{"id":13270,"date":"2015-03-28T11:18:58","date_gmt":"2015-03-28T00:18:58","guid":{"rendered":"http:\/\/www.poliohealth.org.au\/?page_id=13270"},"modified":"2017-09-15T14:59:11","modified_gmt":"2017-09-15T04:59:11","slug":"post-polio-research-papers-sorted-by-journal","status":"publish","type":"page","link":"https:\/\/www.poliohealth.org.au\/research-sorted-by-journal\/","title":{"rendered":"Post-Polio Research Papers – Sorted by Journal"},"content":{"rendered":"
Title: <\/span>Stimulation frequency-dependent neuromuscular junction transmission defects in patients with prior poliomyelitis Abstract: <\/span>Generalized fatigue and muscle fatiguability are major symptoms of post-poliomyelitis syndrome (PPS), and may be due to neuromuscular junction transmission defects, as suggested by increased jitter on single fiber electromyography (SFEMG). To determine the etiology of this defect, we studied jitter at low (1, 5 Hz) and high (10, 15, 20 Hz) frequency stimulation with stimulation SFEMG in 17 post-polio patients with muscle fatiguability, and in 9 normal controls. In 5 of 17 PPS patients and in 1 of 9 controls, jitter was significantly higher (unpaired t-test, P < 0.05) at high frequency stimulation (HFS). In the remaining PPS patients and controls there was no significant difference in jitter at high and low stimulation frequencies. PPS patients with increased jitter at HFS had a significantly longer time interval since acute polio (mean 48.5 years) than PPS patients without increased jitter at HFS (mean 40 years; P < 0.05), but were not distinguished by other historical or clinical criteria. We conclude that the neuromuscular junction defect in post-polio patients is similar to that observed in amyotrophic lateral sclerosis, and is probably due to ineffective conduction along immature nerve sprouts and exhaustion of acetylcholine stores. The appearance of an increase in jitter with HFS in post-polio patients may be dependent upon time after acute polio.<\/p>\n Conclusions: <\/span><\/p>\n Outcome of Research: <\/span>Not applicable<\/p>\n Comments<\/span> (if any)<\/span>:<\/span> The full text of this paper has been generously made available by the publisher.<\/p>\n Link to Full Paper<\/span> (if available)<\/span>:<\/span> Click here to view full text or to download<\/a><\/p>\n Title: <\/span>An Open Trial of Pyridostigmine in Post-poliomyelitis Syndrome Abstract: <\/span>Background: One of the major symptoms of postpoliomyelitis syndrome (PPS) is disabling generalized fatigue. Subjects with PPS also report muscle fatiguability and display electrophysiologic evidence of anticholinesterase-responsive neuromuscular junction transmission defects, suggesting that anticholinesterase therapy may be useful in the management of disabling fatigue. Methods: We initiated an open trial of the oral anticholinesterase pyridostigmine, up to 180 mg per day, in 27 PPS patients with generalized fatigue and muscle fatiguability. Response to Pyridostigmine was assessed with the Hare fatigue scale, the modified Barthel index for activities of daily living, and a modified Klingman mobility index. Results: Two patients could not tolerate the medication. After one month of therapy, 16 patients (64%) reported a reduction in fatigue on the Hare fatigue scale; three of 16 showed improvement on the modified Barthel index for activities of daily living, and two of 16 experienced improvement on a modified Klingman mobility index. Pyridostigmine responders were significantly more fatigued than non-responders on the pre-treatment Hare score, but were not significantly different with regard to age, sex, age at acute poliomyelitis, or severity of acute poliomyelitis. Conclusions: Pyridostigmine may be useful in the management of fatigue in selected patients with PPS. Response to pyridostigmine may be predicted by severity of pre-treatment fatigue.<\/p>\n Conclusions: <\/span><\/p>\n Outcome of Research: <\/span>Not applicable<\/p>\n Comments<\/span> (if any)<\/span>:<\/span> The full text of this paper has been generously made available by the publisher.<\/p>\n Link to Full Paper<\/span> (if available)<\/span>:<\/span> Click here to view full text or to download<\/a><\/p>\n Title: <\/span>Stress and \"Type A\" Behavior as Precipitants of Post-Polio Sequelae: The Felician\/Columbia Survey Abstract: <\/span>A behavioral profile has begun to emerge from studies of persons who survived acute poliomyelitis and are now experiencing post-polio sequelae. Persons who had polio have been shown to be employed full time at four times the rate of the general disabled population (1,2). Persons who had polio have more years of formal education on average than the general population (3), and marry at approximately the same rate as those who are not disabled (4). These data, combined with our own experience with thousands of persons who had polio, indicated that \"polio survivors\" are competent, hard-driving and time-conscious overachievers who demand perfection in all aspects of their personal, professional, and social lives. It appeared that those who survived polio exhibit \"Type A\" behavior and would therefore experience chronic emotional stress. Conclusions: <\/span><\/p>\n Outcome of Research: <\/span>Not applicable<\/p>\n Comments<\/span> (if any)<\/span>:<\/span> The full text of this paper has been generously made available by the publisher.<\/p>\n Link to Full Paper<\/span> (if available)<\/span>:<\/span> Click here to view full text or to download<\/a><\/p>\n Title: <\/span>Gait Analysis Techniques Abstract: <\/span>In the gait laboratory at Rancho Los Amigos Hospital, the emphasis is on patient testing to identify functional problems and determine the effectiveness of treatment programs. Footswitch stride analysis, dynamic EMG, energy-cost measurements, force plate, and instrumented motion analysis are the techniques most often used. Stride data define the temporal and distance factors of gait. We use this information to classify the patient's ability to walk and measure response to treatment programs. Inappropriate muscle action in the patient disabled by an upper motor neuron lesion is identified with dynamic EMG. Intramuscular wire electrodes are used to differentiate the action of adjacent muscles. We use the information to localize the source of abnormal function so that selection of treatment procedures is more precise. Force and motion data aid in determining the functional requirement and the muscular response necessary to meet the demand. Determining the optimum mode of locomotion and developing criteria for program planning have become more realistic with the aid of energy-cost measurements. Microprocessors and personal computer systems have made compact and reliable single-concept instrumentation available for basic gait analysis in the standard clinical environment at a modest cost. The more elaborate composite systems, however, still require custom instrumentation and engineering support.<\/p>\n Conclusions: <\/span>This review of the RLAH gait laboratory has emphasized our clinical focus on patient care. Research projects have followed two directions. Technical developments have related to developing the footswitch, energy cost, and dynamic EMG systems. Functional research has assessed normal performance to provide baselines for interpreting pathological activities.<\/p>\n Outcome of Research: <\/span>Not applicable<\/p>\n Comments<\/span> (if any)<\/span>:<\/span> The full text of this paper has been generously made available by the publisher.<\/p>\n Link to Full Paper<\/span> (if available)<\/span>:<\/span> Click here to view full text or to download<\/a><\/p>\n Title: <\/span>Endurance Training Effect on Individuals With Postpoliomyelitis Abstract: <\/span>Objective: To determine the effects of an endurance training program on the exercise capacity and muscle structure and function in individuals with postpolio syndrome. Conclusions: <\/span>Results: Knee extension was reduced to an average of 60% of control values and did not change with training. Strength measured with a hand-held Myometer increased significantly for elbow flexion, wrist extension, and hip abduction. Exercise test on a bicycle-ergometer showed significant reduction (6 beats\/min) in heart rate at 70W and increase (12 beats\/min) in maximal heart rate with training. The training program could be performed without major complications and resulted in an increase in muscle strength in some muscle groups and in work performance with respect to heart rate at submaximal work load.<\/p>\n Outcome of Research: <\/span><\/p>\n Comments<\/span> (if any)<\/span>:<\/span> The full text of this paper has been generously made available by the publisher.<\/p>\n Link to Full Paper<\/span> (if available)<\/span>:<\/span> Click here to view full text or to download<\/a><\/p>\n Title: <\/span>Findings in Post-Poliomyelitis Syndrome Abstract: <\/span>The purpose of this study was to identify overuse of muscles and other alterations in the mechanics of gait in twenty-one patients who had muscular dysfunction as a late consequence of poliomyelitis. All of the patients had good or normal strength (grade 4 or 5) of the vastus lateralis and zero to fair strength (grade 0 to 3) of the calf, as determined by manual testing. Conclusions: <\/span><\/p>\n Outcome of Research: <\/span><\/p>\n Comments<\/span> (if any)<\/span>:<\/span> The full text of this paper has been generously made available by the publisher.<\/p>\n Link to Full Paper<\/span> (if available)<\/span>:<\/span> Click here to view full text or to download<\/a><\/p>\n Title: <\/span>Gait patterns in association with underlying impairments in polio survivors with calf muscle weakness Abstract: <\/span>The objective was to identify gait patterns in polio survivors with calf muscle weakness and associate them to underlying lower extremity impairments, which are expected to help in the search for an optimal orthosis. Conclusions: <\/span><\/p>\n Outcome of Research: <\/span>Effective<\/p>\n Comments<\/span> (if any)<\/span>:<\/span> Paid subscription required to view or download full text.<\/p>\n Link to Full Paper<\/span> (if available)<\/span>:<\/span> Click here to view Abstract<\/a><\/p>\n Title: <\/span>Effect of aquatic exercise training in persons with poliomyelitis disability Abstract: <\/span>Aquatic exercise, including swimming, reduces the effect of body weight on limbs and joints. A combination of swimming and specific activities involving resistive devices was used in an attempt to improve strength in persons who had symptomatic weakness related to poliomyelitis. Dynamic muscular force application in selected limb movements and range of motion were measured before and after an 8\u2010week aquatic exercise intervention. Peak (PF) and average force (AF) were determined in the water using a differential pressure transducer attached to either the hand, foot, or a resistive device. Arm flexion, extension, adduction, abduction, and horizontal adduction and abduction along with combined hip flexion and knee extension were tested for both PF and AF Subjects were randomly assigned to experimental and control groups; complete data were available on nine experimental and four control subjects. PF and AF changes were greater (p ≤ 0.05) for experimental compared with control for right arm flexion (PF, 96 versus 6%) and extension (PR 105 versus \u201015%; AF, 76 versus \u201030%), respectively. Changes were greater (p ≤0.05) in experimental than control for left arm extension (PF, 88% versus 19%) and horizontal abduction (PF, 127% versus \u201021%; AF, 122% versus \u201017%). Aquatic exercise training in subjects with poliomyelitis disability resulted in significant dynamic strength changes of the upper body while appearing not to exacerbate symptomatic fatigue or pain.<\/p>\n Conclusions: <\/span>Aquatic exercise training in subjects with poliomyelitis disability resulted in significant dynamic strength changes of the upper body while appearing not to exacerbate symptomatic fatigue or pain.<\/p>\n
\nAuthor: <\/span>Daria A. Trojan, Daniel Gendron and Neil R. Cashman
\nAffiliation: <\/span>Department of Neurology, McGill University, Montreal Neurological Institute and Hospital
\nJournal: <\/span><\/span>
\nCitation: <\/span>Journal of the Neurological Sciences, 118 (1993) 150-157
\nPublication Year and Month: <\/span>1993 03<\/p>\n
\nCategory: <\/span>Drugs<\/p>\n
\nAuthor: <\/span>Daria A. Trojan and Neil R. Cashman
\r\n
\r\n
\nAffiliation: <\/span>From the Department of Neurology, Montreal Neurological Institute and Hospital, McGill University, Montreal.
\nJournal: <\/span><\/span>
\nCitation: <\/span>The Canadian Journal of Neurological Sciences Volume 22, No. 3 August 1995 223-227
\nPublication Year and Month: <\/span>1995 08<\/p>\n
\nCategory: <\/span>Psychology<\/p>\n
\nAuthor: <\/span>Richard L. Bruno, PhD, and Nancy M. Frick, MDiv, LhD
\nAffiliation: <\/span>
\nJournal: <\/span><\/span>
\nCitation: <\/span>In LS Halstead and DO Wiechers (Eds.): Research and Clinical Aspects of the Late Effects of Poliomyelitis. White Plains: March of Dimes Research Foundation, 1987.
\nPublication Year and Month: <\/span>1987 <\/p>\n
\r\n
\r\nThe notion that individuals who had polio exhibit \"Type A\" behavior and experience chronic stress was thought to be extremely important for an understanding of the pathophysiology and treatment of post-polio sequelae (PPS). Animal studies have demonstrated that stress accelerates the onset of muscle fatigue (5), augments age-related decreases in the terminal axon branch number (6), and accelerates age-related losses of neurons (7). Therefore, this study was designed to test 2 hypotheses: 1) persons who had poliomyelitis exhibit \"Type A\" behavior and symptoms pathognomonic of chronic stress, and 2) \"Type A\" behavior and stress precipitate or exacerbate PPS.<\/p>\n
\nCategory: <\/span>Orthoses<\/p>\n
\nAuthor: <\/span>JoAnne K. Gronley and Jacquelin Perry
\r\n
\nAffiliation: <\/span>Physical Therapist, Pathokinesiology Service, Rancho Los Amigos Hospital; Director, Pathokinesiology Service, Rancho Los Amigos Hospital, and Professor of Orthopaedic Surgery, University of Southern California
\nJournal: <\/span><\/span>
\nCitation: <\/span>The Journal of American Physical Therapy Assn. Vol. 63, No. 12, December 1984 1831-1838
\nPublication Year and Month: <\/span>1984 12<\/p>\n
\nCategory: <\/span>Exercise<\/p>\n
\nAuthor: <\/span>Brian Ernstoff, MD, Hakon Wetterqvist, MD, PhD, Henry Kvist, MD, PhD, Gunnar Grimby, MD, PhD
\nAffiliation: <\/span>
\nJournal: <\/span><\/span>
\nCitation: <\/span>Ernstoff B, Wetterqvist H, Kvist H, Grimby G. Endurance training effect on individuals with postpoliomyelitis. Arch Phys Med Rehabil 1996;77:843-8.
\nPublication Year and Month: <\/span>1996 <\/p>\n
\r\n
\r\nDesign: Preexercise and postexercise testing was performed with muscle strength evaluations using isokinetic testing as well as hand-held Myometer. Muscle fatigue was determined by use of isokinetic testing, and endurance was determined by exercise testing. Enzymatic evaluation was performed with muscle biopsies taken at the same site; preexercise and postexercise muscle cross-sectional area was measured by computed tomography. Disability and psychosocial evaluation was performed by a Functional Status Questionnaire.
\r\n
\r\nSetting: A university.
\r\n
\r\nSubjects: Seventeen postpolio subjects ranging in age from 39 to 49 years volunteered for a 6-month combined endurance and strength training program. They had a history of acute poliomyelitis at least 25 years earlier and were able to walk with or without aid.
\r\n
\r\nIntervention: Twelve of the subjects (mean age 42 years) completed the program, attending an average of 29 sessions, which were offered for 60 minutes twice a week.
\r\n
\r\nMain Outcome Measures: Strength, endurance, enzymatic activity, and cross-sectional area were measured 3 months before the beginning of training, just before training, and at the completion of the exercise program.
\r\n<\/p>\n
\nCategory: <\/span>Orthoses<\/p>\n
\nAuthor: <\/span>Perry, J.P., Fontaine, J.D., Mulroy, S., Downey, P.T.
\nAffiliation: <\/span>Pathokinesiology Service, Rancho Los Amigos Medical Center, Downey
\nJournal: <\/span><\/span>
\nCitation: <\/span>The Journal of Bone and Joint Surgery Vol. 77-A, No. 8, August 1995, 1148-1153
\nPublication Year and Month: <\/span>1995 08<\/p>\n
\r\n
\r\nDynamic electromyography was used, while the patients were walking, to quantify the intensity and duration of contraction of the inferior part of the gluteus maximus, the long head of the biceps femoris. the vastus lateralis, and the soleus muscles. Patterns of contact of the foot with the floor, temporal-spatial parameters, and motion of the knee and ankle were recorded.
\r\n
\r\nThe principal mechanisms of substitution for a weak calf muscle fell into three groups: overuse of the quadriceps (twelve patients) or a hip extensor (the inferior part of the gluteus maximus in eight patients and the long head of the biceps femoris in four), or both; equinus contracture (twelve patients); and avoidance of loading-response flexion of the knee (five patients). Most patients used more than one method of substitution.
\r\n
\r\nThese obervations support the theory that postpoliomyelitis syndrome results from long-term substitutions for muscular weakness that place increased demands on joints, ligaments, and muscles and that treatment -- based on the early identification of overuse of muscles and ligamentous strain -- should aim at modification of lifestyle and include use of a brace.<\/p>\n
\nCategory: <\/span>Orthoses<\/p>\n
\nAuthor: <\/span>Ploeger, H.E., Bus, S.A., Nollet, F., Brehm, M-A.
\nAffiliation: <\/span>Nil identified
\nJournal: <\/span><\/span>
\nCitation: <\/span>Ploeger, H.E., Bus, S.A., Nollet, F., Brehm, M-A. Gait patterns in association with underlying impairments in polio survivors with calf muscle weakness. Gait & Posture. 2017 58:146-153. doi: 10.1016\/j.gaitpost.2017.07.107.
\nPublication Year and Month: <\/span>2017 07<\/p>\n
\r\n
\r\nUnilaterally affected patients underwent barefoot 3D-gait analyses. Gait pattern clusters were created based on the ankle and knee angle and ankle moment shown in midstance of the affected limb. Impairment clusters were created based on plantarflexor and knee-extensor strength, and ankle and knee joint range-of-motion. The association between gait patterns and underlying impairments were examined descriptively. The Random Forest Algorithm and regression analyses were used to predict gait patterns and parameters.
\r\n
\r\nSeven gait patterns in 73 polio survivors were identified, with two dominant patterns: one with a mildly\/non-deviant ankle angle, ankle moment and knee angle (n\u2005=\u200523), and one with a strongly deviant ankle angle and a mildly\/non-deviant ankle moment and knee angle (n\u2005=\u200518). Gait pattern prediction from underlying impairments was 49% accurate with best prediction performance for the second dominant gait pattern (sensitivity 78% and positive predictive value 74%). The underlying impairments explained between 20 and 32% of the variance in individual gait parameters.
\r\n
\r\nPolio survivors with calf muscle weakness who present a similar impairment profile do not necessarily walk the same. From physical examination alone, the gait pattern nor the individual gait parameters could be accurately predicted. The patient’s gait should therefore be measured to help in the prescription and evaluation of orthoses for these patients.<\/p>\n
\nCategory: <\/span>Exercise<\/p>\n
\nAuthor: <\/span>Prins, J.H., Hartung, H.G., Merritt, D.J., Blancq, R.J., Goebert, D.A.
\nAffiliation: <\/span>
\nJournal: <\/span><\/span>
\nCitation: <\/span>Prins, J.H., Hartung, H.G., Merritt, D.J., Blancq, R.J., Goebert, D.A. (1994) Effect of aquatic exercise training in persons with poliomyelitis disability. Sports Medicine, Training and Rehabilitation. 5(1):29-39
\nPublication Year and Month: <\/span>1994 01<\/p>\n