to investigate the effectiveness of intravenous immunoglobulin (IVIG) for managing pain in patients with PPS. We performed a narrative review.

Methods.
In PubMed, we searched for the keywords ((Immunoglobulin OR IVIG) AND (poliomyelitis OR poliomyelitis syndrome)). We included articles in which IVIG was infused in patients with PPS and pain severity was measured before and after treatment.

Results.
In the results, five articles (4 randomized controlled trials and 1 prospective observational study) were included in this review. Four of the studies reported that IVIG had a positive pain-reducing effect in patients with PPS. In addition, 4 studies evaluated the outcomes related to muscle strength and function. Of these studies, 3 showed some improvement in measurements for muscle strength and function.

Conclusion.
In conclusion, IVIG might be one of the beneficial options for managing pain in PPS. Pain reduction might be responsible for the improvement of muscle strength or function. To confirm the benefits of IVIG in reducing pain, more high-quality studies are required.

Conclusions: In conclusion, this review shows that IVIG administration might be useful for managing pain in patients with PPS. In the 5 articles reviewed, no major adverse effects were reported. Owing to the small number of studies and inconsistent results between the studies, we cannot make a definite conclusion on the effect of IVIG on pain in PPS. However, we think that the previous studies showed a possibility that IVIG can safely manage pain in patients with PPS. To confirm the benefits of IVIG in reducing pain in patients with PPS, more high-quality studies are required. Moreover, the protocols for IVIG infusion used in each study were heterogeneous; therefore, the most effective protocol for IVIG infusion for controlling pain should be evaluated in the future.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio

Title: Experiences and perspectives of patients with post-polio syndrome and therapists with exercise and cognitive behavioural therapy
Author: Minne Bakker, Karen Schipper, Fieke S. Koopman, Frans Nollet and Tineke A. Abma
Affiliation: Department of Medical Humanities, EMGO+ Institute, VU Medical Center
(VUmc), Amsterdam, The Netherlands
Journal: BioMed Central Neurology
Citation: BMC Neurology (2016) 16:23
Publication Year and Month: 2016

Abstract: Background: Many persons affected with poliomyelitis develop post-polio syndrome (PPS) later in their life.
Recently, the effectiveness of Exercise Therapy (ET) and Cognitive Behavioural Therapy (CBT) for PPS has been evaluated in a randomized controlled trial, but did not show a decrease in fatigue or improvement in secondary endpoints like Quality of Life and self-perceived activity limitations. The aim of this explorative study was to gain insight in the perceived effects and experiences of the interventions from the perspectives of the patients and
therapists.
Methods: Qualitative data were collected through semi-structured interviews with 17 patients and 7 therapists. All participants were involved in the trial. A thematic analysis of the data was performed.
Results: Some patients experienced a short term enhanced endurance and a better use of energy during the day. However, in general patients did not experience a long lasting reduction of fatigue from the CBT or ET. Mainly patients of the CBT, but also some patients of the ET described an increase of self-esteem and self-acceptance. As a result, patients were sometimes better able to perform physical activities during the day. In contrast to the CBT, the
ET was in general perceived by the patients as an intensive therapy, which was difficult to fit into their daily routine. Therapists of both the CBT and the ET struggled with a low intrinsic motivation of the patients in the study.
This made it sometimes difficult for the therapists to follow the protocol.

Conclusions: Conclusion: Confirming the negative quantitative study outcome, the qualitative results did not demonstrate lasting effects on fatigue. Patients did, however, experience some benefits on self-esteem and acceptance of the disease. This study showed that it is of great importance to work with feasible interventions; they should fit the patients’ needs on a practical (fit into their daily routine) and mental (fit their need for support) level.

Outcome of Research: More research required

Availability of Paper:

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Dysphagia, Dysphonia, Late Effects of Polio

Title: Pharyngolaryngeal manifestations of post-polio syndrome (Manifestações faringo-laríngeas da síndrome pós-poliomielite)
Author: Noemi Grigoletto De Biase (1), Bruno Teixeira de Moraes (2), Mariana Dantas Aumond Leb (3), Gustavo Polacow Korn (4), Marina Padovani (5), Miriam Moraes (6), Glaucya Madazio (7).
Affiliation: Departament of Laryngology and Voice of the Discipline of Otorhinolaryngology of Federal University of São Paulo - Medical School Paulista (UNIFESP-EPM). São Paulo / SP - Brazil

1) Prof. Doc. Associate of Departament of Fundamentals of Phonoaudiology of Pontifical Catholic University of São Paulo. Advisor of Masters Degree of UNIFESP-EPM.

2) Fellow in Larynx and Voice by the Departament of Otorhinolaryngology and Surgery of Head and Kneck by Federal University of São Paulo - Medical School Paulista (UNIFESP-EPM). Doctor Otorhinolaryngologist.

3) Master in Medicine by UNIFESP-EPM. Doctor Otorhinolaryngologist.

4) PhD in Science by the Departament of Otorhinolaryngology and Surgery of Head and Kneck by Federal University of São Paulo - Medical School Paulista (UNIFESPEPM). Doctor Otorhinolaryngologist.

5) PhD in Science of Human Communication by UNIFESP. Clinical Audiologist.

6) Master in Science of Human Communication by UNIFESP - Clinical Audiologist.

7) PhD in Science of Human Communication by UNIFESP. Clinical Audiologist.
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Intl. Arch. Otorhinolaryngol., São Paulo - Brasil, v.15, n.4, p. 529-533, Oct/Nov/December - 2011.
Publication Year and Month: 2010 04

Abstract: INTRODUCTION: The post-polio syndrome (PPS) is characterized by a new episod of atrophy or muscle weakness in individuals previously affected by poliomyelitis. The symptoms start from an extended period of clinical stability ranging from 20 to 40 years, after the initial chart of polio. Among the pathophysiological mechanisms, the most likely is that the syndrome represents a process of attrition and neuronal metabolic exhaustion due to a continuous process of denervation reinnervation which begins after the initial acute.

OBJECTIVE: Review the clinical characteristics and pathophysiological of PPS,as well as present the approach in cases with pharyngolaryngeal manifestations.

CASE REPORT: We present the clinical case of a male patient with 48 years old, with main complaints of dysphonia, dysphagia and previous history of polio. The patient underwent a diagnostic investigation, in which the voice psychoacoustic findings are described. Laringoscopic, electromyographic and the videoendoscopy of swallowing compatible with PPS. The treatment consisted in phonotherapy in a total of 11 weekly sessions and guidelines for swallowing, with satisfactory improvement of the symptoms.

FINAL COMMENTS: The pharyngolaryngeal manifestations of PPS are susceptible to treatment, obtaining satisfactory results, with improvement of life quality of the patients.

KEYWORDS: poliomyelitis, post-polio syndrome, neuromuscular diseases, larynx diseases, voice disorders.

Conclusions: The diagnosis of PPS depends of the high rate of suspicion and a good anamnesis, in which the patient reports previous history of poliomyelitis. As in the most of the cases these patients present other commemorative resulting of the syndrome, voice alterations become less evident before the whole picture. Active searches in services of references in treatment of PPS can show that the frequency of dysphonia and dysphagia maybe is bigger than the ones described in the literature. Considering that the laryngeal-pharyngeal manifestations of PPS are suitable for treatment with improvement of life quality of the patients, is evident the importance of the diagnosis.

Outcome of Research: Not applicable

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Diagnosis and Management, Differential Diagnosis, Gender Differences, Late Effects of Polio

Title: Postpolio Syndrome: A Review of Lived Experiences of Patients
Author: Oluwaseyi Jacob Oluwasanmi, Devaunna Andrene Mckenzie, Idowu Oluwasegun Adewole, Christian O Aluka, James Iyasse, Esther Olunu, and Adegbenro Omotuyi Fakoya1
Affiliation: Department of Microbiology, All Saints University School of Medicine, Commonwealth of Dominica, Roseau, Dominica
1Department of Anatomical Sciences, University of Medicine and Health Sciences, Basseterre, St. Kitts and Nevis
Address for correspondence: Dr. Adegbenro Omotuyi Fakoya, University of Medicine and Health Sciences, Basseterre, St. Kitts and Nevis. E-mail: [email protected]
Journal: International Journal of Applied & Basic Medical Research
Citation: 9(3), 129–134. https://doi.org/10.4103/ijabmr.IJABMR_333_18
Publication Year and Month: 2019 07

Abstract: Postpolio syndrome (PPS) refers to a group of conditions that are present in patients, years after recovery from initial acute paralytic poliomyelitis. About 15%–80% of 20 million polio survivors worldwide will experience exacerbation of symptoms which typically appear 15–30 years after the resolution of initial poliomyelitis. Symptoms include new muscle weakness, fatigue, myalgia, joint pain, dysphagia, and difficulty breathing. Other reported symptoms include cold intolerance, sleep disorder, dysphonia, loss of stamina, musculoskeletal deformities, cardiovascular disorders, psychosocial problems, and restless legs syndrome. These symptoms are attributed to the superimposed neuronal loss of aging with inflammatory mechanisms, but without any convincing evidence of viral reactivation. Risk factors include female gender, respiratory symptoms, normal aging, permanent disability caused by motor neuron damage, muscle overuse and disuse, aging, and immunologic mechanisms. Hypothyroidism-induced myopathy and fibromyalgia are a differential diagnosis for PPS, and exclusion diagnosis is required as confirmatory criteria for PPS. The symptoms of PPS presented determine the course of management.

Keywords: Fatigue, muscle weakness, myalgia, poliomyelitis, postpolio syndrome

Conclusions: PPS is a sequela of acute poliomyelitis which occurs decades after resolution of the initial paralytic or nonparalytic polio. Fatigue, muscle weakness, myalgia, and joint pain are the major symptoms of PPS. Diagnosis of PPS is made based on the exclusion of other conditions that can cause similar symptoms. The quality of life of patients with PPS is significantly affected by the reoccurrence of the constellations of symptoms they experience. Proper assessment and treatment should be performed to prevent severe impairment of function in patients.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio

Title: Prevalence and risk factors of post-polio syndrome in a cohort of polio survivors.
Author: Paolo Ragonese, Brigida Fierro, Giuseppe Salemi, Giovanna Randisi, Daniela Buffa, Marco D'Amelio, Antonella Aloisio, Giovanni Savettieri
Affiliation: Dipartimento di Neurologia, Oftalmologia, Otorinolaringoiatria e Psichiatria, Università di Palermo, Italy.
Journal: Journal of the Neurological Sciences
Citation: 2005 Sep 15;236(1-2):31-5.
Publication Year and Month: 2005 09

Abstract: OBJECTIVE:
To investigate frequency and associated factors of post polio syndrome (PPS) in an Italian cohort of people with prior poliomyelitis.

METHODS:
We screened subjects admitted for poliomyelitis at the paediatric hospital of the University of Palermo during the time frame 1945-1960. Patients who developed PPS were identified through a structured questionnaire and a neurologic examination. PPS diagnosis was made according to specified diagnostic criteria. Frequency of PPS was calculated in the selected cohort of polio survivors. The association with the investigated risk factors (sex, age at onset of polio, extension and severity of polio, education, associated diseases, cigarette smoking, trauma, polio vaccination) was analysed by the calculation of the odds ratio.

RESULTS:
Forty-eight participants met the adopted diagnostic criteria for PPS, giving a prevalence of 31.0%. The prevalence rate was significantly higher in women than in men (p=0.02). Logistic regression analyses revealed a significant inverse association with onset of poliomyelitis at over 12 months of age (OR 0.33; CI 0.14-0.79) a higher degree of education (OR 0.20; CI 0.07-0.79), and a significant association with the presence of other diseases (OR 9.86; CI 3.69-26.34).

Conclusions: CONCLUSIONS:
In our survey one-third of patients with prior poliomyelitis had PPS. Higher age at onset of poliomyelitis is inversely associated with PPS. The association with other diseases may indicate that a chronic physical stress, particularly in already weak motor units, can contribute to the development of signs and symptoms of PPS. Our results also suggest the impact of socio-economic conditions on the risk of PPS.

Outcome of Research: More research required

Availability of Paper:

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio

Title: Polio: long-term problems
Author: Perry J, Fleming C
Affiliation: Not stated
Journal: Orthopedics
Citation: Orthopedics. 1985 Jul; 8(7):877-81
Publication Year and Month: 1985 07

Abstract: The most common long-term problems seen in polio are brace problems, knee recurvatum, increasing weakness due to overuse and ankle equinus. A definite increased incidence of problems is seen after the patient is more than 30 years post-polio. The basis for most of these problems is chronic mechanical strain of weak musculature and substituting ligaments. Overuse can cause increasing weakness resulting in pain and decreasing function. It is therefore important to follow polio patients closely, especially those that are more than 30 years post-polio. If signs of overuse or chronic mechanical strain are noted, treatment should not be delayed.

Conclusions:

Outcome of Research:

Availability of Paper:

Comments (if any):

Link to Paper (if available):


Category: Late Effects of Polio

Title: Risk of symptoms related to late effects of poliomyelitis
Author: Rekand T, Albrektsen G, Langeland N, Aarli JA
Affiliation: Department of Neurology, Haukeland Hospital, Bergen, Norway
Journal: Acta Neurologica Scandinavica
Citation: Acta Neurol Scand. 2000 Mar;101(3):153-8
Publication Year and Month: 2000 03

Abstract: OBJECTIVE: To compare the risk of developing symptoms related to late effects of poliomyelitis between polio patients and persons of similar age and sex without history of poliomyelitis.

MATERIAL AND METHODS: The study comprised information on 148 patients with prior poliomyelitis and 115 persons with no history of poliomyelitis. Information was obtained by questionnaire and analyzed by multiple logistic regression method.

RESULTS: The risk of experiencing two or more symptoms was significantly higher among the polio patients than among the persons without history of poliomyelitis. The elevation in risk was less pronounced in the nonparalytic group (OR = 2.35; 95% CI = 0.92-5.97) than the group with permanent muscular weakness (OR = 8.84; 95% CI =4.32-18.09).

Conclusions: Although symptoms defined in the PPS are unspecific and may occur in the general population, the risk for developing such symptoms are higher among the polio victims. The difference in risk among nonparalytic and paralytic patients may depend on the extent of motor neuron damage in the acute stage.

Outcome of Research: Not applicable

Availability of Paper: Paid subscription required to view or download full text.

Comments (if any):

Link to Paper (if available): Click here to view Abstract


Category: Late Effects of Polio, Respiratory Complications and Management

Title: Post-Polio Syndrome Causing Late Onset Respiratory
Failure
Author: Sharon Enghelberg MD, Itamar Y. Love MD and Micha Rapoport MD
Affiliation: Department of Internal Medicine C, Shamir Medical Center, Zerifin, Israel
Journal: Israel Medical Association Journal (IMAJ)
Citation: 2020; 22: 395–396
Publication Year and Month: 2020

Abstract: CASE STUDY:
We present a patient with thoracic cage deformity and chronic progressive hypoventilation due to late onset PPS.

Conclusions: PPS can be a significant cause for respiratory deterioration in patients with
previous history of poliomyelitis. Physicians should be aware of this potential
diagnosis, as early diagnosis can facilitate individualized treatment plan and
prevent unnecessary examinations and mistreatment.

Outcome of Research: Not applicable

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any): KEY WORDS: dyspnea, polio, post-polio syndrome
(PPS), respiratory failure, restrictive
lung disease

Link to Paper (if available): Click here to view full text or to download


Category: Cardiorespiratory, Late Effects of Polio, Respiratory Complications and Management

Title: Obesity and Pulmonary Function in Polio Survivors
Author: Soo Jeong Han, MD, PhD (1), Jae-Young Lim, MD, PhD(2), Jee Hyun Suh, MD(1)
Affiliation: 1. Department of Rehabilitation Medicine, Ewha Womans University School of Medicine, Seoul;

2. Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Korea
Journal: Annals of Rehabilitation Medicine
Citation: 2015;39(6):888-896
pISSN: 2234-0645 • eISSN: 2234-0653
http://dx.doi.org/10.5535/arm.2015.39.6.888
Publication Year and Month: 2015 06

Abstract: OBJECTIVE
To examine the correlation between obesity and pulmonary function in polio survivors.

METHODS
This study was conducted based on a questionnaire survey and physical examination. The questionnaire included gender, age, paralyzed regions, physical activity levels, and accompanying diseases. The physical examination included measuring body mass index, waist circumference, muscle power, total fat amount, body fat percentage, and lean body mass. In addition, pulmonary function was tested based on forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), ratio of FEV1 to FVC, and chest circumference. Five university hospitals and a local health clinic participated in this study.

RESULTS
Pearson and partial correlation coefficients that used data collected from 73 polio survivors showed that obesity had a negative correlation with pulmonary function.

CONCLUSION
This study found that pulmonary function has a negative correlation with obesity for polio survivors. Therefore, it is necessary to develop specialized exercise programs to help polio survivors reduce their weight and strengthen their respiratory muscles.

Conclusions: This study found that pulmonary function has a negative correlation with obesity for polio survivors. Therefore, it is necessary to develop specialized exercise programs to help polio survivors reduce their weight and strengthen their respiratory muscles.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any): Keywords: Poliomyelitis, Obesity, Pulmonary function

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio

Title: Post-polio Syndrome: More Than Just a Lower Motor Neuron Disease
Author: Stacey Li Hi Shing, Rangariroyashe H. Chipika, Eoin Finegan, Deirdre Murray, Orla Hardiman and Peter Bede*
Affiliation: Computational Neuroimaging Group, Academic Unit of Neurology, Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
Journal: Frontiers in Neurology
Citation: Front. Neurol., 16 July 2019 | https://doi.org/10.3389/fneur.2019.00773
Publication Year and Month: 2019 07

Abstract: Post-polio syndrome (PPS) is a neurological condition that affects polio survivors decades after their initial infection. Despite its high prevalence, the etiology of PPS remains elusive, mechanisms of progression are poorly understood, and the condition is notoriously under-researched. While motor dysfunction is a hallmark feature of the condition, generalized fatigue, sleep disturbance, decreased endurance, neuropsychological deficits, sensory symptoms, and chronic pain are also often reported and have considerable quality of life implications in PPS. The non-motor aspects of PPS are particularly challenging to evaluate, quantify, and treat. Generalized fatigue is one of the most distressing symptoms of PPS and is likely to be multifactorial due to weight-gain, respiratory compromise, poor sleep, and polypharmacy. No validated diagnostic, monitoring, or prognostic markers have been developed in PPS to date and the mainstay of therapy centers on symptomatic relief and individualized rehabilitation strategies such as energy conservation and muscle strengthening exercise regimes. Despite a number of large clinical trials in PPS, no effective disease-modifying pharmacological treatments are currently available.

Keywords: postpolio syndrome, PPS, polio, poliomyelitis, neuroimaging, biomarker, clinical trials, motor neuron disease

Conclusions: Despite being one of the most devastating neurodegenerative conditions in the world, surprisingly limited research is undertaken in post-polio syndrome. Its pathogenesis remains elusive, no sensitive diagnostic tools have been developed, and validated prognostic and monitoring markers are lacking. Non-motor symptoms of PPS have considerable quality of life implications and are notoriously challenging to manage. The etiology of fatigue in PPS is yet to be elucidated and successful individualized management strategies are needed to maintain mobility, independence, and patient autonomy. There is striking a paucity of neuroimaging studies in PPS that could provide anatomical insights into the substrate of extra-motor symptoms. Ultimately, the characterization of PPS-associated pathology may help research efforts in other motor neuron diseases.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Clinical Evaluation, Diagnosis and Management, Late Effects of Polio

Title: Post-polio Syndrome: More Than Just a Lower Motor Neuron Disease
Author: Stacey Li Hi Shing, Rangariroyashe H. Chipika, Eoin Finegan, Deirdre Murray, Orla Hardiman, and Peter Bede
Affiliation: Computational Neuroimaging Group, Academic Unit of Neurology, Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
Edited by: Francesca Trojsi, University of Campania, Luigi Vanvitelli Caserta, Italy
Reviewed by: Andrea Romigi, Mediterranean Neurological Institute (IRCCS), Italy; Louisa Ng, The University of Melbourne, Australia
*Correspondence: Peter Bede [email protected]
Journal: Frontiers in Neurology
Citation: 10, 773. https://doi.org/10.3389/fneur.2019.00773
Publication Year and Month: 2019 07

Abstract: Post-polio syndrome (PPS) is a neurological condition that affects polio survivors decades after their initial infection. Despite its high prevalence, the etiology of PPS remains elusive, mechanisms of progression are poorly understood, and the condition is notoriously under-researched. While motor dysfunction is a hallmark feature of the condition, generalized fatigue, sleep disturbance, decreased endurance, neuropsychological deficits, sensory symptoms, and chronic pain are also often reported and have considerable quality of life implications in PPS. The non-motor aspects of PPS are particularly challenging to evaluate, quantify, and treat. Generalized fatigue is one of the most distressing symptoms of PPS and is likely to be multifactorial due to weight-gain, respiratory compromise, poor sleep, and polypharmacy. No validated diagnostic, monitoring, or prognostic markers have been developed in PPS to date and the mainstay of therapy centers on symptomatic relief and individualized rehabilitation strategies such as energy conservation and muscle strengthening exercise regimes. Despite a number of large clinical trials in PPS, no effective disease-modifying pharmacological treatments are currently available.

Conclusions: Despite being one of the most devastating neurodegenerative conditions in the world, surprisingly limited research is undertaken in post-polio syndrome. Its pathogenesis remains elusive, no sensitive diagnostic tools have been developed, and validated prognostic and monitoring markers are lacking. Non-motor symptoms of PPS have considerable quality of life implications and are notoriously challenging to manage. The etiology of fatigue in PPS is yet to be elucidated and successful individualized management strategies are needed to maintain mobility, independence, and patient autonomy. There is striking a paucity of neuroimaging studies in PPS that could provide anatomical insights into the substrate of extra-motor symptoms. Ultimately, the characterization of PPS-associated pathology may help research efforts in other motor neuron diseases.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any): This is a good overview of Post-Polio conditions particularly for clinicians new to the topic.

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio, Quality of Life

Title: Quality of life assessment scales in polio survivors: a scoping review
Author: Surajo Kamilu Sulaiman (1), Heather Michelle Aldersey (1), Nora Fayed (1), Bashir Kaka (2) & Christiana Okyere (1)
Affiliation: (1) School of Rehabilitation Therapy, Queen’s University, Louise D. Acton Building, 31 George Street, Kingston, ON, K7L 3N6, Canada

(2) Department of Physiotherapy, Faculty of Allied Health Sciences, College of Health Sciences, Bayero University, PMB 3011, Kano, Nigeria
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Quality of Life Research volume 28, pages 2341–2357 (2019)
https://doi.org/10.1007/s11136-019-02185-x
Publication Year and Month: 2019 04

Abstract: Background
Quality of life evaluation is essential to explore the effect of paralytic polio on the daily life experience of the polio survivor. Researchers have employed a range of assessment instruments to evaluate quality of life among polio survivors. Hence, to select the appropriate scale, it is crucial to compare the contents and psychometric properties of these instruments.

Purpose
This scoping review explores quality of life instruments that are used in polio literature and analyzes their contents and psychometric properties using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) criteria.

Method
Using the Arksey and O’Malley framework, we conducted a literature search in the following electronic databases Medline, CINAHL, Web of Science, Embase, and Google Scholar to identify relevant studies that focused on quality of life of polio survivors. Of the 88 articles that qualify for full-text screening, 34 studies met our inclusion criteria. Two independent reviewers extracted data from the selected studies via Covidence, a reference manager that allows for blinding of reviews.

Results
Most of the instruments included in this review are generic, self-reported, and multidimensional. Despite having mostly adequate psychometric properties, these properties were not evaluated in polio survivors.

Conclusion
The information provided in this review could be used to guide instrument selection and identify the need to develop a new tool or to adapt a pre-existing scale for measuring quality of life among polio survivors.

Conclusions: The information provided in this review could be used to guide instrument selection and identify the need to develop a new tool or to adapt a pre-existing scale for measuring quality of life among polio survivors.

Outcome of Research: More research required

Availability of Paper: Paid subscription required to view or download full text.

Comments (if any):

Link to Paper (if available): Click here to view Abstract


Category: Ageing, Late Effects of Polio

Title: A Review of Secondary Health Conditions in Post-Polio Syndrome: Prevalence and Effects of Aging
Author: Thomas E. McNalley, MD, MA, Kathryn M. Yorkston, PhD1, Mark P. Jensen, PhD1, Anjali R. Truitt, MPH1, Katherine G. Schomer, MA1, Carolyn Baylor, PhD1, and Ivan R. Molton, PhD1
Affiliation: Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
Journal: American Journal of Physical Medicine & Rehabilitation
Citation: 94(2): 139–145. doi:10.1097/PHM.0000000000000166
Publication Year and Month: 2015 02

Abstract: Objective—This study seeks to better understand the prevalence and severity of secondary health conditions in individuals with post-polio syndrome (PPS), and the association between these conditions and aging.

Design—A scoping literature review was conducted searching electronic databases for studies published from 1986 – 2011. The scoping review provided information regarding the prevalence and associations of secondary health conditions in PPS with age or other duration-related variables.

Results—The findings indicate that: (1) individuals with PPS experience a number of serious secondary health conditions; (2) the most common conditions or symptoms are fatigue, pain, respiratory and sleep complaints, and increased risk of falls; (3) reports of the associations between the frequency or severity of conditions and age-related factors are variable, perhaps because of methodological inconsistencies between studies; and (4) there is a marked lack of longitudinal research examining the natural course of health conditions in people aging with PPS.

Conclusions—Longitudinal research is needed to understand the course of health conditions and the impact of multiple secondary conditions in people aging with PPS. Efforts are also needed to develop and test the efficacy of interventions to prevent these health secondary conditions or reduce their negative impact.

Keywords
Post-Polio Syndrome; Secondary Conditions; Aging; Scoping Review

Conclusions: The key findings from this scoping review include the following: (1) people with PPS experience a large number of serious secondary health conditions, including fatigue, pain, depression, muscle weakness, pulmonary and sleep disorders, and falls; (2) although comparisons with normative samples are rare, one study suggests that depression has a greater impact on the lives of people with PPS than on the general population; and (3) a number of methodological issues limit our ability to interpret the findings related to the associations between secondary conditions and aging.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Activity Levels, Late Effects of Polio, Muscle Strength, Psychology, Quality of Life

Title: Health-related quality of life, self-reported impairments and activities of daily living in relation to muscle function in post-polio syndrome
Author: Vanya Gocheva,corresponding author1 Patricia Hafner,1 Anna-Lena Orsini,1,2 Simone Schmidt,1,3 Sabine Schaedelin,4 Nicole Rueedi,1 Daniela Rubino-Nacht,1 Peter Weber,1 and Dirk Fischer1
Affiliation: 1Division of Neuropediatrics and Developmental Medicine, University Children’s Hospital of Basel (UKBB),University of Basel, Spitalstrasse 33, Postfach, 4056 Basel, Switzerland
2Division of Neurology, University Hospital Basel, Basel, Switzerland
3Department of Neurology, General Hospital Hietzing with Neurological Center Rosenhügel, Vienna, Austria
4Department of Clinical Research, Clinical Trial Unit, University Hospital Basel, Basel, Switzerland
Vanya Gocheva, Email: [email protected]
corresponding author.
Journal: Journal of Patient-Reported Outcomes
Citation: 4(1), 59. https://doi.org/10.1186/s41687-020-00226-5
Publication Year and Month: 2020 12

Abstract: Background
The symptoms of post-polio syndrome (PPS) and its resulting disabilities can affect quality of life and the ability to perform daily activities. No study has comprehensively analysed how various patient-reported outcome measures (PROMs) are associated with objectively assessed physical function in patients with PPS.

Aim
To investigate health-related quality of life (HRQOL), self-reported impairments and activities of daily living during 6 months and evaluate their association with clinical muscle function outcomes in individuals with PPS.

Methods
Twenty-seven patients with PPS were included in the study. At baseline and 6 months, patients were administered PROMs measuring HRQOL (WHOQOL-BREF), self-reported impairments related to PPS (SIPP-RS) and activities of daily living (IBM-FRS). Clinical muscle function outcomes included 6 min walking distance (6MWD) and motor function measure (MFM).

Results
There were no changes in self-reported impairments (25.52 to 24.93, p = 0.40), activities of daily living (33.89 to 33.30, p = 0.20), 6MWD (391.52 to 401.85, p = 0.30) and MFM (83.87 to 85.46, p = 0.14) during 6 months, while the HRQOL psychological health decreased during this period (76.85 to 72.38, p = 0.05). A strong association was found between activities of daily living and clinical muscle function outcomes (6MWD: ß = 0.02, 95% CI: 0.02;0.03, t = 6.88, p < 0.01; MFM: ß = 0.25, 95% CI: 0.17;0.33, t = 6.69, p < 0.01). Self-reported impairments and HRQOL domains were not associated with the clinical muscle outcomes.

Conclusions
Study findings indicate that objectively measured walking and motor abilities do not reflect patient’s perspectives of their HRQOL and impairment due to PPS. More research is needed to assess changes over time and capture clinically meaningful changes in individuals with PPS and to increase the understanding of how the patient’s perspective of disability measured by PROMs is related to objectively measured walking and motor abilities.

Conclusions: Self-reported impairments, HRQOL domains, activities of daily living and muscle function outcomes remained stable during 6 months in patients with PPS, except for the HRQOL psychological health domain which declined during this period. Clinical muscle outcomes had no statistically significant relationship with HRQOL and self-reported impairments of PPS patients while a significant relationship was observed with the activities of daily living. More research is needed to assess changes over time and capture clinically meaningful changes in individuals with PPS and to increase the understanding of how the patient’s perspective of disability measured by PROMs is related to objectively measured walking and motor abilities.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio

Title: Long-term follow-up of patients with prior polio over a 17-year period.
Author: Vreede KS, Broman L, Borg K.
Affiliation: Department of Rehabilitation Medicine, Danderyd University Hospital, Building 39, Floor 3, SE-182 88 Stockholm, Sweden, [email protected]
Journal: Journal of Rehabilitation Medicine
Citation: 2016 Apr;48(4):359-64
Publication Year and Month: 2016 04

Abstract: OBJECTIVE:
Follow-up of the health of patients with prior polio over a 17-year period.

DESIGN:
Follow-up study.

PATIENTS:
Patients with prior polio.

METHODS:
The study questionnaire was answered in 1995 by 270 patients. In 2012 the questionnaire was sent again to the surviving patients.

RESULTS:
Of the patients who answered the questionnaire in 1995, 116 (40%) were still alive in 2012. The group of patients who had died was older, and had a mean age of 70 years in 1995. A total of 60 patients participated in the study by answering the questionnaire in both 1995 and 2012. Most of these patients (84%) reported that they felt progressively worse, with poor mobility and increased muscle weakness in 2012 compared with 1995, and more than half reported a lower quality of life in 2012. The number of wheelchair users had increased significantly. Furthermore, the patients experienced increasing problems with activities of daily living (ADL) function.

Conclusions: More than half of the patients with prior polio had died between 1995 and 2012. These patients were, on average, older than patients surviving in 2012. When interviewed in 2012 most of the patients felt progressively worse, with poor mobility and increased muscle weakness.

Outcome of Research: More research required

Availability of Paper:

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio

Title: Psoriasis sparing the lower limb with postpoliomyelitis residual paralysis
Author: Wang TS (1), Tsai TF
Affiliation: (1) Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
Journal: British Journal of Dermatology
Citation: Br J Dermatol. 2014 Aug;171(2):429-31. doi: 10.1111/bjd.12854
Publication Year and Month: 2014 08

Abstract: This paper does not have an abstract.

Conclusions:

Outcome of Research: Not applicable

Availability of Paper: Paid subscription required to view or download full text.

Comments (if any):

Link to Paper (if available): Click here for preview


There are currently 34 papers in this category.

Category: Late Effects of Polio

Title: Risk of symptoms related to late effects of poliomyelitis
Author: Rekand T, Albrektsen G, Langeland N, Aarli JA
Affiliation: Department of Neurology, Haukeland Hospital, Bergen, Norway
Journal: Acta Neurologica Scandinavica
Citation: Acta Neurol Scand. 2000 Mar;101(3):153-8
Publication Year and Month: 2000 03

Abstract: OBJECTIVE: To compare the risk of developing symptoms related to late effects of poliomyelitis between polio patients and persons of similar age and sex without history of poliomyelitis.

MATERIAL AND METHODS: The study comprised information on 148 patients with prior poliomyelitis and 115 persons with no history of poliomyelitis. Information was obtained by questionnaire and analyzed by multiple logistic regression method.

RESULTS: The risk of experiencing two or more symptoms was significantly higher among the polio patients than among the persons without history of poliomyelitis. The elevation in risk was less pronounced in the nonparalytic group (OR = 2.35; 95% CI = 0.92-5.97) than the group with permanent muscular weakness (OR = 8.84; 95% CI =4.32-18.09).

Conclusions: Although symptoms defined in the PPS are unspecific and may occur in the general population, the risk for developing such symptoms are higher among the polio victims. The difference in risk among nonparalytic and paralytic patients may depend on the extent of motor neuron damage in the acute stage.

Outcome of Research: Not applicable

Availability of Paper: Paid subscription required to view or download full text.

Comments (if any):

Link to Paper (if available): Click here to view Abstract


Category: Ageing, Late Effects of Polio

Title: A Review of Secondary Health Conditions in Post-Polio Syndrome: Prevalence and Effects of Aging
Author: Thomas E. McNalley, MD, MA, Kathryn M. Yorkston, PhD1, Mark P. Jensen, PhD1, Anjali R. Truitt, MPH1, Katherine G. Schomer, MA1, Carolyn Baylor, PhD1, and Ivan R. Molton, PhD1
Affiliation: Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
Journal: American Journal of Physical Medicine & Rehabilitation
Citation: 94(2): 139–145. doi:10.1097/PHM.0000000000000166
Publication Year and Month: 2015 02

Abstract: Objective—This study seeks to better understand the prevalence and severity of secondary health conditions in individuals with post-polio syndrome (PPS), and the association between these conditions and aging.

Design—A scoping literature review was conducted searching electronic databases for studies published from 1986 – 2011. The scoping review provided information regarding the prevalence and associations of secondary health conditions in PPS with age or other duration-related variables.

Results—The findings indicate that: (1) individuals with PPS experience a number of serious secondary health conditions; (2) the most common conditions or symptoms are fatigue, pain, respiratory and sleep complaints, and increased risk of falls; (3) reports of the associations between the frequency or severity of conditions and age-related factors are variable, perhaps because of methodological inconsistencies between studies; and (4) there is a marked lack of longitudinal research examining the natural course of health conditions in people aging with PPS.

Conclusions—Longitudinal research is needed to understand the course of health conditions and the impact of multiple secondary conditions in people aging with PPS. Efforts are also needed to develop and test the efficacy of interventions to prevent these health secondary conditions or reduce their negative impact.

Keywords
Post-Polio Syndrome; Secondary Conditions; Aging; Scoping Review

Conclusions: The key findings from this scoping review include the following: (1) people with PPS experience a large number of serious secondary health conditions, including fatigue, pain, depression, muscle weakness, pulmonary and sleep disorders, and falls; (2) although comparisons with normative samples are rare, one study suggests that depression has a greater impact on the lives of people with PPS than on the general population; and (3) a number of methodological issues limit our ability to interpret the findings related to the associations between secondary conditions and aging.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio

Title: Three case studies of late diagnoses of polio in Australian adults
Author: C.Formby, D.Currie
Affiliation: St Vincent's Hospital Melbourne, Polio Services Victoria, Fitzroy, Australia
Journal: Annals of Physical and Rehabilitation Medicine
Citation: Volume 61, Supplement, July 2018, Page e272
Publication Year and Month: 2018 07

Abstract: Introduction/Background
Polio Services Victoria (PSV) is a publicly funded organization; anyone with a history of polio residing in Australia may be seen by the service. The majority of patients referred to the service were diagnosed with polio shortly after they were infected with the virus, for most this was in early childhood and ranges from two to eight decades ago. In the past 18 months three patients were referred to PSV with untypically late diagnoses of polio, two of which were sisters. All were born in Australia between 1930 and 1950 and are considered to have acquired their infection in Australia during their early childhood. The three were able to live relatively uneventful lives however their verbal histories indicate suspicion of polio during their childhood medical examinations in school, but ultimately no formal diagnosis was made at that time. In later life, symptoms characteristic of the late effects of polio emerged. In combination with imaging and nerve conduction studies these symptoms were diagnosed as being the result of a likely childhood infection of polio. Their current and future management plans are typical of that seen regularly within the service with the patients reporting their main problems as being:

–pain;

–fatigue;

–increasing muscle atrophy and associated weakness.

These three cases highlight that although Australia, like most of the world, holds polio free status there may still be further undiagnosed cases. Polio should be considered as a differential diagnosis for patients presenting with any of the cardinal signs and symptoms of late effects of polio who have resided in a country during a time prior to polio eradication. Special consideration should be given where a sibling or close relative was diagnosed with polio.

Conclusions:

Outcome of Research: More research required

Availability of Paper:

Comments (if any):

Link to Paper (if available): Click here for preview


Category: Late Effects of Polio

Title: Post-polio syndrome and risk factors in Korean polio survivors: a baseline survey by telephone interview
Author: Bang H (1), Suh JH (2), Lee SY (3), Kim K (1), Yang EJ (1), Jung SH (1), Jang SN (4), Han SJ (2), Kim WH (5), Oh MG (6), Kim JH (5), Lee SG (7), Lim JY (1)
Affiliation: (1) Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Korea; (2) Department of Rehabilitation Medicine, Ewha Womans University Medical Center, Seoul, Korea; (3) Department of Physical Medicine and Rehabilitation, Soonchunhyang University Bucheon Hospital, Bucheon, Korea; (4) Red Cross College of Nursing, Chung-Ang University, Seoul, Korea; (5) Department of Rehabilitation Medicine, National Rehabilitation Center, Seoul, Korea; (6) Department of Rehabilitation Medicine and Institute of Health Science, Gyeongsang National University College of Medicine, Jinju, Korea; (7) Department of Physical Medicine and Rehabilitation, Research Institute of Medical Sciences, Chonnam National University College of Medical School, Gwangju, Korea
Journal: Annals of Rehabilitation Medicine
Citation: Ann Rehabil Med. 2014 Oct;38(5):637-47. doi: 10.5535/arm.2014.38.5.637
Publication Year and Month: 2014 10

Abstract: OBJECTIVE: To obtain information on the socioeconomic, medical, and functional status of polio survivors, and to use these results as the preliminary data for establishing the middle-aged cohort of polio survivors.

METHODS: The subjects were recruited based on the medical records of multiple hospitals and centers. They were assessed through a structured questionnaire over the phone. Post-poliomyelitis syndrome (PPS) was identified according to the specified diagnostic criteria. Differences between polio survivors with or without PPS were evaluated, and the risk factors for PPS were analyzed by the odds ratio (OR).

RESULTS: Majority of polio survivors were middle-aged and mean age was 51.2±8.3 years. A total of 188 out of 313 polio survivors met the adopted criteria for PPS based on the symptoms, yielding a prevalence of 61.6%. Mean interval between acute poliomyelitis and the development of PPS was 38.5±11.6 years. Female gender (OR 1.82; confidence interval [CI] 1.09-3.06), the age at onset of poliomyelitis (OR 1.75; CI 1.05-2.94), the use of orthoses or walking aids (OR 2.46; CI 1.44-4.20), and the history of medical treatment for paralysis, pain or gait disturbance (OR 2.62; CI 1.52-4.51) represented independent risk factors for PPS.

Conclusions: We found that the majority of Korean polio survivors entered middle age with many medical, functional, and social problems. Female gender, early age of onset of poliomyelitis, the use of orthoses or walking aids, and the history of medical treatment for paralysis, pain or gait disturbance were identified as the significant risk factors for PPS. A comprehensive and multidisciplinary plan should be prepared to manage polio survivors considering their need for health care services and the risk factors for late effects, such as PPS.

Outcome of Research: Not applicable

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Cardiorespiratory, Late Effects of Polio, Respiratory Complications and Management

Title: Obesity and Pulmonary Function in Polio Survivors
Author: Soo Jeong Han, MD, PhD (1), Jae-Young Lim, MD, PhD(2), Jee Hyun Suh, MD(1)
Affiliation: 1. Department of Rehabilitation Medicine, Ewha Womans University School of Medicine, Seoul;

2. Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Korea
Journal: Annals of Rehabilitation Medicine
Citation: 2015;39(6):888-896
pISSN: 2234-0645 • eISSN: 2234-0653
http://dx.doi.org/10.5535/arm.2015.39.6.888
Publication Year and Month: 2015 06

Abstract: OBJECTIVE
To examine the correlation between obesity and pulmonary function in polio survivors.

METHODS
This study was conducted based on a questionnaire survey and physical examination. The questionnaire included gender, age, paralyzed regions, physical activity levels, and accompanying diseases. The physical examination included measuring body mass index, waist circumference, muscle power, total fat amount, body fat percentage, and lean body mass. In addition, pulmonary function was tested based on forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), ratio of FEV1 to FVC, and chest circumference. Five university hospitals and a local health clinic participated in this study.

RESULTS
Pearson and partial correlation coefficients that used data collected from 73 polio survivors showed that obesity had a negative correlation with pulmonary function.

CONCLUSION
This study found that pulmonary function has a negative correlation with obesity for polio survivors. Therefore, it is necessary to develop specialized exercise programs to help polio survivors reduce their weight and strengthen their respiratory muscles.

Conclusions: This study found that pulmonary function has a negative correlation with obesity for polio survivors. Therefore, it is necessary to develop specialized exercise programs to help polio survivors reduce their weight and strengthen their respiratory muscles.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any): Keywords: Poliomyelitis, Obesity, Pulmonary function

Link to Paper (if available): Click here to view full text or to download


Category: Assistive Technology, Late Effects of Polio

Title: Coping with a Second Disability: Implications of the Late Effects of Poliomyelitis for Occupational Therapists
Author: Mary Westbrook, Lynette McDowell
Affiliation: Macquarie University, Sydney. Australia
Journal: Australian Occupational Therapy Journal
Citation: 38(2):83 - 91
Publication Year and Month: 2010 08

Abstract: The long term effects of many physical disabilities have only recently begun to be appreciated. For people who have lived for years with what they thought to be stable conditions, the onset of secondary disabilities may be associated with considerable problems and distress. A questionnaire survey of 324 people with poliomyelitis revealed the occurrence of late effects in 94% of respondents. The majority reported increased weakness, pain and fatigue, problems in carrying out daily living activities and difficulties in obtaining appropriate health care. Although occupational therapists were less likely to be consulted than other professionals, they received one of the highest satisfaction ratings from clients.

Conclusions: Discussion of case studies indicates ways in which occupational therapists can provide symptom relief and enable clients to maintain valued roles. As the survival rates of people with disabilities increase there is a need for greater awareness of, and research into, the late effects of disability.

Outcome of Research: More research required

Availability of Paper:

Comments (if any):

Link to Paper (if available): Click here for preview


Category: Late Effects of Polio

Title: Experiences and perspectives of patients with post-polio syndrome and therapists with exercise and cognitive behavioural therapy
Author: Minne Bakker, Karen Schipper, Fieke S. Koopman, Frans Nollet and Tineke A. Abma
Affiliation: Department of Medical Humanities, EMGO+ Institute, VU Medical Center
(VUmc), Amsterdam, The Netherlands
Journal: BioMed Central Neurology
Citation: BMC Neurology (2016) 16:23
Publication Year and Month: 2016

Abstract: Background: Many persons affected with poliomyelitis develop post-polio syndrome (PPS) later in their life.
Recently, the effectiveness of Exercise Therapy (ET) and Cognitive Behavioural Therapy (CBT) for PPS has been evaluated in a randomized controlled trial, but did not show a decrease in fatigue or improvement in secondary endpoints like Quality of Life and self-perceived activity limitations. The aim of this explorative study was to gain insight in the perceived effects and experiences of the interventions from the perspectives of the patients and
therapists.
Methods: Qualitative data were collected through semi-structured interviews with 17 patients and 7 therapists. All participants were involved in the trial. A thematic analysis of the data was performed.
Results: Some patients experienced a short term enhanced endurance and a better use of energy during the day. However, in general patients did not experience a long lasting reduction of fatigue from the CBT or ET. Mainly patients of the CBT, but also some patients of the ET described an increase of self-esteem and self-acceptance. As a result, patients were sometimes better able to perform physical activities during the day. In contrast to the CBT, the
ET was in general perceived by the patients as an intensive therapy, which was difficult to fit into their daily routine. Therapists of both the CBT and the ET struggled with a low intrinsic motivation of the patients in the study.
This made it sometimes difficult for the therapists to follow the protocol.

Conclusions: Conclusion: Confirming the negative quantitative study outcome, the qualitative results did not demonstrate lasting effects on fatigue. Patients did, however, experience some benefits on self-esteem and acceptance of the disease. This study showed that it is of great importance to work with feasible interventions; they should fit the patients’ needs on a practical (fit into their daily routine) and mental (fit their need for support) level.

Outcome of Research: More research required

Availability of Paper:

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio

Title: Psoriasis sparing the lower limb with postpoliomyelitis residual paralysis
Author: Wang TS (1), Tsai TF
Affiliation: (1) Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
Journal: British Journal of Dermatology
Citation: Br J Dermatol. 2014 Aug;171(2):429-31. doi: 10.1111/bjd.12854
Publication Year and Month: 2014 08

Abstract: This paper does not have an abstract.

Conclusions:

Outcome of Research: Not applicable

Availability of Paper: Paid subscription required to view or download full text.

Comments (if any):

Link to Paper (if available): Click here for preview


Category: Late Effects of Polio, Quality of Life

Title: Relationship between participation in life situations and life satisfaction in persons with late effects of polio
Author: Maria Larsson Lund & Jan Lexell
Affiliation: Maria Larsson Lund - Department of Community Medicine and Rehabilitation, Occupational Therapy, Umeå University, Umeå, Sweden Correspondence: [email protected]

Jan Lexell - Department of Rehabilitation Medicine, Lund University Hospital, Lund, Sweden; Division of Rehabilitation Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden; Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
Journal: Disability and Rehabilitation
Citation: 31(19), 1592–1597. https://doi.org/10.1080/09638280802638881
Publication Year and Month: 2009 09

Abstract:
Purpose. To assess the relationship between participation and problems with participation in life situations, and life satisfaction in persons with late effects of polio.

Methods. One hundred fifty-eight persons with late effects of polio responded to a postal questionnaire including the Swedish versions of the Impact on Participation and Autonomy Questionnaire (IPA-S) and Life Satisfaction Questionnaire (LiSat-11).

Results. The persons' perceived participation in the five domains of participation in the IPA-S was significantly correlated with their satisfaction with life as a whole and with most of the 10 domains of life satisfaction. Significant differences in satisfaction with life as a whole and with eight of the 10 domains in LiSat-11 were found between groups of increasing severe problems with participation. Greater number of reports of severe problems with participation corresponded with gradually decreased satisfaction with life as a whole and with satisfaction in the eight domains in LiSat-11.

Keywords: Activities of daily living, disability evaluation, disabled persons, personal autonomy, postpoliomyelitis syndrome, rehabilitation, quality of life

Conclusions: Perceived participation and problems with participation in life situations are determinants of life satisfaction in persons with late effects of polio. This implies that addressing participation and problems with participation in the rehabilitation of persons with late effects of polio may lead to an enhanced life satisfaction.

Outcome of Research: More research required

Availability of Paper: Paid subscription required to view or download full text.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Clinical Evaluation, Diagnosis and Management, Late Effects of Polio

Title: Post-polio Syndrome: More Than Just a Lower Motor Neuron Disease
Author: Stacey Li Hi Shing, Rangariroyashe H. Chipika, Eoin Finegan, Deirdre Murray, Orla Hardiman, and Peter Bede
Affiliation: Computational Neuroimaging Group, Academic Unit of Neurology, Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
Edited by: Francesca Trojsi, University of Campania, Luigi Vanvitelli Caserta, Italy
Reviewed by: Andrea Romigi, Mediterranean Neurological Institute (IRCCS), Italy; Louisa Ng, The University of Melbourne, Australia
*Correspondence: Peter Bede [email protected]
Journal: Frontiers in Neurology
Citation: 10, 773. https://doi.org/10.3389/fneur.2019.00773
Publication Year and Month: 2019 07

Abstract: Post-polio syndrome (PPS) is a neurological condition that affects polio survivors decades after their initial infection. Despite its high prevalence, the etiology of PPS remains elusive, mechanisms of progression are poorly understood, and the condition is notoriously under-researched. While motor dysfunction is a hallmark feature of the condition, generalized fatigue, sleep disturbance, decreased endurance, neuropsychological deficits, sensory symptoms, and chronic pain are also often reported and have considerable quality of life implications in PPS. The non-motor aspects of PPS are particularly challenging to evaluate, quantify, and treat. Generalized fatigue is one of the most distressing symptoms of PPS and is likely to be multifactorial due to weight-gain, respiratory compromise, poor sleep, and polypharmacy. No validated diagnostic, monitoring, or prognostic markers have been developed in PPS to date and the mainstay of therapy centers on symptomatic relief and individualized rehabilitation strategies such as energy conservation and muscle strengthening exercise regimes. Despite a number of large clinical trials in PPS, no effective disease-modifying pharmacological treatments are currently available.

Conclusions: Despite being one of the most devastating neurodegenerative conditions in the world, surprisingly limited research is undertaken in post-polio syndrome. Its pathogenesis remains elusive, no sensitive diagnostic tools have been developed, and validated prognostic and monitoring markers are lacking. Non-motor symptoms of PPS have considerable quality of life implications and are notoriously challenging to manage. The etiology of fatigue in PPS is yet to be elucidated and successful individualized management strategies are needed to maintain mobility, independence, and patient autonomy. There is striking a paucity of neuroimaging studies in PPS that could provide anatomical insights into the substrate of extra-motor symptoms. Ultimately, the characterization of PPS-associated pathology may help research efforts in other motor neuron diseases.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any): This is a good overview of Post-Polio conditions particularly for clinicians new to the topic.

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio

Title: Post-polio Syndrome: More Than Just a Lower Motor Neuron Disease
Author: Stacey Li Hi Shing, Rangariroyashe H. Chipika, Eoin Finegan, Deirdre Murray, Orla Hardiman and Peter Bede*
Affiliation: Computational Neuroimaging Group, Academic Unit of Neurology, Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
Journal: Frontiers in Neurology
Citation: Front. Neurol., 16 July 2019 | https://doi.org/10.3389/fneur.2019.00773
Publication Year and Month: 2019 07

Abstract: Post-polio syndrome (PPS) is a neurological condition that affects polio survivors decades after their initial infection. Despite its high prevalence, the etiology of PPS remains elusive, mechanisms of progression are poorly understood, and the condition is notoriously under-researched. While motor dysfunction is a hallmark feature of the condition, generalized fatigue, sleep disturbance, decreased endurance, neuropsychological deficits, sensory symptoms, and chronic pain are also often reported and have considerable quality of life implications in PPS. The non-motor aspects of PPS are particularly challenging to evaluate, quantify, and treat. Generalized fatigue is one of the most distressing symptoms of PPS and is likely to be multifactorial due to weight-gain, respiratory compromise, poor sleep, and polypharmacy. No validated diagnostic, monitoring, or prognostic markers have been developed in PPS to date and the mainstay of therapy centers on symptomatic relief and individualized rehabilitation strategies such as energy conservation and muscle strengthening exercise regimes. Despite a number of large clinical trials in PPS, no effective disease-modifying pharmacological treatments are currently available.

Keywords: postpolio syndrome, PPS, polio, poliomyelitis, neuroimaging, biomarker, clinical trials, motor neuron disease

Conclusions: Despite being one of the most devastating neurodegenerative conditions in the world, surprisingly limited research is undertaken in post-polio syndrome. Its pathogenesis remains elusive, no sensitive diagnostic tools have been developed, and validated prognostic and monitoring markers are lacking. Non-motor symptoms of PPS have considerable quality of life implications and are notoriously challenging to manage. The etiology of fatigue in PPS is yet to be elucidated and successful individualized management strategies are needed to maintain mobility, independence, and patient autonomy. There is striking a paucity of neuroimaging studies in PPS that could provide anatomical insights into the substrate of extra-motor symptoms. Ultimately, the characterization of PPS-associated pathology may help research efforts in other motor neuron diseases.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Falls, Late Effects of Polio

Title: Polio survivors have poorer walking adaptability than healthy individuals
Author: Jana Tuijtelaars (1), Melvyn Roerdink (2), Bart Gerardus Hendricus Raijmakers (1), Frans Nollet (1), Merel-Anne Brehm (1)
Affiliation: (1) Amsterdam UMC, University of Amsterdam, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, the Netherlands

(2) Department of Human Movement Sciences, Faculty of Behavioural and Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Van der Boechorststraat 7, Amsterdam, the Netherlands
Journal: Gait & Posture
Citation: https://doi.org/10.1016/j.gaitpost.2021.04.031
Publication Year and Month: 2021 04

Abstract: Background:
Falling is a major health problem in polio survivors, often occurring as a result of tripping, slipping or misplaced steps. Therefore, reduced walking adaptability possibly plays an important role.

Research question:
Does walking adaptability, assessed on an interactive treadmill, differ between polio survivors and healthy individuals?

Methods:
In this cross-sectional study, 48 polio survivors with at least one reported fall in the past year and/or fear of falling and 25 healthy individuals of similar age walked at self-selected comfortable fixed speed on an instrumented treadmill. Walking adaptability was measured as i) target-stepping accuracy (determined as variable error [VE] in mm independent of speed) in three conditions; 0%, 20% and 30% variation in step length and width, and ii) anticipatory and reactive obstacle avoidance (ObA and ObR, in percentage successfully avoided). All trials were checked for valid step detection.

Results:
46 polio survivors (mean ± SD age: 63.2 ± 8.7 years) and 25 healthy individuals (64.3 ± 6.6 years, p = 0.585) showed valid step detection. Compared to healthy individuals (mean±SE VE: 30.6±1.2mm), polio survivors stepped less accurately onto targets (36.4±0.9mm, p = 0.001), especially with their least-affected leg. Polio survivors avoided fewer obstacles successfully (mean±SE ObA: 83±3%, ObR: 59±4%) than healthy individuals (100±0.3%, p < 0.001 and 94±3%, p < 0.001, respectively), with a stronger decline in success rates from anticipatory to reactive obstacle avoidance for polio survivors (p < 0.001).

Significance:
Polio survivors reporting falls and/or fear of falling had a demonstrably reduced walking adaptability, especially so for reactive obstacle avoidance which requires step adjustments under high time-pressure demands. Future research should study the merit of walking-adaptability assessment to currently used clinical methods of fall-risk assessment within this population.

Abbreviations:
CoP: Center of Pressure

CWS: Comfortable Walking Speed

ObA: Obstacle Avoidance Anticipatory

ObR: Obstacle Avoidance Reactive

ST0: Stepping Targets, 0% variation in step length and width relative to normal walking

ST20: Stepping Targets, 20% variation in step length and width relative to normal walking

ST30: Stepping Targets, 30% variation in step length and width relative to normal walking

VE: Variable stepping Error

%GDS: Percentage successful goal-directed steps

Keywords:
Poliomyelitis, walking adaptability, falling, fall, risk, C-Mill, muscle, weakness

Conclusions: Polio survivors had a demonstrable limited ability to adapt walking to environmental circumstances compared to community-dwelling healthy individuals of similar age. They had fewer successful goal-directed steps, stepped less consistently on stepping targets and, despite walking slower, had lower obstacle-avoidance success rates, especially under high time-pressure demands. This diminished walking adaptability could place them at higher risk of falling, especially in everyday life, where walking often needs to be adapted to expected and unexpected circumstances. Future research should study the validity and reproducibility of walking-adaptability assessment in polio survivors to determine its added value to the currently used methods of fall-risk assessment in clinical practice.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Diagnosis and Management, Differential Diagnosis, Gender Differences, Late Effects of Polio

Title: Postpolio Syndrome: A Review of Lived Experiences of Patients
Author: Oluwaseyi Jacob Oluwasanmi, Devaunna Andrene Mckenzie, Idowu Oluwasegun Adewole, Christian O Aluka, James Iyasse, Esther Olunu, and Adegbenro Omotuyi Fakoya1
Affiliation: Department of Microbiology, All Saints University School of Medicine, Commonwealth of Dominica, Roseau, Dominica
1Department of Anatomical Sciences, University of Medicine and Health Sciences, Basseterre, St. Kitts and Nevis
Address for correspondence: Dr. Adegbenro Omotuyi Fakoya, University of Medicine and Health Sciences, Basseterre, St. Kitts and Nevis. E-mail: [email protected]
Journal: International Journal of Applied & Basic Medical Research
Citation: 9(3), 129–134. https://doi.org/10.4103/ijabmr.IJABMR_333_18
Publication Year and Month: 2019 07

Abstract: Postpolio syndrome (PPS) refers to a group of conditions that are present in patients, years after recovery from initial acute paralytic poliomyelitis. About 15%–80% of 20 million polio survivors worldwide will experience exacerbation of symptoms which typically appear 15–30 years after the resolution of initial poliomyelitis. Symptoms include new muscle weakness, fatigue, myalgia, joint pain, dysphagia, and difficulty breathing. Other reported symptoms include cold intolerance, sleep disorder, dysphonia, loss of stamina, musculoskeletal deformities, cardiovascular disorders, psychosocial problems, and restless legs syndrome. These symptoms are attributed to the superimposed neuronal loss of aging with inflammatory mechanisms, but without any convincing evidence of viral reactivation. Risk factors include female gender, respiratory symptoms, normal aging, permanent disability caused by motor neuron damage, muscle overuse and disuse, aging, and immunologic mechanisms. Hypothyroidism-induced myopathy and fibromyalgia are a differential diagnosis for PPS, and exclusion diagnosis is required as confirmatory criteria for PPS. The symptoms of PPS presented determine the course of management.

Keywords: Fatigue, muscle weakness, myalgia, poliomyelitis, postpolio syndrome

Conclusions: PPS is a sequela of acute poliomyelitis which occurs decades after resolution of the initial paralytic or nonparalytic polio. Fatigue, muscle weakness, myalgia, and joint pain are the major symptoms of PPS. Diagnosis of PPS is made based on the exclusion of other conditions that can cause similar symptoms. The quality of life of patients with PPS is significantly affected by the reoccurrence of the constellations of symptoms they experience. Proper assessment and treatment should be performed to prevent severe impairment of function in patients.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Diagnosis and Management, Late Effects of Polio

Title: Post-poliomyelitis syndrome (2019)
Author: Eric Chun Pu Chu1 and Kary Ka Wai Lam2
Affiliation: 1New York Chiropractic and Physiotherapy Center, New York Medical Group, Hong Kong, People’s Republic of China
2Downtown Chiropractic Limited, Hong Kong, People’s Republic of China
Correspondence: Eric Chun Pu ChuNew York Chiropractic and Physiotherapy Centre, New York Medical Group, 41/F Langham Place Office Tower, 8 Argyle Street, Mongkok, Hong Kong, People’s Republic of China, Phone: Tel +852 3 594 7844, Fax: Fax +852 3 594 6193, Email [email protected]
Journal: International Medical Case Reports Journal
Citation: 12, 261–264. https://doi.org/10.2147/IMCRJ.S219481

Publication Year and Month: 2019 08

Abstract: Most developed countries eliminated paralytic poliomyelitis (polio) in the 1970s to 1980s. It was believed that after recovery from acute paralytic poliomyelitis, the physical condition of survivors would remain stable for the rest of their lives. However, the elimination of polio does not equate the end of medical management of polio. Hundreds of thousands of polio survivors worldwide are still at risk of developing the late effects of the disease. Here, we report a case of post-polio syndrome who attended our clinic for the presence of new weakness and neuromuscular problems six decades after recovery from paralytic polio. It is essential that health professionals be aware of these conditions and have an understanding of the underlying pathophysiology of the symptoms.

Conclusions: Post-polio syndrome is related to the exhaustion of the motor units that form decades after the polio attack. This case report describes the effectiveness of manual interventions in assisting our patient in restoring the level of function and alleviating pain. The limitation of the current report is that it is just a single case. Further comparison with more existing therapeutic regimens is warranted to clarify these issues.

Outcome of Research: Not applicable

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio, Respiratory Complications and Management

Title: Post-Polio Syndrome Causing Late Onset Respiratory
Failure
Author: Sharon Enghelberg MD, Itamar Y. Love MD and Micha Rapoport MD
Affiliation: Department of Internal Medicine C, Shamir Medical Center, Zerifin, Israel
Journal: Israel Medical Association Journal (IMAJ)
Citation: 2020; 22: 395–396
Publication Year and Month: 2020

Abstract: CASE STUDY:
We present a patient with thoracic cage deformity and chronic progressive hypoventilation due to late onset PPS.

Conclusions: PPS can be a significant cause for respiratory deterioration in patients with
previous history of poliomyelitis. Physicians should be aware of this potential
diagnosis, as early diagnosis can facilitate individualized treatment plan and
prevent unnecessary examinations and mistreatment.

Outcome of Research: Not applicable

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any): KEY WORDS: dyspnea, polio, post-polio syndrome
(PPS), respiratory failure, restrictive
lung disease

Link to Paper (if available): Click here to view full text or to download


Category: Activity Levels, Late Effects of Polio, Muscle Strength, Psychology, Quality of Life

Title: Health-related quality of life, self-reported impairments and activities of daily living in relation to muscle function in post-polio syndrome
Author: Vanya Gocheva,corresponding author1 Patricia Hafner,1 Anna-Lena Orsini,1,2 Simone Schmidt,1,3 Sabine Schaedelin,4 Nicole Rueedi,1 Daniela Rubino-Nacht,1 Peter Weber,1 and Dirk Fischer1
Affiliation: 1Division of Neuropediatrics and Developmental Medicine, University Children’s Hospital of Basel (UKBB),University of Basel, Spitalstrasse 33, Postfach, 4056 Basel, Switzerland
2Division of Neurology, University Hospital Basel, Basel, Switzerland
3Department of Neurology, General Hospital Hietzing with Neurological Center Rosenhügel, Vienna, Austria
4Department of Clinical Research, Clinical Trial Unit, University Hospital Basel, Basel, Switzerland
Vanya Gocheva, Email: [email protected]
corresponding author.
Journal: Journal of Patient-Reported Outcomes
Citation: 4(1), 59. https://doi.org/10.1186/s41687-020-00226-5
Publication Year and Month: 2020 12

Abstract: Background
The symptoms of post-polio syndrome (PPS) and its resulting disabilities can affect quality of life and the ability to perform daily activities. No study has comprehensively analysed how various patient-reported outcome measures (PROMs) are associated with objectively assessed physical function in patients with PPS.

Aim
To investigate health-related quality of life (HRQOL), self-reported impairments and activities of daily living during 6 months and evaluate their association with clinical muscle function outcomes in individuals with PPS.

Methods
Twenty-seven patients with PPS were included in the study. At baseline and 6 months, patients were administered PROMs measuring HRQOL (WHOQOL-BREF), self-reported impairments related to PPS (SIPP-RS) and activities of daily living (IBM-FRS). Clinical muscle function outcomes included 6 min walking distance (6MWD) and motor function measure (MFM).

Results
There were no changes in self-reported impairments (25.52 to 24.93, p = 0.40), activities of daily living (33.89 to 33.30, p = 0.20), 6MWD (391.52 to 401.85, p = 0.30) and MFM (83.87 to 85.46, p = 0.14) during 6 months, while the HRQOL psychological health decreased during this period (76.85 to 72.38, p = 0.05). A strong association was found between activities of daily living and clinical muscle function outcomes (6MWD: ß = 0.02, 95% CI: 0.02;0.03, t = 6.88, p < 0.01; MFM: ß = 0.25, 95% CI: 0.17;0.33, t = 6.69, p < 0.01). Self-reported impairments and HRQOL domains were not associated with the clinical muscle outcomes.

Conclusions
Study findings indicate that objectively measured walking and motor abilities do not reflect patient’s perspectives of their HRQOL and impairment due to PPS. More research is needed to assess changes over time and capture clinically meaningful changes in individuals with PPS and to increase the understanding of how the patient’s perspective of disability measured by PROMs is related to objectively measured walking and motor abilities.

Conclusions: Self-reported impairments, HRQOL domains, activities of daily living and muscle function outcomes remained stable during 6 months in patients with PPS, except for the HRQOL psychological health domain which declined during this period. Clinical muscle outcomes had no statistically significant relationship with HRQOL and self-reported impairments of PPS patients while a significant relationship was observed with the activities of daily living. More research is needed to assess changes over time and capture clinically meaningful changes in individuals with PPS and to increase the understanding of how the patient’s perspective of disability measured by PROMs is related to objectively measured walking and motor abilities.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio

Title: Long-term follow-up of patients with prior polio over a 17-year period.
Author: Vreede KS, Broman L, Borg K.
Affiliation: Department of Rehabilitation Medicine, Danderyd University Hospital, Building 39, Floor 3, SE-182 88 Stockholm, Sweden, [email protected]
Journal: Journal of Rehabilitation Medicine
Citation: 2016 Apr;48(4):359-64
Publication Year and Month: 2016 04

Abstract: OBJECTIVE:
Follow-up of the health of patients with prior polio over a 17-year period.

DESIGN:
Follow-up study.

PATIENTS:
Patients with prior polio.

METHODS:
The study questionnaire was answered in 1995 by 270 patients. In 2012 the questionnaire was sent again to the surviving patients.

RESULTS:
Of the patients who answered the questionnaire in 1995, 116 (40%) were still alive in 2012. The group of patients who had died was older, and had a mean age of 70 years in 1995. A total of 60 patients participated in the study by answering the questionnaire in both 1995 and 2012. Most of these patients (84%) reported that they felt progressively worse, with poor mobility and increased muscle weakness in 2012 compared with 1995, and more than half reported a lower quality of life in 2012. The number of wheelchair users had increased significantly. Furthermore, the patients experienced increasing problems with activities of daily living (ADL) function.

Conclusions: More than half of the patients with prior polio had died between 1995 and 2012. These patients were, on average, older than patients surviving in 2012. When interviewed in 2012 most of the patients felt progressively worse, with poor mobility and increased muscle weakness.

Outcome of Research: More research required

Availability of Paper:

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Cardiovascular, Exercise, Late Effects of Polio, Muscle Strength

Title: Effects of muscle strengthening and cardiovascular fitness activities for poliomyelitis survivors: A systematic review and meta-anaylsis.
Author: Akhilesh Kumar RAMACHANDRAN, MSc, BEng (1), Stephen P. J. GOODMAN, PhD, Hon BEXSc (2), Michael J. JACKSON, MPT, BEd, BACH (1) and Timothy J. H. LATHLEAN, PhD, MClinRehab, Hon BSc, BBehSc (2,3)
Affiliation: 1) Polio Australia Incorporated

2) Discipline of Exercise and Sports Science, School of Science and Technology, University of New England

3) Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide.
Journal: Journal of Rehabilitation Medicine (JRM) - formerly Scandanavian Journal of Rehabilitation Medicine
Citation: J Rehabil Med 2021; 53: jrm00184, doi: 10.2340/16501977-2832
Publication Year and Month: 2021 04

Abstract: Objective:
To evaluate and assess the effectiveness of muscle strengthening and cardiovascular interventions in improving outcomes in poliomyelitis (polio) survivors.

Data sources:
A systematic literature search was conducted in Medline, PubMed, CINAHL, PsychINFO, Web of Science, and Google Scholar for experimental and observational studies.

Study selection and extraction:
Screening, data-extraction, risk of bias and quality assessment were carried out independently by the authors. The quality appraisal and risk of bias were assessed using the Downs and Black Checklist. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was followed to increase clarity of reporting.

Data synthesis:
A total of 21 studies that met all the inclusion criteria were subjected to statistical analyses according to intervention (muscle strengthening or cardiovascular fitness). A random-effects metaanalysis showed a statistically significant effect for the exercise interventions favouring improvement in outcomes according to the International Classification of Functioning, Disability and Health (ICF).

Conclusion:
This review provides further insight into the effects associated with muscle strengthening and cardiovascular interventions among polio survivors, and helps to further identify the current state of research in this area. Future research is needed, focusing on individualized approaches to exercise with polio survivors and specific exercise prescription recommendations, based on established frameworks, such as the ICF.

Conclusions: The findings of this review and analysis provide “very low level evidence” (according to the Grading of Recommendations Assessment, Development and Evaluate; GRADE) to polio survivors, clinicians and researchers. The main findings of this review relate specifically to changes in body function, and activity and participation, and include evidence of effect on improved functioning without furthering debility in polio survivors. This systematic review and meta-analysis provides additional insights into effects associated with exercise, across various types of interventions, in polio survivors, and advances the level of methodological quality of research in this area. Although there was evidence demonstrating effect across domains, due to inherent biases within the literature to date, further and high-quality primary exercise-focused research is required in order to strengthen the certainty of evidence regarding important research questions about the ongoing health of polio survivors.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any): Polio Australia staff co-authored this article.

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio

Title: Prevalence and risk factors of post-polio syndrome in a cohort of polio survivors.
Author: Paolo Ragonese, Brigida Fierro, Giuseppe Salemi, Giovanna Randisi, Daniela Buffa, Marco D'Amelio, Antonella Aloisio, Giovanni Savettieri
Affiliation: Dipartimento di Neurologia, Oftalmologia, Otorinolaringoiatria e Psichiatria, Università di Palermo, Italy.
Journal: Journal of the Neurological Sciences
Citation: 2005 Sep 15;236(1-2):31-5.
Publication Year and Month: 2005 09

Abstract: OBJECTIVE:
To investigate frequency and associated factors of post polio syndrome (PPS) in an Italian cohort of people with prior poliomyelitis.

METHODS:
We screened subjects admitted for poliomyelitis at the paediatric hospital of the University of Palermo during the time frame 1945-1960. Patients who developed PPS were identified through a structured questionnaire and a neurologic examination. PPS diagnosis was made according to specified diagnostic criteria. Frequency of PPS was calculated in the selected cohort of polio survivors. The association with the investigated risk factors (sex, age at onset of polio, extension and severity of polio, education, associated diseases, cigarette smoking, trauma, polio vaccination) was analysed by the calculation of the odds ratio.

RESULTS:
Forty-eight participants met the adopted diagnostic criteria for PPS, giving a prevalence of 31.0%. The prevalence rate was significantly higher in women than in men (p=0.02). Logistic regression analyses revealed a significant inverse association with onset of poliomyelitis at over 12 months of age (OR 0.33; CI 0.14-0.79) a higher degree of education (OR 0.20; CI 0.07-0.79), and a significant association with the presence of other diseases (OR 9.86; CI 3.69-26.34).

Conclusions: CONCLUSIONS:
In our survey one-third of patients with prior poliomyelitis had PPS. Higher age at onset of poliomyelitis is inversely associated with PPS. The association with other diseases may indicate that a chronic physical stress, particularly in already weak motor units, can contribute to the development of signs and symptoms of PPS. Our results also suggest the impact of socio-economic conditions on the risk of PPS.

Outcome of Research: More research required

Availability of Paper:

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio, Psychology, Quality of Life

Title: The value of a post-polio syndrome self-management programme
Author: Alexandra Curtis,corresponding author1,# Jeong Su Lee,1,# Georgios Kaltsakas,1,2 Vivian Auyeung,2 Simon Shaw,1 Nicholas Hart,1,2 and Joerg Steier1,2
Affiliation: 1Guy’s and St Thomas’ NHS Foundation Trust, London, UK;
2Faculty of Life Sciences and Medicine, King’s College, London, UK
corresponding authorCorresponding author.
Contributions: (I) Conception and design: A Curtis, JS Lee, N Hart, J Steier, V Auyeung; (II) Administrative support: A Curtis, JS Lee, N Hart, J Steier; (III) Provision of study materials or patients: A Curtis, JS Lee, J Steier, S Shaw, V Auyeung; (IV) Collection and assembly of data: A Curtis, JS Lee; (V) Data analysis and interpretation: A Curtis, JS Lee, J Steier, V Auyeung, G Kaltsakas; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors.
#These authors contributed equally to this work.
Correspondence to: Ms. Alexandra Curtis, MRes, BSc. Guy’s and St Thomas’ NHS Foundation Trust, Lane Fox Unit, Westminster Bridge Road, London SE1 7EH, UK. Email: [email protected]
Journal: Journal of Thoracic Disease
Citation: 12(Suppl 2), S153–S162. https://doi.org/10.21037/jtd-cus-2020-009
Publication Year and Month: 2020 10

Abstract: Background
Post-polio syndrome is characterised by symptoms of fatigue, pain and new-onset neuromuscular weakness, and emerges decades after the initial poliovirus infection. We sought to evaluate the only post-polio syndrome specific self-management programme in the United Kingdom.

Methods
This was a retrospective study of patients who had completed a residential self-management programme led by a multi-disciplinary clinical team. Following a confirmed diagnosis of post-polio syndrome by rehabilitation and neurology specialists, patients were offered to participate in the programme. Although group-based, patients also received individually tailored support on physical exercise and fatigue management. Physical effects, physical function, psychosocial well-being measures were assessed at baseline and 6 months follow-up. Knowledge was tested at baseline and immediately following the programme. Statistical comparisons were made using paired t-test and Wilcoxon signed rank test according to the data distribution.

Results
Over a period of 17 years, 214 participants (median age 61.3 years old, 63% female) attended 31 programmes. At 6 months the following post-polio syndrome specific symptoms improved significantly: fatigue, as measured by the Multidimensional Assessment of Fatigue scale [37.6 (7.1) vs. 34.2 (9.3), P=0.005]; and pain [15.0 (6.1) vs. 13.1 (6.7), P=0.001], atrophy [10.0 (8.0–12.0) vs. 9.0 (7.0–11.0), P=0.002] and bulbar symptoms [3.0 (1.0–5.0) vs. 2.0 (0–4.0), P=0.003] as measured by the Index of Post-polio Sequelae scale. Knowledge related to post-polio syndrome also significantly increased [14.0 (11.0–16.0) vs. 17.0 (16.0–19.0), P=0.001]. Participants were able to walk at a faster speed over 10 meters [0.77 (0.59–1.00) vs. 0.83 (0.67–1.10) m/s, P=0.003] and walked longer distances during the 2-minute walk test [76.9 (31.7) vs. 82.0 (38.4) m, P=0.029]. Depression and anxiety scores did not change over time [PHQ-9, 2.0 (0.3–10.8) vs. 2.0 (0.3–6.8), P=0.450; GAD-7, 2.0 (0–7.0) vs. 1.0 (0–3.0), P=0.460] nor was there change in self-reported quality of life {60 [50–70] vs. 60 [55–70], P=0.200}.

Conclusions
This study suggests that a post-polio syndrome self-management programme led to improvement in symptoms, knowledge and walking speed, but not quality of life. Anxiety and depression scores remained low.

Keywords: Rehabilitation, post-polio syndrome (PPS), fatigue, quality of life (QoL)

Conclusions: A self-management programme for PPS can improve fatigue, the severity to which pain, atrophy and bulbar function issues are experienced and the overall knowledge of PPS, as well as physical function over a 6-month period. Despite some limitations the study results are important to a wider audience given the difficulties in collecting systematic data in this cohort and the relatively sparse evidence for the current approach to PPS management. Experiences from PPS management might prove valuable at a time when a new viral pandemic requires us to design future rehabilitation and self-management programmes for many more survivors of a devastating viral condition.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Epidemiology, Late Effects of Polio

Title: Epidemic poliomyelitis, post-poliomyelitis sequelae and the eradication program
Author: Margaret Peel
Affiliation: University of Melbourne - Department of Microbiology and Immunology Melbourne, Australia
Position: Principal Microbiologist
Description: Retired
Journal: Microbiology Australia
Citation: 41(4):196 DOI: 10.1071/MA20053
Publication Year and Month: 2020 11

Abstract: Epidemics of paralytic poliomyelitis (polio) first emerged in the late 19th and early 20th centuries in the United States and the Scandinavian countries. They continued through the first half of the 20th century becoming global. A major epidemic occurred in Australia in 1951 but significant outbreaks were reported from the late 1930s to 1954. The poliovirus is an enterovirus that is usually transmitted by the faecal–oral route but only one in about 150 infections results in paralysis when the central nervous system is invaded. The Salk inactivated polio vaccine (IPV) became available in Australia in 1956 and the Sabin live attenuated oral polio vaccine (OPV) was introduced in 1966. After decades of stability, many survivors of the earlier epidemics experience late-onset sequelae including post-polio syndrome. The World Health Organization launched the global polio eradication initiative (GPEI) in 1988 based on the easily administered OPV. The GPEI has resulted in a dramatic decrease in cases of wild polio so that only Pakistan and Afghanistan report such cases in 2020. However, a major challenge to eradication is the reversion of OPV to neurovirulent mutants resulting in circulating vaccine-derived poliovirus (cVDPV). A novel, genetically stabilised OPV has been developed recently to stop the emergence and spread of cVDPV and OPV is being replaced by IPV in immunisation programs worldwide. Eradication of poliomyelitis is near to achievement and the expectation is that poliomyelitis will join smallpox as dreaded epidemic diseases of the past that will be consigned to history.

Conclusions: Eradication of poliomyelitis is near to achievement and the expectation is that poliomyelitis will join smallpox as dreaded epidemic diseases of the past that will be consigned to history.

Outcome of Research: Effective

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio, Quality of Life

Title: Quality of life assessment scales in polio survivors: a scoping review
Author: Surajo Kamilu Sulaiman (1), Heather Michelle Aldersey (1), Nora Fayed (1), Bashir Kaka (2) & Christiana Okyere (1)
Affiliation: (1) School of Rehabilitation Therapy, Queen’s University, Louise D. Acton Building, 31 George Street, Kingston, ON, K7L 3N6, Canada

(2) Department of Physiotherapy, Faculty of Allied Health Sciences, College of Health Sciences, Bayero University, PMB 3011, Kano, Nigeria
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Quality of Life Research volume 28, pages 2341–2357 (2019)
https://doi.org/10.1007/s11136-019-02185-x
Publication Year and Month: 2019 04

Abstract: Background
Quality of life evaluation is essential to explore the effect of paralytic polio on the daily life experience of the polio survivor. Researchers have employed a range of assessment instruments to evaluate quality of life among polio survivors. Hence, to select the appropriate scale, it is crucial to compare the contents and psychometric properties of these instruments.

Purpose
This scoping review explores quality of life instruments that are used in polio literature and analyzes their contents and psychometric properties using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) criteria.

Method
Using the Arksey and O’Malley framework, we conducted a literature search in the following electronic databases Medline, CINAHL, Web of Science, Embase, and Google Scholar to identify relevant studies that focused on quality of life of polio survivors. Of the 88 articles that qualify for full-text screening, 34 studies met our inclusion criteria. Two independent reviewers extracted data from the selected studies via Covidence, a reference manager that allows for blinding of reviews.

Results
Most of the instruments included in this review are generic, self-reported, and multidimensional. Despite having mostly adequate psychometric properties, these properties were not evaluated in polio survivors.

Conclusion
The information provided in this review could be used to guide instrument selection and identify the need to develop a new tool or to adapt a pre-existing scale for measuring quality of life among polio survivors.

Conclusions: The information provided in this review could be used to guide instrument selection and identify the need to develop a new tool or to adapt a pre-existing scale for measuring quality of life among polio survivors.

Outcome of Research: More research required

Availability of Paper: Paid subscription required to view or download full text.

Comments (if any):

Link to Paper (if available): Click here to view Abstract


Category: Late Effects of Polio, Surgery

Title: Total hip arthroplasty in patients affected by poliomyelitis
Author: C. M. DeDeugd, K. I. Perry, W. H. Trousdale, M. J. Taunton, D. G. Lewallen, M. P. Abdel
Affiliation: Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: The Bone & Joint Journal

Bone Joint J 2018;100-B:733–9
Doi: https://doi.org/10.1302/0301-620X.100B6.BJJ-2018-0127.R1
Publication Year and Month: 2018 06

Abstract: Aims
The aims of this study were to determine the clinical and radiographic outcomes, implant survivorship, and complications of patients with a history of poliomyelitis undergoing total hip arthroplasty (THA) in affected limbs and unaffected limbs of this same population.

Patients and Methods
A retrospective review identified 51 patients (27 male and 24 female, 59 hips) with a mean age of 66 years (38 to 88) and with the history of poliomyelitis who underwent THA for degenerative arthritis between 1970 and 2012. Immigrant status, clinical outcomes, radiographic results, implant survival, and complications were recorded.

Results
In all, 32 THAs (63%) were performed on an affected limb, while 27 (37%) were performed on an unaffected limb. The overall ten-year survivorship free from aseptic loosening, any revision, or any reoperation were 91% (95% CI 0.76 to 0.99), 91% (95% CI 0.64 to 0.97) and 87% (95% CI 0.61 to 0.95), respectively. There were no revisions for prosthetic joint infection. There were no significant differences in any of the above parameters if THA was on the affected or unaffected control limbs.

Conclusion
Patients with a history of poliomyelitis who undergo THA on the affected or unaffected limbs have similar results with overall survivorship and complication rates to those reported results in patients undergoing THA for osteoarthritis. At long-term follow-up, previous clinical concerns about increased hip instability due to post-polio abductor weakness were not observed.

Conclusions: Patients with a history of poliomyelitis who undergo THA on the affected or unaffected limbs have similar results with overall survivorship and complication rates to those reported results in patients undergoing THA for osteoarthritis. At long-term follow-up, previous clinical concerns about increased hip instability due to post-polio abductor weakness were not observed.

Outcome of Research: Not applicable

Availability of Paper: Paid subscription required to view or download full text.

Comments (if any):

Link to Paper (if available): Click here to view Abstract


Category: Dysphagia, Dysphonia, Late Effects of Polio

Title: Pharyngolaryngeal manifestations of post-polio syndrome (Manifestações faringo-laríngeas da síndrome pós-poliomielite)
Author: Noemi Grigoletto De Biase (1), Bruno Teixeira de Moraes (2), Mariana Dantas Aumond Leb (3), Gustavo Polacow Korn (4), Marina Padovani (5), Miriam Moraes (6), Glaucya Madazio (7).
Affiliation: Departament of Laryngology and Voice of the Discipline of Otorhinolaryngology of Federal University of São Paulo - Medical School Paulista (UNIFESP-EPM). São Paulo / SP - Brazil

1) Prof. Doc. Associate of Departament of Fundamentals of Phonoaudiology of Pontifical Catholic University of São Paulo. Advisor of Masters Degree of UNIFESP-EPM.

2) Fellow in Larynx and Voice by the Departament of Otorhinolaryngology and Surgery of Head and Kneck by Federal University of São Paulo - Medical School Paulista (UNIFESP-EPM). Doctor Otorhinolaryngologist.

3) Master in Medicine by UNIFESP-EPM. Doctor Otorhinolaryngologist.

4) PhD in Science by the Departament of Otorhinolaryngology and Surgery of Head and Kneck by Federal University of São Paulo - Medical School Paulista (UNIFESPEPM). Doctor Otorhinolaryngologist.

5) PhD in Science of Human Communication by UNIFESP. Clinical Audiologist.

6) Master in Science of Human Communication by UNIFESP - Clinical Audiologist.

7) PhD in Science of Human Communication by UNIFESP. Clinical Audiologist.
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Intl. Arch. Otorhinolaryngol., São Paulo - Brasil, v.15, n.4, p. 529-533, Oct/Nov/December - 2011.
Publication Year and Month: 2010 04

Abstract: INTRODUCTION: The post-polio syndrome (PPS) is characterized by a new episod of atrophy or muscle weakness in individuals previously affected by poliomyelitis. The symptoms start from an extended period of clinical stability ranging from 20 to 40 years, after the initial chart of polio. Among the pathophysiological mechanisms, the most likely is that the syndrome represents a process of attrition and neuronal metabolic exhaustion due to a continuous process of denervation reinnervation which begins after the initial acute.

OBJECTIVE: Review the clinical characteristics and pathophysiological of PPS,as well as present the approach in cases with pharyngolaryngeal manifestations.

CASE REPORT: We present the clinical case of a male patient with 48 years old, with main complaints of dysphonia, dysphagia and previous history of polio. The patient underwent a diagnostic investigation, in which the voice psychoacoustic findings are described. Laringoscopic, electromyographic and the videoendoscopy of swallowing compatible with PPS. The treatment consisted in phonotherapy in a total of 11 weekly sessions and guidelines for swallowing, with satisfactory improvement of the symptoms.

FINAL COMMENTS: The pharyngolaryngeal manifestations of PPS are susceptible to treatment, obtaining satisfactory results, with improvement of life quality of the patients.

KEYWORDS: poliomyelitis, post-polio syndrome, neuromuscular diseases, larynx diseases, voice disorders.

Conclusions: The diagnosis of PPS depends of the high rate of suspicion and a good anamnesis, in which the patient reports previous history of poliomyelitis. As in the most of the cases these patients present other commemorative resulting of the syndrome, voice alterations become less evident before the whole picture. Active searches in services of references in treatment of PPS can show that the frequency of dysphonia and dysphagia maybe is bigger than the ones described in the literature. Considering that the laryngeal-pharyngeal manifestations of PPS are suitable for treatment with improvement of life quality of the patients, is evident the importance of the diagnosis.

Outcome of Research: Not applicable

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Falls, Late Effects of Polio

Title: Fall-Related Activity Avoidance among Persons with Late Effects of Polio and Its Influence on Daily Life: A Mixed-Methods Study
Author: Christina Brogårdh (1,2), Jan Lexell (1,2) and Catharina Sjödahl Hammarlund (1,3)

Affiliation: 1) Department of Health Sciences, Lund University, 221 00 Lund, Sweden

2) Department of Neurology, Rehabilitation Medicine, Memory Disorders and Geriatrics, Skåne University Hospital, 222 41 Lund, Sweden

3) The PRO-CARE Group, School of Health and Society, Kristianstad University, 291 39 Kristianstad, Sweden

Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Int. J. Environ. Res. Public Health 2021, 18(13), 7202; https://doi.org/10.3390/ijerph18137202
Publication Year and Month: 2021 07

Abstract: Falls are common among persons with late effects of polio (LEoP), which may lead to fear of falling and activity avoidance in everyday life. Here, we assessed the occurrence of fall-related activity avoidance among persons with LEoP and explored how these experiences influenced daily life. Fourteen ambulatory persons (seven women; mean age 70 years) with LEoP participated. They responded to the modified Survey of Activities and Fear of Falling in the Elderly (mSAFFE) and participated in individual interviews, which were analysed by systematic text condensation. Each quotation was deductively analysed from its representation with regard to mSAFFE. We found that many persons often avoided activities related to standing and walking, for example, taking a bath, performing household chores, walking outdoors, attending social events if there were stairs in the building and travelling by public transport, due to fear of falling, increased pain and fatigability. To facilitate the performance of daily activities participants expressed that strategic thinking and aids were important to use. In conclusion, fall-related activity avoidance is common in persons with LEoP, which negatively influence daily life and social participation. To increase daily functioning in this population, fall-related activity avoidance should be included in a multifaceted fall management program.

Keywords: activities of daily living; fear of falling; postpoliomyelitis syndrome; qualitative research

Conclusions: Fall-related activity avoidance is common in persons with LEoP, which negatively influence daily life and social participation. To increase daily functioning in this population, fall-related activity avoidance should be included in a multifaceted fall management program.

Outcome of Research: Effective

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio

Title: People living with post-polio syndrome must not be forgotten
Author: Hill T
Affiliation: British Polio Fellowship
Journal: Nursing Standard
Citation: Nurs Stand. 2015 Nov 4;30(10):30-1. doi: 10.7748/ns.30.10.30.s38
Publication Year and Month: 2015 11

Abstract: As research conducted by YouGov reveals, only 7% of people in Britain are aware of the neurological condition post-polio syndrome (PPS). The British Polio Fellowship is keen to highlight what is now an urgent need for more support for those living with PPS, from both the public and the nursing and medical community.

Conclusions:

Outcome of Research: Not applicable

Availability of Paper: Paid subscription required to view or download full text.

Comments (if any):

Link to Paper (if available): Click here to view Abstract


Category: Late Effects of Polio

Title: New problems in old polio patients: results of a survey of 539 polio survivors
Author: Halstead LS, Rossi CD
Affiliation: Not stated
Journal: Orthopedics
Citation: Orthopedics. 1985 Jul; 8(7):845-50
Publication Year and Month: 1985 07

Abstract: Presented are the results of a questionnaire survey on new health problems in 539 polio survivors. The most common new problems were fatigue, weakness in previously affected and unaffected muscles, muscle pain, and joint pain. The median time from polio to the onset of these problems ranged from 30 to 40 years. Factors at onset of polio most strongly associated with developing these new health problems were: being hospitalized, being over 10 years old, being on a ventilator, and having paralytic involvement of all four limbs. The differential diagnoses of these new problems, implications for treatment and areas for future research are discussed.

Conclusions:

Outcome of Research:

Availability of Paper:

Comments (if any):

Link to Paper (if available):


Category: Late Effects of Polio

Title: Polio: long-term problems
Author: Perry J, Fleming C
Affiliation: Not stated
Journal: Orthopedics
Citation: Orthopedics. 1985 Jul; 8(7):877-81
Publication Year and Month: 1985 07

Abstract: The most common long-term problems seen in polio are brace problems, knee recurvatum, increasing weakness due to overuse and ankle equinus. A definite increased incidence of problems is seen after the patient is more than 30 years post-polio. The basis for most of these problems is chronic mechanical strain of weak musculature and substituting ligaments. Overuse can cause increasing weakness resulting in pain and decreasing function. It is therefore important to follow polio patients closely, especially those that are more than 30 years post-polio. If signs of overuse or chronic mechanical strain are noted, treatment should not be delayed.

Conclusions:

Outcome of Research:

Availability of Paper:

Comments (if any):

Link to Paper (if available):


Category: Pain, Late Effects of Polio

Title: Effectiveness of Intravenous Immunoglobulin for Management of Pain in Patients with Postpolio Syndrome
Author: Min Cheol Chang (1), Jin-Sung Park (2), Jong-moon Hwang (3), and Donghwi Park (4)
Affiliation: (1) Department of Rehabilitation Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea

(2) Department of Neurology, School of Medicine, Kyungpook National University,
Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea

(3) Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea

(4) Department of Physical Medicine and Rehabilitation, Ulsan University Hospital, University of Ulsan College of Medicine,
Ulsan, Republic of Korea
Journal: Pain Research and Management
Citation: Volume 2021, Article ID 6637705, 4 pages
https://doi.org/10.1155/2021/6637705
Publication Year and Month: 2021 03

Abstract: Objective.
Many patients with postpolio syndrome (PPS) experience pain. In this study, we aimed to review previous studies to investigate the effectiveness of intravenous immunoglobulin (IVIG) for managing pain in patients with PPS. We performed a narrative review.

Methods.
In PubMed, we searched for the keywords ((Immunoglobulin OR IVIG) AND (poliomyelitis OR poliomyelitis syndrome)). We included articles in which IVIG was infused in patients with PPS and pain severity was measured before and after treatment.

Results.
In the results, five articles (4 randomized controlled trials and 1 prospective observational study) were included in this review. Four of the studies reported that IVIG had a positive pain-reducing effect in patients with PPS. In addition, 4 studies evaluated the outcomes related to muscle strength and function. Of these studies, 3 showed some improvement in measurements for muscle strength and function.

Conclusion.
In conclusion, IVIG might be one of the beneficial options for managing pain in PPS. Pain reduction might be responsible for the improvement of muscle strength or function. To confirm the benefits of IVIG in reducing pain, more high-quality studies are required.

Conclusions: In conclusion, this review shows that IVIG administration might be useful for managing pain in patients with PPS. In the 5 articles reviewed, no major adverse effects were reported. Owing to the small number of studies and inconsistent results between the studies, we cannot make a definite conclusion on the effect of IVIG on pain in PPS. However, we think that the previous studies showed a possibility that IVIG can safely manage pain in patients with PPS. To confirm the benefits of IVIG in reducing pain in patients with PPS, more high-quality studies are required. Moreover, the protocols for IVIG infusion used in each study were heterogeneous; therefore, the most effective protocol for IVIG infusion for controlling pain should be evaluated in the future.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Cultural Context, Disability Rights, Late Effects of Polio, Quality of Life, Vocational Implications

Title: “The car is my extra legs” – Experiences of outdoor mobility amongst immigrants in Sweden with late effects of polio
Author: Helena Selander, Conceptualization, Data curation, Formal analysis, Methodology, Project administration, Supervision, Validation, Visualization, Writing – original draft, Writing – review & editing,1,2,* Iolanda Santos Tavares Silva, Formal analysis, Methodology, Supervision, Validation, Writing – original draft, Writing – review & editing,1,3 Felicia Kjellgren, Conceptualization, Investigation, Methodology, Writing – review & editing,1 and Katharina S. Sunnerhagen, Conceptualization, Data curation, Funding acquisition, Investigation, Methodology, Project administration, Resources, Supervision, Validation, Writing – review & editing1
Wen-Jun Tu, Editor
Affiliation: 1 Rehabilitation Medicine, Department of Clinical Neuroscience, Sahlgrenska Academy, University of Gothenburg, Sweden
2 The Swedish National Road and Transport Research Institute (VTI), Gothenburg, Sweden
3 Department of Occupational Therapy and Physiotherapy, The Sahlgrenska University Hospital, Gothenburg, Sweden
Chinese Academy of Medical Sciences and Peking Union Medical College, CHINA
Competing Interests: The authors have declared that no competing interests exist.
* E-mail: [email protected]
Journal: PLoS One
Citation: 14(10), e0224685. https://doi.org/10.1371/journal.pone.0224685
Publication Year and Month: 2019 10

Abstract: Background
The aim of the study was to describe the experience of outdoor mobility among immigrants with late effects of polio living in Sweden. There is a need to understand more about this young group of persons since they often have problems with mobility and gait, but they may also face participation restrictions due to issues associated with integration into a new community and culture.

Method
A total of 14 young immigrants with late effects of polio participated and were interviewed individually. The study used a qualitative method to explore personal experiences and the interviews were analyzed through an inductive approach, using qualitative content analysis.

Results
The analysis led to a major theme; self-image and acceptance, that comprised a changeable process and experiences of cultural, social, and gender-specific barriers, but also of environmental and personal factors that impacted their outdoor mobility. By using a car, the participants felt they could come across as normal which also increased their self-esteem.

Conclusions
Independent mobility is a major enabler for ongoing employment and being able to use a car increases the chances for integration into society for young immigrants with late effects of polio. Public transport is not considered to be adequate or efficient enough due to the participants’ mobility impairments, but driving can prevent involuntary isolation and facilitate participation. A car can increase quality of life but may also be a facilitator for work and reduce the demand for societal support.

Conclusions: More work is needed on young immigrants with late effects of polio to identify their mobility needs and find solutions that could minimize barriers and help them to be more independent outdoors. This group in Sweden has often been overlooked in clinical settings and in society generally. It is important to consider the need of care and support for persons with late effects polio as the need for care has been questioned and decision makers (such as health commissioners) believe persons with late effects of polio no longer exist in Sweden. Moreover, they are not prioritized despite needing rehabilitation interventions that could increase their outdoor mobility. Independent mobility is a major enabler for ongoing employment and the ability to access a car can increase their chances for social integration. According to participants in this study, public transport is not adequate or efficient enough for their needs. For young immigrants with late effects of polio, driving can prevent involuntary isolation and facilitate participation. A car may increase quality of life and reduce the demand for societal support.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio, Quality of Life

Title: Life Satisfaction in Persons With Late Effects of Polio: A Test‐Retest Reliability Study
Author: Elisabeth Ekstrand RPT, PhD; Jan Lexell MD, PhD, DPhil h.c.; Christina Brogårdh RPT, PhD
Affiliation: E.E. - Department of Health Sciences, Lund University, Lund, Sweden; andDepartmentof Hand Surgery, Skåne University Hospital, Malmö, Sweden. Address correspondenceto: E.E., Department of Health Sciences,Physiotherapy Research Group, Lund Univer-sity, Box 157, SE-221 00 Lund, Sweden; e-mail: [email protected]
Disclosure: nothing to disclose.

J.L. and C.B. - Department of Health Sciences, Lund University, Lund, Sweden; andDepartment of Neurology, Rehabilitation Medicine, Memory Disorders and Geriatrics,Skåne University Hospital, Lund, Sweden
Disclosure: nothing to disclose.
Journal: PM&R: The Journal of Injury, Function, and Rehabilitation
Citation: Volume 12, Issue 10 p.997-1002
https://doi.org/10.1002/pmrj.12325
Publication Year and Month: 2020 01

Abstract:
Background
The Life Satisfaction Questionnaire (LiSat‐11), including one global item and 10 domain‐specific items, is used to evaluate life satisfaction in persons with the late effects of polio (LEoPs). However, there is a lack of knowledge about its psychometric properties.

Objective
To evaluate the test‐retest reliability of the LiSat‐11 and the associations between the global and domain‐specific items in persons with LEoPs.

Design
A test‐retest design, where data were collected by a postal survey.

Setting
University Hospital, Outpatient Clinic.

Participants
A cross‐sectional sample of persons (20 women and 31 men; mean age 72 years) with LEoPs.

Main Outcome Measurements
LiSat‐11, assessing how satisfied a person is with different aspects of life, such as life as a whole, vocation, economy, leisure, contacts with friends and acquaintances, sexual life, activities of daily living (ADLs), family life, partner relationship, somatic health, and psychological health.

Methods
LiSat‐11 was administered on two occasions, 2 weeks apart. The test‐retest reliability was evaluated by Kappa statistics, the percent agreement (PA), and the Svensson rank‐invariant method. The association between the items was evaluated with the Spearman rank correlation coefficient (rho).

Results
The Kappa coefficients showed good to excellent agreement (0.64‐0.90) and the PA ≤1 point was high (>92%) for all items. No items showed any systematic or random disagreements according to the Svensson method. All domain‐specific items correlated significantly with the global item “Life as a whole” (P < .01; rhos 0.41 to 0.75).

Conclusions
LiSat‐11 is reliable for assessing life satisfaction in persons with LEoPs. The global item “Life as a whole” is useful as an overall measure but cannot fully replace the information obtained from the domain‐specific items of LiSat‐11.

Conclusions: LiSat‐11 is a reliable outcome measure to assess life satisfaction in persons with LEoPs. The association between the global item “Life as a whole” and the domain‐specific items indicates that LiSat‐11 measures various aspects that can affect a personʼs life satisfaction. The global question “Life as a whole” is useful as an overall measure but cannot fully replace the information obtained from the domain‐specific questions of LiSat‐11.

Outcome of Research: Effective

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio

Title: Late functional deterioration following paralytic poliomyelitis
Author: D. Kidd, R.S. Howard, A.J. Williams, F.W. Heatley, C.P. Panayiotopoulos and G.T. Spencer
Affiliation: Departments of Neurology, Respiratory Medicine and Orthopaedics, the Lane-Fox Unit, St Thomas' Hospital, London, UK
Journal: Post-Polio Network (NSW) Inc
Citation: QJ Med 1997; 90: 189 - 196
Publication Year and Month: 1997 01

Abstract: Many patients with previous poliomyelitis develop 'post-polio syndrome' (PPS) in which late functional deterioration follows a period of relative stability. The frequency with which PPS can be attributed to clearly defined causes remains uncertain. We reviewed 283 newly-referred patients with previous poliomyelitis seen consecutively over a 4-year period; 239 patients developed symptoms of functional deterioration at a mean of 35 (5-65) years after the paralytic illness. Functional deterioration was associated with orthopaedic disorders in 170 cases, neurological disorders in 35, respiratory disorders in 19 and other disorders in 15. Progressive post-polio muscular atrophy was not observed. Functional deterioration following paralytic poliomyelitis is common, and associated with orthopaedic, neurological, respiratory and general medical factors which are potentially treatable.

Conclusions:

Outcome of Research: Not applicable

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio, Surgery

Title: Physical Therapist Management Following Rotator Cuff Repair for a Patient With Postpolio Syndrome
Author: Mary Carlson, Tana Hadlock
Affiliation: M Carlson, PT, PhD, is Associate Professor, Physical Therapy Program,
University of Texas at El Paso, 1101 N Campbell, El Paso, TX 79902 (USA).

T Hadlock, MA, OTR, is Instructor, Occupational Therapy Program, Yamaguchi Health and Welfare College, Ube City, Yamaguchi Prefecture, Japan.
Journal: PTJ: Physical Therapy & Rehabilitation Journal (Prior to 2021, was titled Physical Therapy)
Citation: Phys Ther. 2007;87:179–192.
https://doi.org/10.2522/ptj.20050200
Publication Year and Month: 2007 02

Abstract: Background and Purpose
Postpoliomyelitis sequelae, such as gait instability and progressive weakness, predispose people with postpolio syndrome to secondary disabilities. With aging, people who depend on their upper extremities to accommodate lower-extremity deficits may anticipate overuse injuries. The purpose of this case report is to describe the use of mobilization and exercise in postoperative rehabilitation of rotator cuff surgery on a patient with postpolio syndrome.

Case Description
A 48-year-old woman with postpolio syndrome had rotator cuff surgical repair followed by physical therapy intervention. Maitland mobilization and mild functional exercises were chosen to avoid triggering fatigue.

Outcomes
Measurements taken preoperatively, before and after physical therapy intervention, and 2 years after intervention showed return to independent status with excellent retention.

Discussion
No fatigue or overuse weakness was encountered. This is the first case report to document physical therapy following rotator cuff repair in a patient with postpolio syndrome.

Conclusions: In summary, this is the first case report to document the effects of physical therapy in a patient with PPS who had a rotator cuff tear resulting from extended use due to postpolio sequelae. The physical therapist used a Maitland technique with functional active exercises for the patient. The physical therapist additionally emphasized communication and used the patient responses to adjust treatment. The patient was knowledgeable about her condition and was able to be an active partner of the rehabilitation team, monitor fatigue, and modify her exercises and activities as needed. Additionally, the change between her status immediately following rehabilitation and 2 years later showed continued progress in strength and ROM. We believe that the combination of good practitioner/patient communication, use of the Maitland technique to increase joint ROM without patient effort, and careful selection of a few functionally important active and resistive exercises contributed to the success of this patient’s rehabilitation.

Future research might use a single-subject research design for multiple individuals with PPS who have rehabilitation following orthopedic surgery. A standardized functional survey would strengthen the design, and a handheld dynamometer could be used to quantify muscle strength in lieu of the BTE device. The single-subject design is stronger than the case report and can infer an effect of the intervention on the outcome.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio

Title: Living with polio and postpolio syndrome in the United Kingdom
Author: Atwal A (1), Giles A, Spiliotopoulou G, Plastow N, Wilson L
Affiliation: (1) School of Health Science and Social Care, Brunel University, Kingston Lane, Uxbridge, Middlesex, London, UK - [email protected]

Journal: Scandinavian Journal of Caring Sciences
Citation: Scand J Caring Sci. 2013 Jun;27(2):238-45. doi: 10.1111/j.1471-6712.2012.01029.x
Publication Year and Month: 2013 06

Abstract: The term Postpolio Syndrome (PPS) is used to describe new and late manifestations of poliomyelitis that occur later in life in polio survivors. Polio had been eradicated in the United Kingdom (UK) and most of Europe, although this is not the case in all countries. Research in this area has tended to focus upon the impact of polio and PPS on health status and functional health rather than its overall effect on people's lives. This study's two main aims were to explore the ways in which polio and PPS in the UK has affected the respondents' lives and to ascertain their views about how the quality of life could be improved. The two questions were as follows: (1) How has the health of people with polio and PPS affected their quality of life? (2) What would people with polio and PPS change to improve their quality of life? Deductive content analysis using existing qualitative data from a cross-sectional survey of 336 returned questionnaires from persons with polio and PPS was carried out. The average age of the participants was 54 years. Our research found that polio survivors valued social occupations and participation in family life. Our research has also shown that healthcare professionals still do not understand polio and PPS and this lack of understanding influences their clients' quality of life. Finances and accessibility of environments also influence participation in chosen occupations. Rehabilitation programmes for people with polio and PPS need to be targeted towards maintaining and improving accessible environments and participation in chosen occupations, and healthcare professionals need to ensure that persons with polio and PPS are referred to persons with specific expertise in this area.

Conclusions:

Outcome of Research: Not applicable

Availability of Paper: Paid subscription required to view or download full text.

Comments (if any):

Link to Paper (if available): Click here to view Abstract


There are currently 34 papers in this category.

Category: Falls, Late Effects of Polio

Title: Fall-Related Activity Avoidance among Persons with Late Effects of Polio and Its Influence on Daily Life: A Mixed-Methods Study
Author: Christina Brogårdh (1,2), Jan Lexell (1,2) and Catharina Sjödahl Hammarlund (1,3)

Affiliation: 1) Department of Health Sciences, Lund University, 221 00 Lund, Sweden

2) Department of Neurology, Rehabilitation Medicine, Memory Disorders and Geriatrics, Skåne University Hospital, 222 41 Lund, Sweden

3) The PRO-CARE Group, School of Health and Society, Kristianstad University, 291 39 Kristianstad, Sweden

Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Int. J. Environ. Res. Public Health 2021, 18(13), 7202; https://doi.org/10.3390/ijerph18137202
Publication Year and Month: 2021 07

Abstract: Falls are common among persons with late effects of polio (LEoP), which may lead to fear of falling and activity avoidance in everyday life. Here, we assessed the occurrence of fall-related activity avoidance among persons with LEoP and explored how these experiences influenced daily life. Fourteen ambulatory persons (seven women; mean age 70 years) with LEoP participated. They responded to the modified Survey of Activities and Fear of Falling in the Elderly (mSAFFE) and participated in individual interviews, which were analysed by systematic text condensation. Each quotation was deductively analysed from its representation with regard to mSAFFE. We found that many persons often avoided activities related to standing and walking, for example, taking a bath, performing household chores, walking outdoors, attending social events if there were stairs in the building and travelling by public transport, due to fear of falling, increased pain and fatigability. To facilitate the performance of daily activities participants expressed that strategic thinking and aids were important to use. In conclusion, fall-related activity avoidance is common in persons with LEoP, which negatively influence daily life and social participation. To increase daily functioning in this population, fall-related activity avoidance should be included in a multifaceted fall management program.

Keywords: activities of daily living; fear of falling; postpoliomyelitis syndrome; qualitative research

Conclusions: Fall-related activity avoidance is common in persons with LEoP, which negatively influence daily life and social participation. To increase daily functioning in this population, fall-related activity avoidance should be included in a multifaceted fall management program.

Outcome of Research: Effective

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Falls, Late Effects of Polio

Title: Polio survivors have poorer walking adaptability than healthy individuals
Author: Jana Tuijtelaars (1), Melvyn Roerdink (2), Bart Gerardus Hendricus Raijmakers (1), Frans Nollet (1), Merel-Anne Brehm (1)
Affiliation: (1) Amsterdam UMC, University of Amsterdam, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, the Netherlands

(2) Department of Human Movement Sciences, Faculty of Behavioural and Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Van der Boechorststraat 7, Amsterdam, the Netherlands
Journal: Gait & Posture
Citation: https://doi.org/10.1016/j.gaitpost.2021.04.031
Publication Year and Month: 2021 04

Abstract: Background:
Falling is a major health problem in polio survivors, often occurring as a result of tripping, slipping or misplaced steps. Therefore, reduced walking adaptability possibly plays an important role.

Research question:
Does walking adaptability, assessed on an interactive treadmill, differ between polio survivors and healthy individuals?

Methods:
In this cross-sectional study, 48 polio survivors with at least one reported fall in the past year and/or fear of falling and 25 healthy individuals of similar age walked at self-selected comfortable fixed speed on an instrumented treadmill. Walking adaptability was measured as i) target-stepping accuracy (determined as variable error [VE] in mm independent of speed) in three conditions; 0%, 20% and 30% variation in step length and width, and ii) anticipatory and reactive obstacle avoidance (ObA and ObR, in percentage successfully avoided). All trials were checked for valid step detection.

Results:
46 polio survivors (mean ± SD age: 63.2 ± 8.7 years) and 25 healthy individuals (64.3 ± 6.6 years, p = 0.585) showed valid step detection. Compared to healthy individuals (mean±SE VE: 30.6±1.2mm), polio survivors stepped less accurately onto targets (36.4±0.9mm, p = 0.001), especially with their least-affected leg. Polio survivors avoided fewer obstacles successfully (mean±SE ObA: 83±3%, ObR: 59±4%) than healthy individuals (100±0.3%, p < 0.001 and 94±3%, p < 0.001, respectively), with a stronger decline in success rates from anticipatory to reactive obstacle avoidance for polio survivors (p < 0.001).

Significance:
Polio survivors reporting falls and/or fear of falling had a demonstrably reduced walking adaptability, especially so for reactive obstacle avoidance which requires step adjustments under high time-pressure demands. Future research should study the merit of walking-adaptability assessment to currently used clinical methods of fall-risk assessment within this population.

Abbreviations:
CoP: Center of Pressure

CWS: Comfortable Walking Speed

ObA: Obstacle Avoidance Anticipatory

ObR: Obstacle Avoidance Reactive

ST0: Stepping Targets, 0% variation in step length and width relative to normal walking

ST20: Stepping Targets, 20% variation in step length and width relative to normal walking

ST30: Stepping Targets, 30% variation in step length and width relative to normal walking

VE: Variable stepping Error

%GDS: Percentage successful goal-directed steps

Keywords:
Poliomyelitis, walking adaptability, falling, fall, risk, C-Mill, muscle, weakness

Conclusions: Polio survivors had a demonstrable limited ability to adapt walking to environmental circumstances compared to community-dwelling healthy individuals of similar age. They had fewer successful goal-directed steps, stepped less consistently on stepping targets and, despite walking slower, had lower obstacle-avoidance success rates, especially under high time-pressure demands. This diminished walking adaptability could place them at higher risk of falling, especially in everyday life, where walking often needs to be adapted to expected and unexpected circumstances. Future research should study the validity and reproducibility of walking-adaptability assessment in polio survivors to determine its added value to the currently used methods of fall-risk assessment in clinical practice.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Cardiovascular, Exercise, Late Effects of Polio, Muscle Strength

Title: Effects of muscle strengthening and cardiovascular fitness activities for poliomyelitis survivors: A systematic review and meta-anaylsis.
Author: Akhilesh Kumar RAMACHANDRAN, MSc, BEng (1), Stephen P. J. GOODMAN, PhD, Hon BEXSc (2), Michael J. JACKSON, MPT, BEd, BACH (1) and Timothy J. H. LATHLEAN, PhD, MClinRehab, Hon BSc, BBehSc (2,3)
Affiliation: 1) Polio Australia Incorporated

2) Discipline of Exercise and Sports Science, School of Science and Technology, University of New England

3) Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide.
Journal: Journal of Rehabilitation Medicine (JRM) - formerly Scandanavian Journal of Rehabilitation Medicine
Citation: J Rehabil Med 2021; 53: jrm00184, doi: 10.2340/16501977-2832
Publication Year and Month: 2021 04

Abstract: Objective:
To evaluate and assess the effectiveness of muscle strengthening and cardiovascular interventions in improving outcomes in poliomyelitis (polio) survivors.

Data sources:
A systematic literature search was conducted in Medline, PubMed, CINAHL, PsychINFO, Web of Science, and Google Scholar for experimental and observational studies.

Study selection and extraction:
Screening, data-extraction, risk of bias and quality assessment were carried out independently by the authors. The quality appraisal and risk of bias were assessed using the Downs and Black Checklist. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was followed to increase clarity of reporting.

Data synthesis:
A total of 21 studies that met all the inclusion criteria were subjected to statistical analyses according to intervention (muscle strengthening or cardiovascular fitness). A random-effects metaanalysis showed a statistically significant effect for the exercise interventions favouring improvement in outcomes according to the International Classification of Functioning, Disability and Health (ICF).

Conclusion:
This review provides further insight into the effects associated with muscle strengthening and cardiovascular interventions among polio survivors, and helps to further identify the current state of research in this area. Future research is needed, focusing on individualized approaches to exercise with polio survivors and specific exercise prescription recommendations, based on established frameworks, such as the ICF.

Conclusions: The findings of this review and analysis provide “very low level evidence” (according to the Grading of Recommendations Assessment, Development and Evaluate; GRADE) to polio survivors, clinicians and researchers. The main findings of this review relate specifically to changes in body function, and activity and participation, and include evidence of effect on improved functioning without furthering debility in polio survivors. This systematic review and meta-analysis provides additional insights into effects associated with exercise, across various types of interventions, in polio survivors, and advances the level of methodological quality of research in this area. Although there was evidence demonstrating effect across domains, due to inherent biases within the literature to date, further and high-quality primary exercise-focused research is required in order to strengthen the certainty of evidence regarding important research questions about the ongoing health of polio survivors.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any): Polio Australia staff co-authored this article.

Link to Paper (if available): Click here to view full text or to download


Category: Pain, Late Effects of Polio

Title: Effectiveness of Intravenous Immunoglobulin for Management of Pain in Patients with Postpolio Syndrome
Author: Min Cheol Chang (1), Jin-Sung Park (2), Jong-moon Hwang (3), and Donghwi Park (4)
Affiliation: (1) Department of Rehabilitation Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea

(2) Department of Neurology, School of Medicine, Kyungpook National University,
Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea

(3) Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea

(4) Department of Physical Medicine and Rehabilitation, Ulsan University Hospital, University of Ulsan College of Medicine,
Ulsan, Republic of Korea
Journal: Pain Research and Management
Citation: Volume 2021, Article ID 6637705, 4 pages
https://doi.org/10.1155/2021/6637705
Publication Year and Month: 2021 03

Abstract: Objective.
Many patients with postpolio syndrome (PPS) experience pain. In this study, we aimed to review previous studies to investigate the effectiveness of intravenous immunoglobulin (IVIG) for managing pain in patients with PPS. We performed a narrative review.

Methods.
In PubMed, we searched for the keywords ((Immunoglobulin OR IVIG) AND (poliomyelitis OR poliomyelitis syndrome)). We included articles in which IVIG was infused in patients with PPS and pain severity was measured before and after treatment.

Results.
In the results, five articles (4 randomized controlled trials and 1 prospective observational study) were included in this review. Four of the studies reported that IVIG had a positive pain-reducing effect in patients with PPS. In addition, 4 studies evaluated the outcomes related to muscle strength and function. Of these studies, 3 showed some improvement in measurements for muscle strength and function.

Conclusion.
In conclusion, IVIG might be one of the beneficial options for managing pain in PPS. Pain reduction might be responsible for the improvement of muscle strength or function. To confirm the benefits of IVIG in reducing pain, more high-quality studies are required.

Conclusions: In conclusion, this review shows that IVIG administration might be useful for managing pain in patients with PPS. In the 5 articles reviewed, no major adverse effects were reported. Owing to the small number of studies and inconsistent results between the studies, we cannot make a definite conclusion on the effect of IVIG on pain in PPS. However, we think that the previous studies showed a possibility that IVIG can safely manage pain in patients with PPS. To confirm the benefits of IVIG in reducing pain in patients with PPS, more high-quality studies are required. Moreover, the protocols for IVIG infusion used in each study were heterogeneous; therefore, the most effective protocol for IVIG infusion for controlling pain should be evaluated in the future.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Activity Levels, Late Effects of Polio, Muscle Strength, Psychology, Quality of Life

Title: Health-related quality of life, self-reported impairments and activities of daily living in relation to muscle function in post-polio syndrome
Author: Vanya Gocheva,corresponding author1 Patricia Hafner,1 Anna-Lena Orsini,1,2 Simone Schmidt,1,3 Sabine Schaedelin,4 Nicole Rueedi,1 Daniela Rubino-Nacht,1 Peter Weber,1 and Dirk Fischer1
Affiliation: 1Division of Neuropediatrics and Developmental Medicine, University Children’s Hospital of Basel (UKBB),University of Basel, Spitalstrasse 33, Postfach, 4056 Basel, Switzerland
2Division of Neurology, University Hospital Basel, Basel, Switzerland
3Department of Neurology, General Hospital Hietzing with Neurological Center Rosenhügel, Vienna, Austria
4Department of Clinical Research, Clinical Trial Unit, University Hospital Basel, Basel, Switzerland
Vanya Gocheva, Email: [email protected]
corresponding author.
Journal: Journal of Patient-Reported Outcomes
Citation: 4(1), 59. https://doi.org/10.1186/s41687-020-00226-5
Publication Year and Month: 2020 12

Abstract: Background
The symptoms of post-polio syndrome (PPS) and its resulting disabilities can affect quality of life and the ability to perform daily activities. No study has comprehensively analysed how various patient-reported outcome measures (PROMs) are associated with objectively assessed physical function in patients with PPS.

Aim
To investigate health-related quality of life (HRQOL), self-reported impairments and activities of daily living during 6 months and evaluate their association with clinical muscle function outcomes in individuals with PPS.

Methods
Twenty-seven patients with PPS were included in the study. At baseline and 6 months, patients were administered PROMs measuring HRQOL (WHOQOL-BREF), self-reported impairments related to PPS (SIPP-RS) and activities of daily living (IBM-FRS). Clinical muscle function outcomes included 6 min walking distance (6MWD) and motor function measure (MFM).

Results
There were no changes in self-reported impairments (25.52 to 24.93, p = 0.40), activities of daily living (33.89 to 33.30, p = 0.20), 6MWD (391.52 to 401.85, p = 0.30) and MFM (83.87 to 85.46, p = 0.14) during 6 months, while the HRQOL psychological health decreased during this period (76.85 to 72.38, p = 0.05). A strong association was found between activities of daily living and clinical muscle function outcomes (6MWD: ß = 0.02, 95% CI: 0.02;0.03, t = 6.88, p < 0.01; MFM: ß = 0.25, 95% CI: 0.17;0.33, t = 6.69, p < 0.01). Self-reported impairments and HRQOL domains were not associated with the clinical muscle outcomes.

Conclusions
Study findings indicate that objectively measured walking and motor abilities do not reflect patient’s perspectives of their HRQOL and impairment due to PPS. More research is needed to assess changes over time and capture clinically meaningful changes in individuals with PPS and to increase the understanding of how the patient’s perspective of disability measured by PROMs is related to objectively measured walking and motor abilities.

Conclusions: Self-reported impairments, HRQOL domains, activities of daily living and muscle function outcomes remained stable during 6 months in patients with PPS, except for the HRQOL psychological health domain which declined during this period. Clinical muscle outcomes had no statistically significant relationship with HRQOL and self-reported impairments of PPS patients while a significant relationship was observed with the activities of daily living. More research is needed to assess changes over time and capture clinically meaningful changes in individuals with PPS and to increase the understanding of how the patient’s perspective of disability measured by PROMs is related to objectively measured walking and motor abilities.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Epidemiology, Late Effects of Polio

Title: Epidemic poliomyelitis, post-poliomyelitis sequelae and the eradication program
Author: Margaret Peel
Affiliation: University of Melbourne - Department of Microbiology and Immunology Melbourne, Australia
Position: Principal Microbiologist
Description: Retired
Journal: Microbiology Australia
Citation: 41(4):196 DOI: 10.1071/MA20053
Publication Year and Month: 2020 11

Abstract: Epidemics of paralytic poliomyelitis (polio) first emerged in the late 19th and early 20th centuries in the United States and the Scandinavian countries. They continued through the first half of the 20th century becoming global. A major epidemic occurred in Australia in 1951 but significant outbreaks were reported from the late 1930s to 1954. The poliovirus is an enterovirus that is usually transmitted by the faecal–oral route but only one in about 150 infections results in paralysis when the central nervous system is invaded. The Salk inactivated polio vaccine (IPV) became available in Australia in 1956 and the Sabin live attenuated oral polio vaccine (OPV) was introduced in 1966. After decades of stability, many survivors of the earlier epidemics experience late-onset sequelae including post-polio syndrome. The World Health Organization launched the global polio eradication initiative (GPEI) in 1988 based on the easily administered OPV. The GPEI has resulted in a dramatic decrease in cases of wild polio so that only Pakistan and Afghanistan report such cases in 2020. However, a major challenge to eradication is the reversion of OPV to neurovirulent mutants resulting in circulating vaccine-derived poliovirus (cVDPV). A novel, genetically stabilised OPV has been developed recently to stop the emergence and spread of cVDPV and OPV is being replaced by IPV in immunisation programs worldwide. Eradication of poliomyelitis is near to achievement and the expectation is that poliomyelitis will join smallpox as dreaded epidemic diseases of the past that will be consigned to history.

Conclusions: Eradication of poliomyelitis is near to achievement and the expectation is that poliomyelitis will join smallpox as dreaded epidemic diseases of the past that will be consigned to history.

Outcome of Research: Effective

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio, Psychology, Quality of Life

Title: The value of a post-polio syndrome self-management programme
Author: Alexandra Curtis,corresponding author1,# Jeong Su Lee,1,# Georgios Kaltsakas,1,2 Vivian Auyeung,2 Simon Shaw,1 Nicholas Hart,1,2 and Joerg Steier1,2
Affiliation: 1Guy’s and St Thomas’ NHS Foundation Trust, London, UK;
2Faculty of Life Sciences and Medicine, King’s College, London, UK
corresponding authorCorresponding author.
Contributions: (I) Conception and design: A Curtis, JS Lee, N Hart, J Steier, V Auyeung; (II) Administrative support: A Curtis, JS Lee, N Hart, J Steier; (III) Provision of study materials or patients: A Curtis, JS Lee, J Steier, S Shaw, V Auyeung; (IV) Collection and assembly of data: A Curtis, JS Lee; (V) Data analysis and interpretation: A Curtis, JS Lee, J Steier, V Auyeung, G Kaltsakas; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors.
#These authors contributed equally to this work.
Correspondence to: Ms. Alexandra Curtis, MRes, BSc. Guy’s and St Thomas’ NHS Foundation Trust, Lane Fox Unit, Westminster Bridge Road, London SE1 7EH, UK. Email: [email protected]
Journal: Journal of Thoracic Disease
Citation: 12(Suppl 2), S153–S162. https://doi.org/10.21037/jtd-cus-2020-009
Publication Year and Month: 2020 10

Abstract: Background
Post-polio syndrome is characterised by symptoms of fatigue, pain and new-onset neuromuscular weakness, and emerges decades after the initial poliovirus infection. We sought to evaluate the only post-polio syndrome specific self-management programme in the United Kingdom.

Methods
This was a retrospective study of patients who had completed a residential self-management programme led by a multi-disciplinary clinical team. Following a confirmed diagnosis of post-polio syndrome by rehabilitation and neurology specialists, patients were offered to participate in the programme. Although group-based, patients also received individually tailored support on physical exercise and fatigue management. Physical effects, physical function, psychosocial well-being measures were assessed at baseline and 6 months follow-up. Knowledge was tested at baseline and immediately following the programme. Statistical comparisons were made using paired t-test and Wilcoxon signed rank test according to the data distribution.

Results
Over a period of 17 years, 214 participants (median age 61.3 years old, 63% female) attended 31 programmes. At 6 months the following post-polio syndrome specific symptoms improved significantly: fatigue, as measured by the Multidimensional Assessment of Fatigue scale [37.6 (7.1) vs. 34.2 (9.3), P=0.005]; and pain [15.0 (6.1) vs. 13.1 (6.7), P=0.001], atrophy [10.0 (8.0–12.0) vs. 9.0 (7.0–11.0), P=0.002] and bulbar symptoms [3.0 (1.0–5.0) vs. 2.0 (0–4.0), P=0.003] as measured by the Index of Post-polio Sequelae scale. Knowledge related to post-polio syndrome also significantly increased [14.0 (11.0–16.0) vs. 17.0 (16.0–19.0), P=0.001]. Participants were able to walk at a faster speed over 10 meters [0.77 (0.59–1.00) vs. 0.83 (0.67–1.10) m/s, P=0.003] and walked longer distances during the 2-minute walk test [76.9 (31.7) vs. 82.0 (38.4) m, P=0.029]. Depression and anxiety scores did not change over time [PHQ-9, 2.0 (0.3–10.8) vs. 2.0 (0.3–6.8), P=0.450; GAD-7, 2.0 (0–7.0) vs. 1.0 (0–3.0), P=0.460] nor was there change in self-reported quality of life {60 [50–70] vs. 60 [55–70], P=0.200}.

Conclusions
This study suggests that a post-polio syndrome self-management programme led to improvement in symptoms, knowledge and walking speed, but not quality of life. Anxiety and depression scores remained low.

Keywords: Rehabilitation, post-polio syndrome (PPS), fatigue, quality of life (QoL)

Conclusions: A self-management programme for PPS can improve fatigue, the severity to which pain, atrophy and bulbar function issues are experienced and the overall knowledge of PPS, as well as physical function over a 6-month period. Despite some limitations the study results are important to a wider audience given the difficulties in collecting systematic data in this cohort and the relatively sparse evidence for the current approach to PPS management. Experiences from PPS management might prove valuable at a time when a new viral pandemic requires us to design future rehabilitation and self-management programmes for many more survivors of a devastating viral condition.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio, Quality of Life

Title: Life Satisfaction in Persons With Late Effects of Polio: A Test‐Retest Reliability Study
Author: Elisabeth Ekstrand RPT, PhD; Jan Lexell MD, PhD, DPhil h.c.; Christina Brogårdh RPT, PhD
Affiliation: E.E. - Department of Health Sciences, Lund University, Lund, Sweden; andDepartmentof Hand Surgery, Skåne University Hospital, Malmö, Sweden. Address correspondenceto: E.E., Department of Health Sciences,Physiotherapy Research Group, Lund Univer-sity, Box 157, SE-221 00 Lund, Sweden; e-mail: elisabet[email protected]
Disclosure: nothing to disclose.

J.L. and C.B. - Department of Health Sciences, Lund University, Lund, Sweden; andDepartment of Neurology, Rehabilitation Medicine, Memory Disorders and Geriatrics,Skåne University Hospital, Lund, Sweden
Disclosure: nothing to disclose.
Journal: PM&R: The Journal of Injury, Function, and Rehabilitation
Citation: Volume 12, Issue 10 p.997-1002
https://doi.org/10.1002/pmrj.12325
Publication Year and Month: 2020 01

Abstract:
Background
The Life Satisfaction Questionnaire (LiSat‐11), including one global item and 10 domain‐specific items, is used to evaluate life satisfaction in persons with the late effects of polio (LEoPs). However, there is a lack of knowledge about its psychometric properties.

Objective
To evaluate the test‐retest reliability of the LiSat‐11 and the associations between the global and domain‐specific items in persons with LEoPs.

Design
A test‐retest design, where data were collected by a postal survey.

Setting
University Hospital, Outpatient Clinic.

Participants
A cross‐sectional sample of persons (20 women and 31 men; mean age 72 years) with LEoPs.

Main Outcome Measurements
LiSat‐11, assessing how satisfied a person is with different aspects of life, such as life as a whole, vocation, economy, leisure, contacts with friends and acquaintances, sexual life, activities of daily living (ADLs), family life, partner relationship, somatic health, and psychological health.

Methods
LiSat‐11 was administered on two occasions, 2 weeks apart. The test‐retest reliability was evaluated by Kappa statistics, the percent agreement (PA), and the Svensson rank‐invariant method. The association between the items was evaluated with the Spearman rank correlation coefficient (rho).

Results
The Kappa coefficients showed good to excellent agreement (0.64‐0.90) and the PA ≤1 point was high (>92%) for all items. No items showed any systematic or random disagreements according to the Svensson method. All domain‐specific items correlated significantly with the global item “Life as a whole” (P < .01; rhos 0.41 to 0.75).

Conclusions
LiSat‐11 is reliable for assessing life satisfaction in persons with LEoPs. The global item “Life as a whole” is useful as an overall measure but cannot fully replace the information obtained from the domain‐specific items of LiSat‐11.

Conclusions: LiSat‐11 is a reliable outcome measure to assess life satisfaction in persons with LEoPs. The association between the global item “Life as a whole” and the domain‐specific items indicates that LiSat‐11 measures various aspects that can affect a personʼs life satisfaction. The global question “Life as a whole” is useful as an overall measure but cannot fully replace the information obtained from the domain‐specific questions of LiSat‐11.

Outcome of Research: Effective

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio, Respiratory Complications and Management

Title: Post-Polio Syndrome Causing Late Onset Respiratory
Failure
Author: Sharon Enghelberg MD, Itamar Y. Love MD and Micha Rapoport MD
Affiliation: Department of Internal Medicine C, Shamir Medical Center, Zerifin, Israel
Journal: Israel Medical Association Journal (IMAJ)
Citation: 2020; 22: 395–396
Publication Year and Month: 2020

Abstract: CASE STUDY:
We present a patient with thoracic cage deformity and chronic progressive hypoventilation due to late onset PPS.

Conclusions: PPS can be a significant cause for respiratory deterioration in patients with
previous history of poliomyelitis. Physicians should be aware of this potential
diagnosis, as early diagnosis can facilitate individualized treatment plan and
prevent unnecessary examinations and mistreatment.

Outcome of Research: Not applicable

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any): KEY WORDS: dyspnea, polio, post-polio syndrome
(PPS), respiratory failure, restrictive
lung disease

Link to Paper (if available): Click here to view full text or to download


Category: Cultural Context, Disability Rights, Late Effects of Polio, Quality of Life, Vocational Implications

Title: “The car is my extra legs” – Experiences of outdoor mobility amongst immigrants in Sweden with late effects of polio
Author: Helena Selander, Conceptualization, Data curation, Formal analysis, Methodology, Project administration, Supervision, Validation, Visualization, Writing – original draft, Writing – review & editing,1,2,* Iolanda Santos Tavares Silva, Formal analysis, Methodology, Supervision, Validation, Writing – original draft, Writing – review & editing,1,3 Felicia Kjellgren, Conceptualization, Investigation, Methodology, Writing – review & editing,1 and Katharina S. Sunnerhagen, Conceptualization, Data curation, Funding acquisition, Investigation, Methodology, Project administration, Resources, Supervision, Validation, Writing – review & editing1
Wen-Jun Tu, Editor
Affiliation: 1 Rehabilitation Medicine, Department of Clinical Neuroscience, Sahlgrenska Academy, University of Gothenburg, Sweden
2 The Swedish National Road and Transport Research Institute (VTI), Gothenburg, Sweden
3 Department of Occupational Therapy and Physiotherapy, The Sahlgrenska University Hospital, Gothenburg, Sweden
Chinese Academy of Medical Sciences and Peking Union Medical College, CHINA
Competing Interests: The authors have declared that no competing interests exist.
* E-mail: [email protected]
Journal: PLoS One
Citation: 14(10), e0224685. https://doi.org/10.1371/journal.pone.0224685
Publication Year and Month: 2019 10

Abstract: Background
The aim of the study was to describe the experience of outdoor mobility among immigrants with late effects of polio living in Sweden. There is a need to understand more about this young group of persons since they often have problems with mobility and gait, but they may also face participation restrictions due to issues associated with integration into a new community and culture.

Method
A total of 14 young immigrants with late effects of polio participated and were interviewed individually. The study used a qualitative method to explore personal experiences and the interviews were analyzed through an inductive approach, using qualitative content analysis.

Results
The analysis led to a major theme; self-image and acceptance, that comprised a changeable process and experiences of cultural, social, and gender-specific barriers, but also of environmental and personal factors that impacted their outdoor mobility. By using a car, the participants felt they could come across as normal which also increased their self-esteem.

Conclusions
Independent mobility is a major enabler for ongoing employment and being able to use a car increases the chances for integration into society for young immigrants with late effects of polio. Public transport is not considered to be adequate or efficient enough due to the participants’ mobility impairments, but driving can prevent involuntary isolation and facilitate participation. A car can increase quality of life but may also be a facilitator for work and reduce the demand for societal support.

Conclusions: More work is needed on young immigrants with late effects of polio to identify their mobility needs and find solutions that could minimize barriers and help them to be more independent outdoors. This group in Sweden has often been overlooked in clinical settings and in society generally. It is important to consider the need of care and support for persons with late effects polio as the need for care has been questioned and decision makers (such as health commissioners) believe persons with late effects of polio no longer exist in Sweden. Moreover, they are not prioritized despite needing rehabilitation interventions that could increase their outdoor mobility. Independent mobility is a major enabler for ongoing employment and the ability to access a car can increase their chances for social integration. According to participants in this study, public transport is not adequate or efficient enough for their needs. For young immigrants with late effects of polio, driving can prevent involuntary isolation and facilitate participation. A car may increase quality of life and reduce the demand for societal support.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Diagnosis and Management, Late Effects of Polio

Title: Post-poliomyelitis syndrome (2019)
Author: Eric Chun Pu Chu1 and Kary Ka Wai Lam2
Affiliation: 1New York Chiropractic and Physiotherapy Center, New York Medical Group, Hong Kong, People’s Republic of China
2Downtown Chiropractic Limited, Hong Kong, People’s Republic of China
Correspondence: Eric Chun Pu ChuNew York Chiropractic and Physiotherapy Centre, New York Medical Group, 41/F Langham Place Office Tower, 8 Argyle Street, Mongkok, Hong Kong, People’s Republic of China, Phone: Tel +852 3 594 7844, Fax: Fax +852 3 594 6193, Email [email protected]
Journal: International Medical Case Reports Journal
Citation: 12, 261–264. https://doi.org/10.2147/IMCRJ.S219481

Publication Year and Month: 2019 08

Abstract: Most developed countries eliminated paralytic poliomyelitis (polio) in the 1970s to 1980s. It was believed that after recovery from acute paralytic poliomyelitis, the physical condition of survivors would remain stable for the rest of their lives. However, the elimination of polio does not equate the end of medical management of polio. Hundreds of thousands of polio survivors worldwide are still at risk of developing the late effects of the disease. Here, we report a case of post-polio syndrome who attended our clinic for the presence of new weakness and neuromuscular problems six decades after recovery from paralytic polio. It is essential that health professionals be aware of these conditions and have an understanding of the underlying pathophysiology of the symptoms.

Conclusions: Post-polio syndrome is related to the exhaustion of the motor units that form decades after the polio attack. This case report describes the effectiveness of manual interventions in assisting our patient in restoring the level of function and alleviating pain. The limitation of the current report is that it is just a single case. Further comparison with more existing therapeutic regimens is warranted to clarify these issues.

Outcome of Research: Not applicable

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Clinical Evaluation, Diagnosis and Management, Late Effects of Polio

Title: Post-polio Syndrome: More Than Just a Lower Motor Neuron Disease
Author: Stacey Li Hi Shing, Rangariroyashe H. Chipika, Eoin Finegan, Deirdre Murray, Orla Hardiman, and Peter Bede
Affiliation: Computational Neuroimaging Group, Academic Unit of Neurology, Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
Edited by: Francesca Trojsi, University of Campania, Luigi Vanvitelli Caserta, Italy
Reviewed by: Andrea Romigi, Mediterranean Neurological Institute (IRCCS), Italy; Louisa Ng, The University of Melbourne, Australia
*Correspondence: Peter Bede [email protected]
Journal: Frontiers in Neurology
Citation: 10, 773. https://doi.org/10.3389/fneur.2019.00773
Publication Year and Month: 2019 07

Abstract: Post-polio syndrome (PPS) is a neurological condition that affects polio survivors decades after their initial infection. Despite its high prevalence, the etiology of PPS remains elusive, mechanisms of progression are poorly understood, and the condition is notoriously under-researched. While motor dysfunction is a hallmark feature of the condition, generalized fatigue, sleep disturbance, decreased endurance, neuropsychological deficits, sensory symptoms, and chronic pain are also often reported and have considerable quality of life implications in PPS. The non-motor aspects of PPS are particularly challenging to evaluate, quantify, and treat. Generalized fatigue is one of the most distressing symptoms of PPS and is likely to be multifactorial due to weight-gain, respiratory compromise, poor sleep, and polypharmacy. No validated diagnostic, monitoring, or prognostic markers have been developed in PPS to date and the mainstay of therapy centers on symptomatic relief and individualized rehabilitation strategies such as energy conservation and muscle strengthening exercise regimes. Despite a number of large clinical trials in PPS, no effective disease-modifying pharmacological treatments are currently available.

Conclusions: Despite being one of the most devastating neurodegenerative conditions in the world, surprisingly limited research is undertaken in post-polio syndrome. Its pathogenesis remains elusive, no sensitive diagnostic tools have been developed, and validated prognostic and monitoring markers are lacking. Non-motor symptoms of PPS have considerable quality of life implications and are notoriously challenging to manage. The etiology of fatigue in PPS is yet to be elucidated and successful individualized management strategies are needed to maintain mobility, independence, and patient autonomy. There is striking a paucity of neuroimaging studies in PPS that could provide anatomical insights into the substrate of extra-motor symptoms. Ultimately, the characterization of PPS-associated pathology may help research efforts in other motor neuron diseases.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any): This is a good overview of Post-Polio conditions particularly for clinicians new to the topic.

Link to Paper (if available): Click here to view full text or to download


Category: Diagnosis and Management, Differential Diagnosis, Gender Differences, Late Effects of Polio

Title: Postpolio Syndrome: A Review of Lived Experiences of Patients
Author: Oluwaseyi Jacob Oluwasanmi, Devaunna Andrene Mckenzie, Idowu Oluwasegun Adewole, Christian O Aluka, James Iyasse, Esther Olunu, and Adegbenro Omotuyi Fakoya1
Affiliation: Department of Microbiology, All Saints University School of Medicine, Commonwealth of Dominica, Roseau, Dominica
1Department of Anatomical Sciences, University of Medicine and Health Sciences, Basseterre, St. Kitts and Nevis
Address for correspondence: Dr. Adegbenro Omotuyi Fakoya, University of Medicine and Health Sciences, Basseterre, St. Kitts and Nevis. E-mail: [email protected]
Journal: International Journal of Applied & Basic Medical Research
Citation: 9(3), 129–134. https://doi.org/10.4103/ijabmr.IJABMR_333_18
Publication Year and Month: 2019 07

Abstract: Postpolio syndrome (PPS) refers to a group of conditions that are present in patients, years after recovery from initial acute paralytic poliomyelitis. About 15%–80% of 20 million polio survivors worldwide will experience exacerbation of symptoms which typically appear 15–30 years after the resolution of initial poliomyelitis. Symptoms include new muscle weakness, fatigue, myalgia, joint pain, dysphagia, and difficulty breathing. Other reported symptoms include cold intolerance, sleep disorder, dysphonia, loss of stamina, musculoskeletal deformities, cardiovascular disorders, psychosocial problems, and restless legs syndrome. These symptoms are attributed to the superimposed neuronal loss of aging with inflammatory mechanisms, but without any convincing evidence of viral reactivation. Risk factors include female gender, respiratory symptoms, normal aging, permanent disability caused by motor neuron damage, muscle overuse and disuse, aging, and immunologic mechanisms. Hypothyroidism-induced myopathy and fibromyalgia are a differential diagnosis for PPS, and exclusion diagnosis is required as confirmatory criteria for PPS. The symptoms of PPS presented determine the course of management.

Keywords: Fatigue, muscle weakness, myalgia, poliomyelitis, postpolio syndrome

Conclusions: PPS is a sequela of acute poliomyelitis which occurs decades after resolution of the initial paralytic or nonparalytic polio. Fatigue, muscle weakness, myalgia, and joint pain are the major symptoms of PPS. Diagnosis of PPS is made based on the exclusion of other conditions that can cause similar symptoms. The quality of life of patients with PPS is significantly affected by the reoccurrence of the constellations of symptoms they experience. Proper assessment and treatment should be performed to prevent severe impairment of function in patients.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio

Title: Post-polio Syndrome: More Than Just a Lower Motor Neuron Disease
Author: Stacey Li Hi Shing, Rangariroyashe H. Chipika, Eoin Finegan, Deirdre Murray, Orla Hardiman and Peter Bede*
Affiliation: Computational Neuroimaging Group, Academic Unit of Neurology, Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
Journal: Frontiers in Neurology
Citation: Front. Neurol., 16 July 2019 | https://doi.org/10.3389/fneur.2019.00773
Publication Year and Month: 2019 07

Abstract: Post-polio syndrome (PPS) is a neurological condition that affects polio survivors decades after their initial infection. Despite its high prevalence, the etiology of PPS remains elusive, mechanisms of progression are poorly understood, and the condition is notoriously under-researched. While motor dysfunction is a hallmark feature of the condition, generalized fatigue, sleep disturbance, decreased endurance, neuropsychological deficits, sensory symptoms, and chronic pain are also often reported and have considerable quality of life implications in PPS. The non-motor aspects of PPS are particularly challenging to evaluate, quantify, and treat. Generalized fatigue is one of the most distressing symptoms of PPS and is likely to be multifactorial due to weight-gain, respiratory compromise, poor sleep, and polypharmacy. No validated diagnostic, monitoring, or prognostic markers have been developed in PPS to date and the mainstay of therapy centers on symptomatic relief and individualized rehabilitation strategies such as energy conservation and muscle strengthening exercise regimes. Despite a number of large clinical trials in PPS, no effective disease-modifying pharmacological treatments are currently available.

Keywords: postpolio syndrome, PPS, polio, poliomyelitis, neuroimaging, biomarker, clinical trials, motor neuron disease

Conclusions: Despite being one of the most devastating neurodegenerative conditions in the world, surprisingly limited research is undertaken in post-polio syndrome. Its pathogenesis remains elusive, no sensitive diagnostic tools have been developed, and validated prognostic and monitoring markers are lacking. Non-motor symptoms of PPS have considerable quality of life implications and are notoriously challenging to manage. The etiology of fatigue in PPS is yet to be elucidated and successful individualized management strategies are needed to maintain mobility, independence, and patient autonomy. There is striking a paucity of neuroimaging studies in PPS that could provide anatomical insights into the substrate of extra-motor symptoms. Ultimately, the characterization of PPS-associated pathology may help research efforts in other motor neuron diseases.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio, Quality of Life

Title: Quality of life assessment scales in polio survivors: a scoping review
Author: Surajo Kamilu Sulaiman (1), Heather Michelle Aldersey (1), Nora Fayed (1), Bashir Kaka (2) & Christiana Okyere (1)
Affiliation: (1) School of Rehabilitation Therapy, Queen’s University, Louise D. Acton Building, 31 George Street, Kingston, ON, K7L 3N6, Canada

(2) Department of Physiotherapy, Faculty of Allied Health Sciences, College of Health Sciences, Bayero University, PMB 3011, Kano, Nigeria
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Quality of Life Research volume 28, pages 2341–2357 (2019)
https://doi.org/10.1007/s11136-019-02185-x
Publication Year and Month: 2019 04

Abstract: Background
Quality of life evaluation is essential to explore the effect of paralytic polio on the daily life experience of the polio survivor. Researchers have employed a range of assessment instruments to evaluate quality of life among polio survivors. Hence, to select the appropriate scale, it is crucial to compare the contents and psychometric properties of these instruments.

Purpose
This scoping review explores quality of life instruments that are used in polio literature and analyzes their contents and psychometric properties using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) criteria.

Method
Using the Arksey and O’Malley framework, we conducted a literature search in the following electronic databases Medline, CINAHL, Web of Science, Embase, and Google Scholar to identify relevant studies that focused on quality of life of polio survivors. Of the 88 articles that qualify for full-text screening, 34 studies met our inclusion criteria. Two independent reviewers extracted data from the selected studies via Covidence, a reference manager that allows for blinding of reviews.

Results
Most of the instruments included in this review are generic, self-reported, and multidimensional. Despite having mostly adequate psychometric properties, these properties were not evaluated in polio survivors.

Conclusion
The information provided in this review could be used to guide instrument selection and identify the need to develop a new tool or to adapt a pre-existing scale for measuring quality of life among polio survivors.

Conclusions: The information provided in this review could be used to guide instrument selection and identify the need to develop a new tool or to adapt a pre-existing scale for measuring quality of life among polio survivors.

Outcome of Research: More research required

Availability of Paper: Paid subscription required to view or download full text.

Comments (if any):

Link to Paper (if available): Click here to view Abstract


Category: Late Effects of Polio

Title: Three case studies of late diagnoses of polio in Australian adults
Author: C.Formby, D.Currie
Affiliation: St Vincent's Hospital Melbourne, Polio Services Victoria, Fitzroy, Australia
Journal: Annals of Physical and Rehabilitation Medicine
Citation: Volume 61, Supplement, July 2018, Page e272
Publication Year and Month: 2018 07

Abstract: Introduction/Background
Polio Services Victoria (PSV) is a publicly funded organization; anyone with a history of polio residing in Australia may be seen by the service. The majority of patients referred to the service were diagnosed with polio shortly after they were infected with the virus, for most this was in early childhood and ranges from two to eight decades ago. In the past 18 months three patients were referred to PSV with untypically late diagnoses of polio, two of which were sisters. All were born in Australia between 1930 and 1950 and are considered to have acquired their infection in Australia during their early childhood. The three were able to live relatively uneventful lives however their verbal histories indicate suspicion of polio during their childhood medical examinations in school, but ultimately no formal diagnosis was made at that time. In later life, symptoms characteristic of the late effects of polio emerged. In combination with imaging and nerve conduction studies these symptoms were diagnosed as being the result of a likely childhood infection of polio. Their current and future management plans are typical of that seen regularly within the service with the patients reporting their main problems as being:

–pain;

–fatigue;

–increasing muscle atrophy and associated weakness.

These three cases highlight that although Australia, like most of the world, holds polio free status there may still be further undiagnosed cases. Polio should be considered as a differential diagnosis for patients presenting with any of the cardinal signs and symptoms of late effects of polio who have resided in a country during a time prior to polio eradication. Special consideration should be given where a sibling or close relative was diagnosed with polio.

Conclusions:

Outcome of Research: More research required

Availability of Paper:

Comments (if any):

Link to Paper (if available): Click here for preview


Category: Late Effects of Polio, Surgery

Title: Total hip arthroplasty in patients affected by poliomyelitis
Author: C. M. DeDeugd, K. I. Perry, W. H. Trousdale, M. J. Taunton, D. G. Lewallen, M. P. Abdel
Affiliation: Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: The Bone & Joint Journal

Bone Joint J 2018;100-B:733–9
Doi: https://doi.org/10.1302/0301-620X.100B6.BJJ-2018-0127.R1
Publication Year and Month: 2018 06

Abstract: Aims
The aims of this study were to determine the clinical and radiographic outcomes, implant survivorship, and complications of patients with a history of poliomyelitis undergoing total hip arthroplasty (THA) in affected limbs and unaffected limbs of this same population.

Patients and Methods
A retrospective review identified 51 patients (27 male and 24 female, 59 hips) with a mean age of 66 years (38 to 88) and with the history of poliomyelitis who underwent THA for degenerative arthritis between 1970 and 2012. Immigrant status, clinical outcomes, radiographic results, implant survival, and complications were recorded.

Results
In all, 32 THAs (63%) were performed on an affected limb, while 27 (37%) were performed on an unaffected limb. The overall ten-year survivorship free from aseptic loosening, any revision, or any reoperation were 91% (95% CI 0.76 to 0.99), 91% (95% CI 0.64 to 0.97) and 87% (95% CI 0.61 to 0.95), respectively. There were no revisions for prosthetic joint infection. There were no significant differences in any of the above parameters if THA was on the affected or unaffected control limbs.

Conclusion
Patients with a history of poliomyelitis who undergo THA on the affected or unaffected limbs have similar results with overall survivorship and complication rates to those reported results in patients undergoing THA for osteoarthritis. At long-term follow-up, previous clinical concerns about increased hip instability due to post-polio abductor weakness were not observed.

Conclusions: Patients with a history of poliomyelitis who undergo THA on the affected or unaffected limbs have similar results with overall survivorship and complication rates to those reported results in patients undergoing THA for osteoarthritis. At long-term follow-up, previous clinical concerns about increased hip instability due to post-polio abductor weakness were not observed.

Outcome of Research: Not applicable

Availability of Paper: Paid subscription required to view or download full text.

Comments (if any):

Link to Paper (if available): Click here to view Abstract


Category: Late Effects of Polio

Title: Long-term follow-up of patients with prior polio over a 17-year period.
Author: Vreede KS, Broman L, Borg K.
Affiliation: Department of Rehabilitation Medicine, Danderyd University Hospital, Building 39, Floor 3, SE-182 88 Stockholm, Sweden, [email protected]
Journal: Journal of Rehabilitation Medicine
Citation: 2016 Apr;48(4):359-64
Publication Year and Month: 2016 04

Abstract: OBJECTIVE:
Follow-up of the health of patients with prior polio over a 17-year period.

DESIGN:
Follow-up study.

PATIENTS:
Patients with prior polio.

METHODS:
The study questionnaire was answered in 1995 by 270 patients. In 2012 the questionnaire was sent again to the surviving patients.

RESULTS:
Of the patients who answered the questionnaire in 1995, 116 (40%) were still alive in 2012. The group of patients who had died was older, and had a mean age of 70 years in 1995. A total of 60 patients participated in the study by answering the questionnaire in both 1995 and 2012. Most of these patients (84%) reported that they felt progressively worse, with poor mobility and increased muscle weakness in 2012 compared with 1995, and more than half reported a lower quality of life in 2012. The number of wheelchair users had increased significantly. Furthermore, the patients experienced increasing problems with activities of daily living (ADL) function.

Conclusions: More than half of the patients with prior polio had died between 1995 and 2012. These patients were, on average, older than patients surviving in 2012. When interviewed in 2012 most of the patients felt progressively worse, with poor mobility and increased muscle weakness.

Outcome of Research: More research required

Availability of Paper:

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio

Title: Experiences and perspectives of patients with post-polio syndrome and therapists with exercise and cognitive behavioural therapy
Author: Minne Bakker, Karen Schipper, Fieke S. Koopman, Frans Nollet and Tineke A. Abma
Affiliation: Department of Medical Humanities, EMGO+ Institute, VU Medical Center
(VUmc), Amsterdam, The Netherlands
Journal: BioMed Central Neurology
Citation: BMC Neurology (2016) 16:23
Publication Year and Month: 2016

Abstract: Background: Many persons affected with poliomyelitis develop post-polio syndrome (PPS) later in their life.
Recently, the effectiveness of Exercise Therapy (ET) and Cognitive Behavioural Therapy (CBT) for PPS has been evaluated in a randomized controlled trial, but did not show a decrease in fatigue or improvement in secondary endpoints like Quality of Life and self-perceived activity limitations. The aim of this explorative study was to gain insight in the perceived effects and experiences of the interventions from the perspectives of the patients and
therapists.
Methods: Qualitative data were collected through semi-structured interviews with 17 patients and 7 therapists. All participants were involved in the trial. A thematic analysis of the data was performed.
Results: Some patients experienced a short term enhanced endurance and a better use of energy during the day. However, in general patients did not experience a long lasting reduction of fatigue from the CBT or ET. Mainly patients of the CBT, but also some patients of the ET described an increase of self-esteem and self-acceptance. As a result, patients were sometimes better able to perform physical activities during the day. In contrast to the CBT, the
ET was in general perceived by the patients as an intensive therapy, which was difficult to fit into their daily routine. Therapists of both the CBT and the ET struggled with a low intrinsic motivation of the patients in the study.
This made it sometimes difficult for the therapists to follow the protocol.

Conclusions: Conclusion: Confirming the negative quantitative study outcome, the qualitative results did not demonstrate lasting effects on fatigue. Patients did, however, experience some benefits on self-esteem and acceptance of the disease. This study showed that it is of great importance to work with feasible interventions; they should fit the patients’ needs on a practical (fit into their daily routine) and mental (fit their need for support) level.

Outcome of Research: More research required

Availability of Paper:

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio

Title: People living with post-polio syndrome must not be forgotten
Author: Hill T
Affiliation: British Polio Fellowship
Journal: Nursing Standard
Citation: Nurs Stand. 2015 Nov 4;30(10):30-1. doi: 10.7748/ns.30.10.30.s38
Publication Year and Month: 2015 11

Abstract: As research conducted by YouGov reveals, only 7% of people in Britain are aware of the neurological condition post-polio syndrome (PPS). The British Polio Fellowship is keen to highlight what is now an urgent need for more support for those living with PPS, from both the public and the nursing and medical community.

Conclusions:

Outcome of Research: Not applicable

Availability of Paper: Paid subscription required to view or download full text.

Comments (if any):

Link to Paper (if available): Click here to view Abstract


Category: Cardiorespiratory, Late Effects of Polio, Respiratory Complications and Management

Title: Obesity and Pulmonary Function in Polio Survivors
Author: Soo Jeong Han, MD, PhD (1), Jae-Young Lim, MD, PhD(2), Jee Hyun Suh, MD(1)
Affiliation: 1. Department of Rehabilitation Medicine, Ewha Womans University School of Medicine, Seoul;

2. Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Korea
Journal: Annals of Rehabilitation Medicine
Citation: 2015;39(6):888-896
pISSN: 2234-0645 • eISSN: 2234-0653
http://dx.doi.org/10.5535/arm.2015.39.6.888
Publication Year and Month: 2015 06

Abstract: OBJECTIVE
To examine the correlation between obesity and pulmonary function in polio survivors.

METHODS
This study was conducted based on a questionnaire survey and physical examination. The questionnaire included gender, age, paralyzed regions, physical activity levels, and accompanying diseases. The physical examination included measuring body mass index, waist circumference, muscle power, total fat amount, body fat percentage, and lean body mass. In addition, pulmonary function was tested based on forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), ratio of FEV1 to FVC, and chest circumference. Five university hospitals and a local health clinic participated in this study.

RESULTS
Pearson and partial correlation coefficients that used data collected from 73 polio survivors showed that obesity had a negative correlation with pulmonary function.

CONCLUSION
This study found that pulmonary function has a negative correlation with obesity for polio survivors. Therefore, it is necessary to develop specialized exercise programs to help polio survivors reduce their weight and strengthen their respiratory muscles.

Conclusions: This study found that pulmonary function has a negative correlation with obesity for polio survivors. Therefore, it is necessary to develop specialized exercise programs to help polio survivors reduce their weight and strengthen their respiratory muscles.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any): Keywords: Poliomyelitis, Obesity, Pulmonary function

Link to Paper (if available): Click here to view full text or to download


Category: Ageing, Late Effects of Polio

Title: A Review of Secondary Health Conditions in Post-Polio Syndrome: Prevalence and Effects of Aging
Author: Thomas E. McNalley, MD, MA, Kathryn M. Yorkston, PhD1, Mark P. Jensen, PhD1, Anjali R. Truitt, MPH1, Katherine G. Schomer, MA1, Carolyn Baylor, PhD1, and Ivan R. Molton, PhD1
Affiliation: Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
Journal: American Journal of Physical Medicine & Rehabilitation
Citation: 94(2): 139–145. doi:10.1097/PHM.0000000000000166
Publication Year and Month: 2015 02

Abstract: Objective—This study seeks to better understand the prevalence and severity of secondary health conditions in individuals with post-polio syndrome (PPS), and the association between these conditions and aging.

Design—A scoping literature review was conducted searching electronic databases for studies published from 1986 – 2011. The scoping review provided information regarding the prevalence and associations of secondary health conditions in PPS with age or other duration-related variables.

Results—The findings indicate that: (1) individuals with PPS experience a number of serious secondary health conditions; (2) the most common conditions or symptoms are fatigue, pain, respiratory and sleep complaints, and increased risk of falls; (3) reports of the associations between the frequency or severity of conditions and age-related factors are variable, perhaps because of methodological inconsistencies between studies; and (4) there is a marked lack of longitudinal research examining the natural course of health conditions in people aging with PPS.

Conclusions—Longitudinal research is needed to understand the course of health conditions and the impact of multiple secondary conditions in people aging with PPS. Efforts are also needed to develop and test the efficacy of interventions to prevent these health secondary conditions or reduce their negative impact.

Keywords
Post-Polio Syndrome; Secondary Conditions; Aging; Scoping Review

Conclusions: The key findings from this scoping review include the following: (1) people with PPS experience a large number of serious secondary health conditions, including fatigue, pain, depression, muscle weakness, pulmonary and sleep disorders, and falls; (2) although comparisons with normative samples are rare, one study suggests that depression has a greater impact on the lives of people with PPS than on the general population; and (3) a number of methodological issues limit our ability to interpret the findings related to the associations between secondary conditions and aging.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio

Title: Post-polio syndrome and risk factors in Korean polio survivors: a baseline survey by telephone interview
Author: Bang H (1), Suh JH (2), Lee SY (3), Kim K (1), Yang EJ (1), Jung SH (1), Jang SN (4), Han SJ (2), Kim WH (5), Oh MG (6), Kim JH (5), Lee SG (7), Lim JY (1)
Affiliation: (1) Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Korea; (2) Department of Rehabilitation Medicine, Ewha Womans University Medical Center, Seoul, Korea; (3) Department of Physical Medicine and Rehabilitation, Soonchunhyang University Bucheon Hospital, Bucheon, Korea; (4) Red Cross College of Nursing, Chung-Ang University, Seoul, Korea; (5) Department of Rehabilitation Medicine, National Rehabilitation Center, Seoul, Korea; (6) Department of Rehabilitation Medicine and Institute of Health Science, Gyeongsang National University College of Medicine, Jinju, Korea; (7) Department of Physical Medicine and Rehabilitation, Research Institute of Medical Sciences, Chonnam National University College of Medical School, Gwangju, Korea
Journal: Annals of Rehabilitation Medicine
Citation: Ann Rehabil Med. 2014 Oct;38(5):637-47. doi: 10.5535/arm.2014.38.5.637
Publication Year and Month: 2014 10

Abstract: OBJECTIVE: To obtain information on the socioeconomic, medical, and functional status of polio survivors, and to use these results as the preliminary data for establishing the middle-aged cohort of polio survivors.

METHODS: The subjects were recruited based on the medical records of multiple hospitals and centers. They were assessed through a structured questionnaire over the phone. Post-poliomyelitis syndrome (PPS) was identified according to the specified diagnostic criteria. Differences between polio survivors with or without PPS were evaluated, and the risk factors for PPS were analyzed by the odds ratio (OR).

RESULTS: Majority of polio survivors were middle-aged and mean age was 51.2±8.3 years. A total of 188 out of 313 polio survivors met the adopted criteria for PPS based on the symptoms, yielding a prevalence of 61.6%. Mean interval between acute poliomyelitis and the development of PPS was 38.5±11.6 years. Female gender (OR 1.82; confidence interval [CI] 1.09-3.06), the age at onset of poliomyelitis (OR 1.75; CI 1.05-2.94), the use of orthoses or walking aids (OR 2.46; CI 1.44-4.20), and the history of medical treatment for paralysis, pain or gait disturbance (OR 2.62; CI 1.52-4.51) represented independent risk factors for PPS.

Conclusions: We found that the majority of Korean polio survivors entered middle age with many medical, functional, and social problems. Female gender, early age of onset of poliomyelitis, the use of orthoses or walking aids, and the history of medical treatment for paralysis, pain or gait disturbance were identified as the significant risk factors for PPS. A comprehensive and multidisciplinary plan should be prepared to manage polio survivors considering their need for health care services and the risk factors for late effects, such as PPS.

Outcome of Research: Not applicable

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio

Title: Psoriasis sparing the lower limb with postpoliomyelitis residual paralysis
Author: Wang TS (1), Tsai TF
Affiliation: (1) Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
Journal: British Journal of Dermatology
Citation: Br J Dermatol. 2014 Aug;171(2):429-31. doi: 10.1111/bjd.12854
Publication Year and Month: 2014 08

Abstract: This paper does not have an abstract.

Conclusions:

Outcome of Research: Not applicable

Availability of Paper: Paid subscription required to view or download full text.

Comments (if any):

Link to Paper (if available): Click here for preview


Category: Late Effects of Polio

Title: Living with polio and postpolio syndrome in the United Kingdom
Author: Atwal A (1), Giles A, Spiliotopoulou G, Plastow N, Wilson L
Affiliation: (1) School of Health Science and Social Care, Brunel University, Kingston Lane, Uxbridge, Middlesex, London, UK - [email protected]

Journal: Scandinavian Journal of Caring Sciences
Citation: Scand J Caring Sci. 2013 Jun;27(2):238-45. doi: 10.1111/j.1471-6712.2012.01029.x
Publication Year and Month: 2013 06

Abstract: The term Postpolio Syndrome (PPS) is used to describe new and late manifestations of poliomyelitis that occur later in life in polio survivors. Polio had been eradicated in the United Kingdom (UK) and most of Europe, although this is not the case in all countries. Research in this area has tended to focus upon the impact of polio and PPS on health status and functional health rather than its overall effect on people's lives. This study's two main aims were to explore the ways in which polio and PPS in the UK has affected the respondents' lives and to ascertain their views about how the quality of life could be improved. The two questions were as follows: (1) How has the health of people with polio and PPS affected their quality of life? (2) What would people with polio and PPS change to improve their quality of life? Deductive content analysis using existing qualitative data from a cross-sectional survey of 336 returned questionnaires from persons with polio and PPS was carried out. The average age of the participants was 54 years. Our research found that polio survivors valued social occupations and participation in family life. Our research has also shown that healthcare professionals still do not understand polio and PPS and this lack of understanding influences their clients' quality of life. Finances and accessibility of environments also influence participation in chosen occupations. Rehabilitation programmes for people with polio and PPS need to be targeted towards maintaining and improving accessible environments and participation in chosen occupations, and healthcare professionals need to ensure that persons with polio and PPS are referred to persons with specific expertise in this area.

Conclusions:

Outcome of Research: Not applicable

Availability of Paper: Paid subscription required to view or download full text.

Comments (if any):

Link to Paper (if available): Click here to view Abstract


Category: Assistive Technology, Late Effects of Polio

Title: Coping with a Second Disability: Implications of the Late Effects of Poliomyelitis for Occupational Therapists
Author: Mary Westbrook, Lynette McDowell
Affiliation: Macquarie University, Sydney. Australia
Journal: Australian Occupational Therapy Journal
Citation: 38(2):83 - 91
Publication Year and Month: 2010 08

Abstract: The long term effects of many physical disabilities have only recently begun to be appreciated. For people who have lived for years with what they thought to be stable conditions, the onset of secondary disabilities may be associated with considerable problems and distress. A questionnaire survey of 324 people with poliomyelitis revealed the occurrence of late effects in 94% of respondents. The majority reported increased weakness, pain and fatigue, problems in carrying out daily living activities and difficulties in obtaining appropriate health care. Although occupational therapists were less likely to be consulted than other professionals, they received one of the highest satisfaction ratings from clients.

Conclusions: Discussion of case studies indicates ways in which occupational therapists can provide symptom relief and enable clients to maintain valued roles. As the survival rates of people with disabilities increase there is a need for greater awareness of, and research into, the late effects of disability.

Outcome of Research: More research required

Availability of Paper:

Comments (if any):

Link to Paper (if available): Click here for preview


Category: Dysphagia, Dysphonia, Late Effects of Polio

Title: Pharyngolaryngeal manifestations of post-polio syndrome (Manifestações faringo-laríngeas da síndrome pós-poliomielite)
Author: Noemi Grigoletto De Biase (1), Bruno Teixeira de Moraes (2), Mariana Dantas Aumond Leb (3), Gustavo Polacow Korn (4), Marina Padovani (5), Miriam Moraes (6), Glaucya Madazio (7).
Affiliation: Departament of Laryngology and Voice of the Discipline of Otorhinolaryngology of Federal University of São Paulo - Medical School Paulista (UNIFESP-EPM). São Paulo / SP - Brazil

1) Prof. Doc. Associate of Departament of Fundamentals of Phonoaudiology of Pontifical Catholic University of São Paulo. Advisor of Masters Degree of UNIFESP-EPM.

2) Fellow in Larynx and Voice by the Departament of Otorhinolaryngology and Surgery of Head and Kneck by Federal University of São Paulo - Medical School Paulista (UNIFESP-EPM). Doctor Otorhinolaryngologist.

3) Master in Medicine by UNIFESP-EPM. Doctor Otorhinolaryngologist.

4) PhD in Science by the Departament of Otorhinolaryngology and Surgery of Head and Kneck by Federal University of São Paulo - Medical School Paulista (UNIFESPEPM). Doctor Otorhinolaryngologist.

5) PhD in Science of Human Communication by UNIFESP. Clinical Audiologist.

6) Master in Science of Human Communication by UNIFESP - Clinical Audiologist.

7) PhD in Science of Human Communication by UNIFESP. Clinical Audiologist.
Journal: NEW - PUT DETAILS IN CITATION FIELD
Citation: Intl. Arch. Otorhinolaryngol., São Paulo - Brasil, v.15, n.4, p. 529-533, Oct/Nov/December - 2011.
Publication Year and Month: 2010 04

Abstract: INTRODUCTION: The post-polio syndrome (PPS) is characterized by a new episod of atrophy or muscle weakness in individuals previously affected by poliomyelitis. The symptoms start from an extended period of clinical stability ranging from 20 to 40 years, after the initial chart of polio. Among the pathophysiological mechanisms, the most likely is that the syndrome represents a process of attrition and neuronal metabolic exhaustion due to a continuous process of denervation reinnervation which begins after the initial acute.

OBJECTIVE: Review the clinical characteristics and pathophysiological of PPS,as well as present the approach in cases with pharyngolaryngeal manifestations.

CASE REPORT: We present the clinical case of a male patient with 48 years old, with main complaints of dysphonia, dysphagia and previous history of polio. The patient underwent a diagnostic investigation, in which the voice psychoacoustic findings are described. Laringoscopic, electromyographic and the videoendoscopy of swallowing compatible with PPS. The treatment consisted in phonotherapy in a total of 11 weekly sessions and guidelines for swallowing, with satisfactory improvement of the symptoms.

FINAL COMMENTS: The pharyngolaryngeal manifestations of PPS are susceptible to treatment, obtaining satisfactory results, with improvement of life quality of the patients.

KEYWORDS: poliomyelitis, post-polio syndrome, neuromuscular diseases, larynx diseases, voice disorders.

Conclusions: The diagnosis of PPS depends of the high rate of suspicion and a good anamnesis, in which the patient reports previous history of poliomyelitis. As in the most of the cases these patients present other commemorative resulting of the syndrome, voice alterations become less evident before the whole picture. Active searches in services of references in treatment of PPS can show that the frequency of dysphonia and dysphagia maybe is bigger than the ones described in the literature. Considering that the laryngeal-pharyngeal manifestations of PPS are suitable for treatment with improvement of life quality of the patients, is evident the importance of the diagnosis.

Outcome of Research: Not applicable

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio, Quality of Life

Title: Relationship between participation in life situations and life satisfaction in persons with late effects of polio
Author: Maria Larsson Lund & Jan Lexell
Affiliation: Maria Larsson Lund - Department of Community Medicine and Rehabilitation, Occupational Therapy, Umeå University, Umeå, Sweden Correspondence: [email protected]

Jan Lexell - Department of Rehabilitation Medicine, Lund University Hospital, Lund, Sweden; Division of Rehabilitation Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden; Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
Journal: Disability and Rehabilitation
Citation: 31(19), 1592–1597. https://doi.org/10.1080/09638280802638881
Publication Year and Month: 2009 09

Abstract:
Purpose. To assess the relationship between participation and problems with participation in life situations, and life satisfaction in persons with late effects of polio.

Methods. One hundred fifty-eight persons with late effects of polio responded to a postal questionnaire including the Swedish versions of the Impact on Participation and Autonomy Questionnaire (IPA-S) and Life Satisfaction Questionnaire (LiSat-11).

Results. The persons' perceived participation in the five domains of participation in the IPA-S was significantly correlated with their satisfaction with life as a whole and with most of the 10 domains of life satisfaction. Significant differences in satisfaction with life as a whole and with eight of the 10 domains in LiSat-11 were found between groups of increasing severe problems with participation. Greater number of reports of severe problems with participation corresponded with gradually decreased satisfaction with life as a whole and with satisfaction in the eight domains in LiSat-11.

Keywords: Activities of daily living, disability evaluation, disabled persons, personal autonomy, postpoliomyelitis syndrome, rehabilitation, quality of life

Conclusions: Perceived participation and problems with participation in life situations are determinants of life satisfaction in persons with late effects of polio. This implies that addressing participation and problems with participation in the rehabilitation of persons with late effects of polio may lead to an enhanced life satisfaction.

Outcome of Research: More research required

Availability of Paper: Paid subscription required to view or download full text.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio, Surgery

Title: Physical Therapist Management Following Rotator Cuff Repair for a Patient With Postpolio Syndrome
Author: Mary Carlson, Tana Hadlock
Affiliation: M Carlson, PT, PhD, is Associate Professor, Physical Therapy Program,
University of Texas at El Paso, 1101 N Campbell, El Paso, TX 79902 (USA).

T Hadlock, MA, OTR, is Instructor, Occupational Therapy Program, Yamaguchi Health and Welfare College, Ube City, Yamaguchi Prefecture, Japan.
Journal: PTJ: Physical Therapy & Rehabilitation Journal (Prior to 2021, was titled Physical Therapy)
Citation: Phys Ther. 2007;87:179–192.
https://doi.org/10.2522/ptj.20050200
Publication Year and Month: 2007 02

Abstract: Background and Purpose
Postpoliomyelitis sequelae, such as gait instability and progressive weakness, predispose people with postpolio syndrome to secondary disabilities. With aging, people who depend on their upper extremities to accommodate lower-extremity deficits may anticipate overuse injuries. The purpose of this case report is to describe the use of mobilization and exercise in postoperative rehabilitation of rotator cuff surgery on a patient with postpolio syndrome.

Case Description
A 48-year-old woman with postpolio syndrome had rotator cuff surgical repair followed by physical therapy intervention. Maitland mobilization and mild functional exercises were chosen to avoid triggering fatigue.

Outcomes
Measurements taken preoperatively, before and after physical therapy intervention, and 2 years after intervention showed return to independent status with excellent retention.

Discussion
No fatigue or overuse weakness was encountered. This is the first case report to document physical therapy following rotator cuff repair in a patient with postpolio syndrome.

Conclusions: In summary, this is the first case report to document the effects of physical therapy in a patient with PPS who had a rotator cuff tear resulting from extended use due to postpolio sequelae. The physical therapist used a Maitland technique with functional active exercises for the patient. The physical therapist additionally emphasized communication and used the patient responses to adjust treatment. The patient was knowledgeable about her condition and was able to be an active partner of the rehabilitation team, monitor fatigue, and modify her exercises and activities as needed. Additionally, the change between her status immediately following rehabilitation and 2 years later showed continued progress in strength and ROM. We believe that the combination of good practitioner/patient communication, use of the Maitland technique to increase joint ROM without patient effort, and careful selection of a few functionally important active and resistive exercises contributed to the success of this patient’s rehabilitation.

Future research might use a single-subject research design for multiple individuals with PPS who have rehabilitation following orthopedic surgery. A standardized functional survey would strengthen the design, and a handheld dynamometer could be used to quantify muscle strength in lieu of the BTE device. The single-subject design is stronger than the case report and can infer an effect of the intervention on the outcome.

Outcome of Research: More research required

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio

Title: Prevalence and risk factors of post-polio syndrome in a cohort of polio survivors.
Author: Paolo Ragonese, Brigida Fierro, Giuseppe Salemi, Giovanna Randisi, Daniela Buffa, Marco D'Amelio, Antonella Aloisio, Giovanni Savettieri
Affiliation: Dipartimento di Neurologia, Oftalmologia, Otorinolaringoiatria e Psichiatria, Università di Palermo, Italy.
Journal: Journal of the Neurological Sciences
Citation: 2005 Sep 15;236(1-2):31-5.
Publication Year and Month: 2005 09

Abstract: OBJECTIVE:
To investigate frequency and associated factors of post polio syndrome (PPS) in an Italian cohort of people with prior poliomyelitis.

METHODS:
We screened subjects admitted for poliomyelitis at the paediatric hospital of the University of Palermo during the time frame 1945-1960. Patients who developed PPS were identified through a structured questionnaire and a neurologic examination. PPS diagnosis was made according to specified diagnostic criteria. Frequency of PPS was calculated in the selected cohort of polio survivors. The association with the investigated risk factors (sex, age at onset of polio, extension and severity of polio, education, associated diseases, cigarette smoking, trauma, polio vaccination) was analysed by the calculation of the odds ratio.

RESULTS:
Forty-eight participants met the adopted diagnostic criteria for PPS, giving a prevalence of 31.0%. The prevalence rate was significantly higher in women than in men (p=0.02). Logistic regression analyses revealed a significant inverse association with onset of poliomyelitis at over 12 months of age (OR 0.33; CI 0.14-0.79) a higher degree of education (OR 0.20; CI 0.07-0.79), and a significant association with the presence of other diseases (OR 9.86; CI 3.69-26.34).

Conclusions: CONCLUSIONS:
In our survey one-third of patients with prior poliomyelitis had PPS. Higher age at onset of poliomyelitis is inversely associated with PPS. The association with other diseases may indicate that a chronic physical stress, particularly in already weak motor units, can contribute to the development of signs and symptoms of PPS. Our results also suggest the impact of socio-economic conditions on the risk of PPS.

Outcome of Research: More research required

Availability of Paper:

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio

Title: Risk of symptoms related to late effects of poliomyelitis
Author: Rekand T, Albrektsen G, Langeland N, Aarli JA
Affiliation: Department of Neurology, Haukeland Hospital, Bergen, Norway
Journal: Acta Neurologica Scandinavica
Citation: Acta Neurol Scand. 2000 Mar;101(3):153-8
Publication Year and Month: 2000 03

Abstract: OBJECTIVE: To compare the risk of developing symptoms related to late effects of poliomyelitis between polio patients and persons of similar age and sex without history of poliomyelitis.

MATERIAL AND METHODS: The study comprised information on 148 patients with prior poliomyelitis and 115 persons with no history of poliomyelitis. Information was obtained by questionnaire and analyzed by multiple logistic regression method.

RESULTS: The risk of experiencing two or more symptoms was significantly higher among the polio patients than among the persons without history of poliomyelitis. The elevation in risk was less pronounced in the nonparalytic group (OR = 2.35; 95% CI = 0.92-5.97) than the group with permanent muscular weakness (OR = 8.84; 95% CI =4.32-18.09).

Conclusions: Although symptoms defined in the PPS are unspecific and may occur in the general population, the risk for developing such symptoms are higher among the polio victims. The difference in risk among nonparalytic and paralytic patients may depend on the extent of motor neuron damage in the acute stage.

Outcome of Research: Not applicable

Availability of Paper: Paid subscription required to view or download full text.

Comments (if any):

Link to Paper (if available): Click here to view Abstract


Category: Late Effects of Polio

Title: Late functional deterioration following paralytic poliomyelitis
Author: D. Kidd, R.S. Howard, A.J. Williams, F.W. Heatley, C.P. Panayiotopoulos and G.T. Spencer
Affiliation: Departments of Neurology, Respiratory Medicine and Orthopaedics, the Lane-Fox Unit, St Thomas' Hospital, London, UK
Journal: Post-Polio Network (NSW) Inc
Citation: QJ Med 1997; 90: 189 - 196
Publication Year and Month: 1997 01

Abstract: Many patients with previous poliomyelitis develop 'post-polio syndrome' (PPS) in which late functional deterioration follows a period of relative stability. The frequency with which PPS can be attributed to clearly defined causes remains uncertain. We reviewed 283 newly-referred patients with previous poliomyelitis seen consecutively over a 4-year period; 239 patients developed symptoms of functional deterioration at a mean of 35 (5-65) years after the paralytic illness. Functional deterioration was associated with orthopaedic disorders in 170 cases, neurological disorders in 35, respiratory disorders in 19 and other disorders in 15. Progressive post-polio muscular atrophy was not observed. Functional deterioration following paralytic poliomyelitis is common, and associated with orthopaedic, neurological, respiratory and general medical factors which are potentially treatable.

Conclusions:

Outcome of Research: Not applicable

Availability of Paper: The full text of this paper has been generously made available by the publisher.

Comments (if any):

Link to Paper (if available): Click here to view full text or to download


Category: Late Effects of Polio

Title: New problems in old polio patients: results of a survey of 539 polio survivors
Author: Halstead LS, Rossi CD
Affiliation: Not stated
Journal: Orthopedics
Citation: Orthopedics. 1985 Jul; 8(7):845-50
Publication Year and Month: 1985 07

Abstract: Presented are the results of a questionnaire survey on new health problems in 539 polio survivors. The most common new problems were fatigue, weakness in previously affected and unaffected muscles, muscle pain, and joint pain. The median time from polio to the onset of these problems ranged from 30 to 40 years. Factors at onset of polio most strongly associated with developing these new health problems were: being hospitalized, being over 10 years old, being on a ventilator, and having paralytic involvement of all four limbs. The differential diagnoses of these new problems, implications for treatment and areas for future research are discussed.

Conclusions:

Outcome of Research:

Availability of Paper:

Comments (if any):

Link to Paper (if available):


Category: Late Effects of Polio

Title: Polio: long-term problems
Author: Perry J, Fleming C
Affiliation: Not stated
Journal: Orthopedics
Citation: Orthopedics. 1985 Jul; 8(7):877-81
Publication Year and Month: 1985 07

Abstract: The most common long-term problems seen in polio are brace problems, knee recurvatum, increasing weakness due to overuse and ankle equinus. A definite increased incidence of problems is seen after the patient is more than 30 years post-polio. The basis for most of these problems is chronic mechanical strain of weak musculature and substituting ligaments. Overuse can cause increasing weakness resulting in pain and decreasing function. It is therefore important to follow polio patients closely, especially those that are more than 30 years post-polio. If signs of overuse or chronic mechanical strain are noted, treatment should not be delayed.

Conclusions:

Outcome of Research:

Availability of Paper:

Comments (if any):

Link to Paper (if available):


There are currently 34 papers in this category.

Outcomes of Research or Clinical Trials Activity Levels Acute Flaccid Paralysis Ageing Anaerobic Threshold Anaesthesia Assistive Technology Brain Cardiorespiratory Cardiovascular Clinical Evaluation Cold Intolerance Complementary Therapies Continence Coping Styles and Strategies Cultural Context Diagnosis and Management Differential Diagnosis Drugs Dysphagia Dysphonia Epidemiology Exercise Falls Fatigue Fractures Gender Differences Immune Response Inflammation Late Effects of Polio Muscle Strength Muscular Atrophy Orthoses Pain Polio Immunisation Post-Polio Motor Unit Psychology Quality of Life Renal Complications Respiratory Complications and Management Restless Legs Syndrome Sleep Analaysis Surgery Vitality Vocational Implications