{"id":13275,"date":"2015-03-28T11:35:24","date_gmt":"2015-03-28T00:35:24","guid":{"rendered":"http:\/\/www.poliohealth.org.au\/?page_id=13275"},"modified":"2017-09-15T14:59:18","modified_gmt":"2017-09-15T04:59:18","slug":"post-polio-research-papers-sorted-by-publication-date","status":"publish","type":"page","link":"https:\/\/www.poliohealth.org.au\/research-sorted-by-publication-date\/","title":{"rendered":"Post-Polio Research Papers – Sorted by Publication Date"},"content":{"rendered":"
Title: <\/span>Updated consensus statement: Intravenous immunoglobulin in the treatment of neuromuscular disorders report of the AANEM ad hoc committee Abstract: <\/span>Intravenous immune globulin (IVIG) is an immune-modulating biologic therapy that is increasingly being used in neuromuscular disorders despite the paucity of high-quality evidence for various specific diseases. To address this, the AANEM created the 2009 consensus statement to provide guidance on the use of IVIG in neuromuscular disorders. Since then, there have been several randomized controlled trials for IVIG, a new FDA-approved indication for dermatomyositis and a revised classification system for myositis, prompting the AANEM to convene an ad hoc panel to update the existing guidelines.New recommendations based on an updated systemic review of the literature were categorized as Class I-IV. Based on Class I evidence, IVIG is recommended in the treatment of chronic inflammatory demyelinating polyneuropathy, Guillain-Barré Syndrome (GBS) in adults, multifocal motor neuropathy, dermatomyositis, stiff-person syndrome and myasthenia gravis exacerbations but not stable disease. Based on Class II evidence, IVIG is also recommended for Lambert-Eaton myasthenic syndrome and pediatric GBS. In contrast, based on Class I evidence, IVIG is not recommended for inclusion body myositis, post-polio syndrome, IgM paraproteinemic neuropathy and small fiber neuropathy that is idiopathic or associated with tri-sulfated heparin disaccharide or fibroblast growth factor receptor-3 autoantibodies. Although only Class IV evidence exists for IVIG use in necrotizing autoimmune myopathy, it should be considered for anti-hydroxy-3-methyl-glutaryl-coenzyme A reductase myositis given the risk of long-term disability. Insufficient evidence exists for the use of IVIG in Miller-Fisher syndrome, IgG and IgA paraproteinemic neuropathy, autonomic neuropathy, chronic autoimmune neuropathy, polymyositis, idiopathic brachial plexopathy and diabetic lumbosacral radiculoplexopathy.<\/p>\n Conclusions: <\/span>IVIG is not recommended for Post-Polio Syndrome (PPS) as there is no long-term benefit.<\/p>\n Outcome of Research: <\/span>More research required<\/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>The risk of post-polio syndrome among immigrant groups in Sweden Abstract: <\/span>To examine the risk of post-polio syndrome (PPS) in immigrant groups using native Swedish-born individuals as referents. This is a retrospective study. The study population included all individuals aged 18 years and older registered in Sweden. PPS was defined as having at least one registered diagnosis in the Swedish National Patient Register. The incidence of post-polio in different immigrant groups, using Swedish-born individuals as referents, was assessed by Cox regression, with hazard ratios (HRs) and 99% confidence intervals (CI). The models were stratified by sex and adjusted for age, geographical residence in Sweden, educational level, marital status, co-morbidities, and neighbourhood socioeconomic status. In total 5300 post-polio cases were registered, 2413 males and 2887 females. Fully adjusted HRs (99% CI) in immigrants versus Swedish-born were 1.77 in men (1.52–2.07) and 1.39 (1.19–1.62) in women. Statistically significant excess risks of post-polio were found in the following subgroups: men and women from Africa, HRs (with 99% CI) 7.40 (5.17–10.59) and 8.39 (5.44–12.95), respectively, and Asia, HRs 6.32 (5.11–7.81) and 4.36 (3.38–5.62) respectively, and in men from Latin America, HR 3.66 (2.17–6.18). It is of importance to be aware of risks of PPS in immigrants settled in Western countries, and that it is more common in immigrants from regions of the world where polio is still prevalent. Patients with PPS need treatment and proper follow-up until polio has been eradicated through global vaccination programs.<\/p>\n Conclusions: <\/span>In conclusion, we found a higher risk of PPSs in individuals from non-Western regions, especially from Africa and Asia. It is of importance to be aware of PPS in the whole healthcare system in Western countries, and that it is more common in immigrants from regions of the world where polio is still prevalent. PPS patients need treatment and follow-up for their lifetime. PPS will only disappear decades after the worldwide eradication of polio.<\/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>Plasma CHI3L1 in Amyotrophic Lateral Sclerosis: A Potential Differential Diagnostic Biomarker Abstract: <\/span>Background: Motor neuron diseases (MNDs) are fatal neurodegenerative diseases. Biomarkers could help with defining patients’ prognoses and stratifications. Besides neurofilaments, chitinases are a promising family of possible biomarkers which correlate with neuroinflammatory status. We evaluated the plasmatic levels of CHI3L1 in MNDs, MND mimics, and healthy controls (HCs). Conclusions: <\/span>The measurement of the plasmatic levels of CHI3L1 could be useful in the differential diagnosis between MNDs and MND mimics. This is an important issue, since the early diagnosis of an MND is a determinant in the early starting of neuroprotective therapy and in clinical trial recruitment. Outcome of Research: <\/span>More research required<\/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>Late effects of polio: Interviewing general practitioners and health professionals about the need for and the means of promoting continuing professional development. Abstract: <\/span>Background and objectives Conclusions: <\/span>Thousands of Australian and New Zealand polio survivors are experiencing sequelae from past polio infections, many in migrant communities and including women of childbearing age. HCPs need to be aware of LEoP and PPS and incorporate this knowledge into their assessment and management of patients. A lack of awareness of LEoP and PPS, combined with time constraints for CPD, serves to perpetuate a serious gap in clinical knowledge, with potential adverse consequences for patients at risk of not being diagnosed or poorly managed. 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>Factors Associated with the Severity of COVID-19 Outcomes in People with Neuromuscular Diseases: Data from the International Neuromuscular COVID-19 Registry Abstract: <\/span>BACKGROUND Conclusions: <\/span>CONCLUSIONS Outcome of Research: <\/span>More research required<\/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>Use and usability of custom-made knee-ankle-foot orthoses in polio survivors with knee instability: A cross-sectional survey Abstract: <\/span>Objective: To investigate the use of custom-made knee-ankle-foot orthoses in daily life and differences in usability factors of knee-ankle-foot orthoses between users and discontinued users. Conclusions: <\/span>A majority of 76% of the polio survivors provided with a custom-made KAFO used their orthosis in daily life. Important usability factors were low perceived walking ability status without orthosis, previous orthosis experience, prescribed KAFO type, high perceived effectiveness and satisfaction when standing and walking with a KAFO. When prescribing a KAFO, it is important to consider these factors and discuss goals of use and expected benefits of the KAFO with the individuals concerned, especially in relation to perceived walking limitations and activities in daily life. Providing proper guidance and training upon delivery of the KAFO may especially be important in the case of first-time orthosis users.<\/p>\n Outcome of Research: <\/span>Effective<\/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>Pain in Post-Polio Syndrome: A separate pain entity? Abstract: <\/span>Background: Most patients with polio recover from the initial infection, but develop muscle weakness, pain and fatigue after 15–40 years, a condition called post-polio syndrome. Although poliovirus has been almost eliminated, 12–20 million people worldwide still have polio sequelae. The pain is described mainly as nociceptive, but some patients experience neuropathic pain. The aim of this study was to further characterize post-polio pain. Conclusions: <\/span>In conclusion, pain in PPS is mostly of deep aching character and muscle cramps, localized in the polio-weakened limb. This type of pain seems to be specific to PPS. It is suggested that this pain is termed post-polio muscular pain (PPMP). Future studies should aim to characterize PPMP and to analyse the influence of motor and sensory dysfunction on the pain.<\/p>\n Outcome of Research: <\/span>More research required<\/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>Spinal cord gray matter atrophy is associated with functional decline in post-polio syndrome Abstract: <\/span>Objective: To determine if patients with post- polio syndrome (PPS) show spinal cord gray matter (SCGM) atrophy and to assess associations between SCGM atrophy, muscle strength and patient- reported functional decline. Conclusions: <\/span>The rAMIRA approach is a novel, promising, clinically feasible and sensitive method for segment-wise quantitation of GM atrophy in the cervical and thoracic SC in patients with lower motor neuron disorders. This study demonstrated its clinical applicability and vali-dated it in patients with PPS, a presumed pure, lower motor neuron disorder, which can serve as a model for other neurodegenerative, genetic or autoimmune diseases of the SCGM.
\nAuthor: <\/span>Jinny Tavee MD (1), Thomas H. Brannagan III MD (2), Michael W. Lenihan MD (3), Sri Muppidi MD (4), Liz Kellermeyer BA, MLS (1), Peter D Donofrio MD, AANEM (5)
\nAffiliation: <\/span>(1) National Jewish Health, Division of Neurology, Denver, Colorado, USA
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\r\n(2) Vagelos College of Physicians and Surgeons, Neurological Institute, Columbia University, New York, New York, USA
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\r\n(3) Adirondack Neurology Associates, PC, Glens Falls, New York, USA
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\r\n(4) Stanford Neuroscience Health Center, Palo Alto, California, USA
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\r\n(5) Neurology Clinic, Vanderbilt University, Nashville, Tennessee, USA
\nJournal: <\/span>Muscle & Nerve
\nCitation: <\/span>Tavee, J, Brannagan, TH, Lenihan, MW, et al. Updated consensus statement: Intravenous immunoglobulin in the treatment of neuromuscular disorders report of the AANEM ad hoc committee. Muscle & Nerve. 2023; 1-19. doi:10.1002\/mus.27922
\nPublication Year and Month: <\/span>2023 07<\/span><\/p>\n
\nCategory: <\/span>Late Effects of Polio<\/p>\n
\nAuthor: <\/span>Per Wändell (1,2), Kristian Borg (3), Xinjun Li (2), Axel C. Carlsson (1,4), Jan Sundquist (2,5,6) & Kristina Sundquist (2,5,6)
\nAffiliation: <\/span>(1) Division of Family Medicine and Primary Care, NVS Department, Karolinska Institutet, Alfred Nobels Allé 23, 141 83, Huddinge, Sweden
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\r\n(2) Center for Primary Health Care Research, Lund University, Malmö, Sweden
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\r\n(3) Division of Rehabilitation Medicine, Department of Clinical Sciences, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden
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\r\n(4) Academic Primary Health Care Centre, Region Stockholm, Stockholm, Sweden
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\r\n(5) Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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\r\n(6) Department of Functional Pathology, Center for Community-Based Healthcare Research and Education (CoHRE), School of Medicine, Shimane University, Matsue, Japan
\nJournal: <\/span>NEW - PUT DETAILS IN CITATION FIELD
\nCitation: <\/span>Scientific Reports volume 13, Article number: 6044 (2023)
\r\nhttps:\/\/doi.org\/10.1038\/s41598-023-33240-w
\nPublication Year and Month: <\/span>2023 04<\/span><\/p>\n
\nCategory: <\/span>Diagnosis and Management, Differential Diagnosis<\/p>\n
\nAuthor: <\/span> Alessandro Bombaci*, Umberto Manera, Giovanni De Marco, Federico Casale, Paolina Salamone, Giuseppe Fuda, Giulia Marchese, Barbara Iazzolino, Laura Peotta, Cristina Moglia, Andrea Calvo and Adriano Chiò
\nAffiliation: <\/span>“Rita Levi Montalcini” Department of Neuroscience, University of Turin, 10126 Turin, Italy
\nJournal: <\/span>NEW - PUT DETAILS IN CITATION FIELD
\nCitation: <\/span>J. Clin. Med. 2023, 12(6), 2367; https:\/\/doi.org\/10.3390\/jcm12062367
\nPublication Year and Month: <\/span>2023 03<\/span><\/p>\n
\r\n
\r\nMethods: We used a sandwich ELISA to quantify the CHI3L1 in plasma samples from 44 MND patients, 7 hereditary spastic paraplegia (HSP) patients, 9 MND mimics, and 19 HCs. We also collected a ALSFRSr scale, MRC scale, spirometry, mutational status, progression rate (PR), blood sampling, and neuropsychological evaluation.
\r\n
\r\nResults: The plasma levels of the CHI3L1 were different among groups (p = 0.005). Particularly, the MND mimics showed higher CHI3L1 levels compared with the MND patients and HCs. The CHI3L1 levels did not differ among PMA, PLS, and ALS, and we did not find a correlation among the CHI3L1 levels and clinical scores, spirometry parameters, PR, and neuropsychological features. Of note, the red blood cell count and haemoglobin was correlated with the CHI3L1 levels (respectively, p < 0.001, r = 0.63; p = 0.022, and r = 0.52).
\r\n
\r\nConclusions: The CHI3L1 plasma levels were increased in the MND mimics cohort compared with MNDs group. The increase of CHI3L1 in neuroinflammatory processes could explain our findings. We confirmed that the CHI3L1 plasma levels did not allow for differentiation between ALS and HCs, nor were they correlated with neuropsychological impairment.
\r\n
\r\nKeywords: biomarker; chitinases; cognitive impairment; differential diagnosis; early diagnosis; MND mimics; red blood cells<\/p>\n
\r\nFurther multicentre and longitudinal studies on a larger patient cohort, testing alongside other fluid biomarkers, are needed to better explain the role of CHI3L1 in the diagnosis and prognosis of MNDs and, also, of MND mimics.<\/p>\n
\nCategory: <\/span><\/p>\n
\nAuthor: <\/span>Petra Quinlan-Turner (1), Phyllis Lau (2), Keith R McVilly (3)
\nAffiliation: <\/span>(1) MBBS, PMETB GP (UK), MPH(Hons), Policy Officer, Surgery Recovery and Reform Branch, Commissioning and System Improvement Division, Victorian Department of Health, Melbourne, Vic. (1 author)
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\r\n(2) BPharmSci (Hons), GradDip Drug Eval Pharm Sci, PhD, Senior Research Fellow, Department Of General Practice, Faculty of Medicine, Dentistry and Health Science, The University Of Melbourne, Carlton, Vic. (1 author)
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\r\n(3) PhD, MAPS, FCClP, FIASSIDD, Professor of Disability and Inclusion, School of Social and Political Sciences, The University of Melbourne, Melbourne, Vic. (1 author)
\nJournal: <\/span>NEW - PUT DETAILS IN CITATION FIELD
\nCitation: <\/span>Australian Journal of General Practice, 01 May 2023, 52(5):317-323
\r\nDOI: 10.31128\/ajgp-07-22-6504 PMID: 37149772
\nPublication Year and Month: <\/span>2023 03<\/span><\/p>\n
\r\nPolio Australia estimates tens of thousands of polio survivors are experiencing late effects of polio (LEoP), including increased cases among young women of childbearing age in some migrant communities. Because polio has been declared eradicated in Australia, the provision and uptake of education by general practitioners (GPs) and healthcare professionals (HCPs) is minimal. We explored the awareness of LEoP among HCPs and ways to enhance knowledge dissemination to improve clinical practice.
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\r\nMethod
\r\nA qualitative study was undertaken, informed by a descriptive (transcendental) phenomenological approach. Semistructured interviews were audio recorded, transcribed and analysed inductively, with a conciliation among the research team used to finalise the themes.
\r\n
\r\nResults
\r\nHCPs expressed the importance of learning about LEoP and how this may help build supportive patient-practitioner relationships and contribute to patient outcomes. Factors influencing the uptake of professional development included motivation, possibly stemming from a lack of awareness of LEoP, together with the time and logistical limitations of practice generally.
\r\n
\r\nDiscussion
\r\nOnline learning activities followed by an assessment may be attractive for some HCPs, but peer-based and multidisciplinary continuing professional development activities remain preferred.<\/p>\n
\r\n
\r\nProfessional organisations could combine to develop multidisciplinary peer learning modules on LEoP. Existing online resources, such as the LEoP module on HealthPathways, could be more widely promoted. Organising dedicated symposia, such as that co-hosted by the University of Otago and Polio New Zealand , could also help with the dissemination of knowledge. Importantly, exploring the views of polio survivors and involving them in the co-development and delivery of educational materials could improve the relevance to all stakeholders involved.<\/p>\n
\nCategory: <\/span>Immune Response<\/p>\n
\nAuthor: <\/span>Chiara Pizzamiglio (1,2), Robert D. S. Pitceathly (1,2), Michael P. Lunn (1), Stefen Brady (3), Fabiola De Marchi (4), Lucia Galan (5), Jeannine M. Heckmann (6), Alejandro Horga (5), Maria J. Molnar (7), Acary S. B. Oliveira (8), Wladimir B. V. R. Pinto (8), Guido Primiano (9,10), Ernestina Santos (11), Benedikt Schoser (12), Serenella Servidei (9,10), Paulo V. Sgobbi Souza (8), Venugopalan Vishnu (13), Michael G. Hanna (1,2), Mazen M. Dimachkie (14), Pedro M. Machado (1), The Neuromuscular Diseases and COVID-19 Study Group
\nAffiliation: <\/span>For The Neuromuscular Diseases and COVID-19 Study Group. Individual affiliations are not listed.
\nJournal: <\/span>European Journal of Neurology
\nCitation: <\/span>Pizzamiglio, C., Pitceathly, R.D.S., Lunn, M.P., Brady, S., De Marchi, F., Galan, L., Heckmann, J.M., Horga, A., Molnar, M.J., Oliveira, A.S.B., Pinto, W.B.V.R., Primiano, G., Santos, E., Schoser, B., Servidei, S., Sgobbi Souza, P.V., Vishnu, V., Hanna, M.G., Dimachkie, M.M., Machado, P.M. and (2022), Factors Associated with the Severity of COVID-19 Outcomes in People with Neuromuscular Diseases: Data from the International Neuromuscular COVID-19 Registry. Eur J Neurol. Accepted Author Manuscript. https:\/\/doi.org\/10.1111\/ene.15613
\nPublication Year and Month: <\/span>2022 10<\/span><\/p>\n
\r\nTo determine factors associated with the severity of COVID-19 outcomes in people with neuromuscular diseases (NMDs).
\r\n
\r\nMETHODS
\r\nNMD cases of any age and confirmed\/presumptive COVID-19, submitted to the International Neuromuscular COVID-19 Registry up to 31\/December\/2021, were included. A mutually exclusive ordinal COVID-19 severity scale was defined: (1) no hospitalisation; (2) hospitalisation without oxygenation; (3) hospitalisation with ventilation\/oxygenation; (4) death. Multivariable ordinal logistic regression analyses were used to estimate odds ratios for severe outcome, adjusting for age, sex, race\/ethnicity, NMD, comorbidities, baseline functional status (modified Rankin scale [mRS]), use of immunosuppressive\/immunomodulatory medication, and pandemic calendar period.
\r\n
\r\nRESULTS
\r\nOf 315 patients from 13 countries (mean age 50.3 [±17.7] years, 154 [48.9%] female), 175 (55.5%) were not hospitalised, 27 (8.6%) were hospitalised without supplemental oxygen, 91 (28.9%) were hospitalised with ventilation\/supplemental oxygen, and 22 (7%) died. Higher odds of severe COVID-19 outcomes were observed for: age≥50 years (50-64 years: OR=2.4, 95%CI 1.33-4.31; >64 years: OR=4.16, 95%CI 2.12-8.15; both vs. <50 years), non-White race\/ethnicity (OR=1.81, 95%CI 1.07-3.06; vs. White), mRS moderately severe\/severe disability (OR=3.02, 95%CI 1.6-5.69; vs. no\/slight\/moderate disability), history of respiratory dysfunction (OR=3.16, 95%CI 1.79-5.58), obesity (OR=2.24, 95%CI 1.18-4.25), ≥3 comorbidities (OR=3.2, 95%CI 1.76-5.83; vs. ≤2; if comorbidity count used instead of specific comorbidities), glucocorticoid treatment (OR=2.33, 95%CI 1.14-4.78), and Guillain-Barré syndrome (OR=3.1, 95%CI 1.35-7.13; vs. mitochondrial disease).<\/p>\n
\r\nAmong people with NMDs, there is differential risk of COVID-19 outcomes according to demographic and clinical characteristics. These findings could be used to develop tailored management strategies and evidence-based recommendations for NMD patients.<\/p>\n
\nCategory: <\/span>Orthoses<\/p>\n
\nAuthor: <\/span>Bart Raijmakers, Roelofine A Berendsen-de Gooijer, Hilde E Ploeger, Fieke S Koopman, Frans Nollet, Merel-Anne Brehm
\nAffiliation: <\/span>Amsterdam University Medical Centers, University of Amsterdam, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, The Netherlands. b.g.raijmakers@amsterdamumc.nl.
\nJournal: <\/span>Journal of Rehabilitation Medicine (JRM) - formerly Scandanavian Journal of Rehabilitation Medicine
\nCitation: <\/span>54:jrm00261
\r\ndoi: 10.2340\/jrm.v53.1122.
\nPublication Year and Month: <\/span>2022 02<\/span><\/p>\n
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\r\nDesign: Cross-sectional survey study.
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\r\nSubjects: A total of 163 polio survivors provided with a knee-ankle-foot orthosis at an outpatient clinic of a university hospital.
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\r\nMethods: Use and usability of knee-ankle-foot orthoses in daily life were assessed with a postal questionnaire. Usability factors were formulated using the International Organization for Standardization (ISO) 9241-11 standard.
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\r\nResults: A total of 106 respondents (65%) returned the questionnaire. Of these, 98 were eligible for analysis. Seventy-four respondents (76%) reported using their knee-ankle-foot orthosis. Compared with discontinued users (24%), users experienced more limitations when walking without an orthosis (p = 0.001), were more often experienced with wearing a previous orthosis (p < 0.001) and were more often prescribed with a locked rather than a stance-control knee-ankle-foot orthosis (p = 0.015). Furthermore, users reported better effectiveness of their knee-ankle-foot orthosis (p < 0.001), more satisfaction with goals of use and knee-ankle-foot orthosis-related aspects (p < 0.001).
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\r\nConclusion: The majority of polio survivors used their custom-made knee-ankle-foot orthoses in daily life. Factors related to continued use, such as walking ability without orthosis, expectations of the orthosis, previous orthosis experience and type of knee-ankle-foot orthosis provided, should be considered and discussed when prescribing a knee-ankle-foot orthosis in polio survivors.
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\r\nKeywords: poliomyelitis, leg muscle weakness, knee-ankle-foot orthoses, usability, physical mobility, rehabilitation<\/p>\n
\nCategory: <\/span>Late Effects of Polio, Pain<\/p>\n
\nAuthor: <\/span>Evert Christiaan Boshuis, MD (1), Eva Melin, MD, PhD (2) and Kristian Borg, MD, PhD (2)
\nAffiliation: <\/span>(1) Department of Psychiatry, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
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\r\n(2) Division of Rehabilitation Medicine, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
\nJournal: <\/span>Journal of Rehabilitation Medicine (JRM) - formerly Scandanavian Journal of Rehabilitation Medicine
\nCitation: <\/span>Clinical Communications, 5, jrmcc00077.
\r\nDOI: https:\/\/doi.org\/10.2340\/20030711-1000077
\nPublication Year and Month: <\/span>2022 01<\/span><\/p>\n
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\r\nPatients and methods: A total of 20 patients with post-polio syndrome participated in the study. Physical examination was performed, and questionnaires containing pain drawing and visual analogue scales (VAS) for pain intensity during rest and motion and VAS for fatigue were completed. A walk test was performed to evaluate physical performance.
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\r\nResults: Pain intensity was high (42\/100 on the VAS at rest and 62\/100 while moving). The pain was localized in both joints and muscles. Pain in the muscles was of “deep aching” character, included “muscle cramps” and was located mainly in polio-weakened limbs.
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\r\nConclusion: Muscle pain in patients with post-polio syndrome does not fulfil the criteria for either nociceptive or neuropathic pain; thus, it is suggested that the pain is termed “post-polio muscular pain”. The intensity of post-polio muscular pain is higher while moving, but does not influence physical function, and is separate from fatigue.
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\r\n
\r\nLAY ABSTRACT
\r\nMost polio patients recover from the initial infection, but develop muscle weakness, pain and fatigue after 15–40 years, a condition called Post-Polio Syndrome. Though the poliovirus has almost been eliminated, 12-20 million people worldwide still have polio-equelae. The pain is mainly described as nociceptive, but some patients experience neuropathic pain. This study was undertaken to further characterize post-polio pain. We examined 20 Post-polio patients and found that the pain was localised in both joints and muscles. The pain in the muscles was of ‘deep aching’ character, included ‘muscle cramps’ and was mainly located in polio-weakened limbs. The intensity of the pain is higher while moving but does not influence the physical function. To know more about the characteristics of the pain perceived gives better possibilities for treatment and rehabilitation<\/p>\n
\nCategory: <\/span>Brain, Diagnosis and Management, Late Effects of Polio, Post-Polio Motor Unit<\/p>\n
\nAuthor: <\/span>Maria Janina Wendebourg (1,2), Matthias Weigel (1,2,3,4,5), Laura Richter (1), Vanya Gocheva (6), Patricia Hafner (6), Anna-Lena Orsini (6), Valentina Crepulja (1,2), Simone Schmidt (6), Antal Huck (4), Johanna Oechtering (1), Maria Blatow (7), Tanja Haas (3,4), Cristina Granziera (1,2,5), Ludwig Kappos (1,2,5), Philippe Cattin (4), Oliver Bieri (3,4) Dirk Fischer (6), Regina Schlaeger (1,2,5)
\nAffiliation: <\/span>1. Neurology Clinic and Policlinic, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
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\r\n2. Translational Imaging in Neurology (ThINk), Department of Biomedical Engineering, University of Basel, Basel, Switzerland
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\r\n3. Division of Radiological Physics, Department of Radiology, University Hospital Basel, Basel, Switzerland
\r\n
\r\n4. Department of Biomedical Engineering, University of Basel, Basel, Switzerland
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\r\n5. MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel and University of Basel, Basel, Switzerland
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\r\n6. Division of Pediatric Neurology, University of Basel Children's Hospital, Basel, Switzerland
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\r\n7. Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich,
\nJournal: <\/span>European Journal of Neurology
\nCitation: <\/span>Eur J Neurol. 2022;00:1–11.
\r\nDOI: 10.1111\/ene.15261
\nPublication Year and Month: <\/span>2022 01<\/span><\/p>\n
\r\n
\r\nMethods: Twenty patients diagnosed with PPS (March of Dimes criteria) and 20 age- and sex- matched healthy controls (HC) underwent 3T axial 2D- rAMIRA magnetic resonance imaging at the intervertebral disc levels C2\/C3–C6\/C7, T9\/T10 and the lumbar enlarge-ment level (Tmax) (0.5 × 0.5 mm2 in- plane resolution). SCGM areas were segmented manu-ally by two independent raters. Muscle strength, self-reported fatigue, depression and pain measures were assessed.
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\r\nResults: Post- polio syndrome patients showed significantly and preferentially re-duced SCGM areas at C2\/C3 (p= 0.048), C3\/C4 (p= 0.001), C4\/C5 (p< 0.001), C5\/C6 (p= 0.004) and Tmax (p= 0.041) compared to HC. SCGM areas were significantly associated with muscle strength in corresponding myotomes even after adjustment for fatigue, pain and depression. SCGM areaTmax together with age and sex explained 68% of ankle dorsiflexion strength variance. No associations were found with age at or time since infection. Patients reporting PPS- related decline in arm function showed significant cervical SCGM atrophy compared to stable patients adjusted for initial disease severity.
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\r\nConclusions: Patients with PPS show significant SCGM atrophy that correlates with mus-cle strength and is associated with PPS- related functional decline. Our findings suggest a secondary neurodegenerative process underlying SCGM atrophy in PPS that is not ex-plained by aging or residua of the initial infection alone. Confirmation by longitudinal studies is needed. The described imaging methodology is promising for developing novel imaging surrogates for SCGM diseases.
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\r\nPatients with PPS show significant SCGM atrophy, particularly at levels close to the cervical and lumbar enlargements. Even after adjustment for the level of depression, fatigue and pain, potential confounding symptoms frequently observed in PPS, SCGM atrophy is significantly and segment-wise associated with muscle strength in corresponding myotomes. Moreover, SCGM atrophy is associated with patient-reported PPS-related functional decline. Secondary analyses suggest that SCGM atrophy is rather due to a second dis-ease phase than being a sole residuum of the initial infection or a pure aging effect. These observations support the hypothesis of a focally accentuated neurodegenerative process in the SC underlying PPS. Larger, ideally multicentric, longitudinal studies conducted over a sufficiently long timespan are an important next step to confirm our results and gain more insights into the development of SCGM atrophy over time and its correlation to clinical symptom evolution in patients with PPS.<\/p>\n