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Atwal A, Duncan H, Queally C, Cedar SH. Polio survivors perceptions of a multi-disciplinary rehabilitation programme. Disabil Rehabil 2017; 41:150-157. [PMID: 28974103 DOI: 10.1080/09638288.2017.1381184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PURPOSE Post-polio syndrome refers to a late complication of the poliovirus infection. Management of post-polio syndrome is complex due to the extensive symptomology. European and United Kingdom guidelines have advised the use of rehabilitation programmes to manage post-polio syndrome. There is a paucity of research in relation to the effectiveness of rehabilitation interventions. The objective of this study is to explore polio survivor's perceptions of an in-patient multi-disciplinary rehabilitation programme. METHODS Semi-structured interviews of community dwelling polio survivors who attended in-patient rehabilitation programme in the United Kingdom. Thematic analysis was used to describe and interpret interview data. RESULTS Participants' experiences were influenced by past experiences of polio and their self-concept. Participants generally had a positive experience and valued being with other polio survivors. Positive strategies, such as pacing and reflection changed their mind-sets into their lives after the programme, though they still faced challenges in daily living. Some participants supported others with post-polio syndrome after completing the programme. CONCLUSIONS Our research identified that participants experienced long term positive benefits from attending a rehabilitation programme. Strategies that users found helpful that explored the effectiveness of interventions to manage polio are not cited within a Cochrane review. If we are to recognise the lived experience and service user empowerment within a model of co- production it is essential that patient preferences are evaluated and used as evidence to justify service provision. Further research is required with polio survivors to explore how best rehabilitation programmes can adopt the principles of co-production. Implications for Rehabilitation The patients' expertise and lived experience must be at the centre of a rehabilitation programme. Strategies such as pacing and reflection are perceived as important strategies to enable self-management of polio and post-polio syndrome despite the limited evidence base to support these interventions. Polio rehabilitation programmes should not be time limited and commissioners and therapists need to ensure that follow up support is provided. When measuring outcomes patient preferences and views must be evaluated.
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Affiliation(s)
- Anita Atwal
- a School of Health and Social Care , London Southbank University , London , UK
| | - Helen Duncan
- b School of Health and Social Care , Brunel University , London , UK
| | - Claire Queally
- b School of Health and Social Care , Brunel University , London , UK
| | - S H Cedar
- a School of Health and Social Care , London Southbank University , London , UK
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Huang YH, Chen HC, Huang KW, Chen PC, Hu CJ, Tsai CP, Tam KW, Kuan YC. Intravenous immunoglobulin for postpolio syndrome: a systematic review and meta-analysis. BMC Neurol 2015; 15:39. [PMID: 25886512 PMCID: PMC4379590 DOI: 10.1186/s12883-015-0301-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 03/11/2015] [Indexed: 11/28/2022] Open
Abstract
Background Postpolio syndrome (PPS) is characterized by progressive disabilities that develop decades after prior paralytic poliomyelitis. Because chronic inflammation may be the process underlying the development of PPS, immunomodulatory management, such as intravenous immunoglobulin (IVIg) administration, may be beneficial. Methods We performed a systematic review and meta-analysis of published randomized controlled trials (RCTs) and prospective studies that evaluated the efficacy of IVIg in managing PPS. Electronic databases, including PubMed, EMBASE, CINAHL, and the Cochrane Central Register of Controlled Trials, were searched for articles on PPS published before December 2014. The primary outcomes were pain severity, fatigue scores, and muscle strength. The secondary outcomes were physical performance, quality of life (QoL), and cytokine expression levels. Results We identified 3 RCTs involving 241 patients and 5 prospective studies involving 267 patients. The meta-analysis of pain severity (weighted mean difference [WMD] = −1.02, 95% confidence interval [CI] = −2.51 to 0.47), fatigue scores (WMD = 0.28, 95% CI −0.56 to 1.12), and muscle strength revealed no significant differences between the IVIg and the placebo group. Regarding QoL, the RCTs yielded controversial outcomes, with improvement in only certain domains of the Short Form 36 (SF-36). Moreover, one prospective study reported significant improvement on SF-36, particularly in patients aged younger than 65 years, those with paresis of the lower limbs, and high pain intensity. Conclusion The present review indicated that IVIg is unlikely to produce significant improvements in pain, fatigue, or muscle strength. Thus, routinely administering IVIg to patients with PPS is not recommended based on RCTs. However, a potential effect in younger patients with lower limbs weakness and intense pain requires confirmation from further well-structured trials.
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Affiliation(s)
- Yao-Hsien Huang
- Department of Neurology, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan.
| | - Hung-Chou Chen
- Center for Evidence-Based Health Care, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan. .,Department of Physical Medicine and Rehabilitation, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan.
| | - Kuang-Wei Huang
- Department of Gastroenterology, College of Medicine, Taipei Medical University, Taipei, Taiwan. .,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan. .,Department of Gastroenterology, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan.
| | - Po-Chih Chen
- Department of Neurology, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan. .,College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.
| | - Chaur-Jong Hu
- Department of Neurology, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan. .,Department of Neurology, School of Medicine, Taipei Medical University, Taipei, Taiwan.
| | - Chin-Piao Tsai
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan. .,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
| | - Ka-Wai Tam
- Center for Evidence-Based Health Care, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan. .,Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. .,Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. .,Division of General Surgery, Department of Surgery, Taipei Medical University-Shuang Ho Hospital, Taipei, Taiwan. .,Center for Evidence-Based Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. .,Taipei Medical University-Shuang Ho Hospital, 291 Zhongzheng Road, Zhonghe District, New Taipei City, 23561, Taiwan.
| | - Yi-Chun Kuan
- Department of Neurology, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan. .,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan. .,Department of Neurology, School of Medicine, Taipei Medical University, Taipei, Taiwan. .,Taipei Medical University-Shuang Ho Hospital, 291 Zhongzheng Road, Zhonghe District, New Taipei City, 23561, Taiwan.
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Atwal A, Spiliotopoulou G, Coleman C, Harding K, Quirke C, Smith N, Osseiran Z, Plastow N, Wilson L. Polio survivors' perceptions of the meaning of quality of life and strategies used to promote participation in everyday activities. Health Expect 2014; 18:715-26. [PMID: 24438097 PMCID: PMC5060821 DOI: 10.1111/hex.12152] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2013] [Indexed: 12/11/2022] Open
Abstract
Introduction The term ‘post‐polio syndrome’ (PPS) is used to describe new and late manifestations of poliomyelitis that occur later in life. Research in this area has focused upon health status rather than its effect on quality of life. Aim To gain an in‐depth understanding of the meaning of quality of life for polio survivors and to determine the type of strategies that are used by people with PPS and the support that they consider as important to facilitate participation in everyday life activities that have an impact on their quality of life. Method Six focus groups were conducted with 51 participants from two regions in England. Data were audio‐taped and analysed using thematic analysis. Results Our research found that polio survivors used terms used to describe quality of life which could be associated with that of happiness. Our research has identified resolvable factors that influence quality of life namely inaccessible environments, attitudes of health‐care professionals and societal attitudes. Polio survivors have tried alternative therapies, chiefly acupuncture and massage, and found them to be effective in enhancing their quality of life. Conclusion It is suggested that health‐care professionals should consider factors which influence happiness and implement a person‐centred approach with the views of the polio survivor being listened to. The three factors that influenced quality of life could be resolved by health‐care professionals and by society. With regard to strategies used, we suggest that polio survivors should have access to the treatments that they perceive as important, although further research is required to design optimal interventions for this client group.
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Affiliation(s)
- Anita Atwal
- Division of Occupational Therapy, School of Health Sciences and Social Care, Brunel University, Uxbridge, UK
| | - Georgia Spiliotopoulou
- Division of Occupational Therapy, School of Health Sciences and Social Care, Brunel University, Uxbridge, UK
| | - Caron Coleman
- Division of Occupational Therapy, School of Health Sciences and Social Care, Brunel University, Uxbridge, UK
| | - Kate Harding
- Division of Occupational Therapy, School of Health Sciences and Social Care, Brunel University, Uxbridge, UK
| | - Caroline Quirke
- Division of Occupational Therapy, School of Health Sciences and Social Care, Brunel University, Uxbridge, UK
| | - Nicole Smith
- Division of Occupational Therapy, School of Health Sciences and Social Care, Brunel University, Uxbridge, UK
| | - Zeina Osseiran
- Division of Occupational Therapy, School of Health Sciences and Social Care, Brunel University, Uxbridge, UK
| | - Nicola Plastow
- Division of Occupational Therapy, School of Health Sciences and Social Care, Brunel University, Uxbridge, UK
| | - Lesley Wilson
- Division of Occupational Therapy, School of Health Sciences and Social Care, Brunel University, Uxbridge, UK
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Yelnik AP, Andriantsifanetra C, Bradai N, Sportouch P, Beaudreuil J, Dizien O. Poliomyelitis sequels in France and the clinical and social needs of survivors: a retrospective study of 200 patients. Ann Phys Rehabil Med 2013; 56:542-50. [PMID: 24120581 DOI: 10.1016/j.rehab.2013.08.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Revised: 08/06/2013] [Accepted: 08/07/2013] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Polio survivors in France are estimated at 50,000. This study aimed at describing their needs from their clinical and vocational conditions. METHOD A retrospective study of our physical and rehabilitation medicine (PRM) consultation activity. RESULTS One hundred and fifteen women/85 men, with a mean age of 51years±14.3 (17 to 82). Paralysis involved only one lower limb in 108 patients, the two lower limbs in 56 patients and only one upper limb in 4. At the time of the first consultation 137 patients had experienced functional worsening. The complaints were pain (105 subjects), fatigue (59) and new paresis (58). Only 25% had retired. Post-polio syndrome criteria were present in 46 subjects (23%). Patients who had contracted poliomyelitis in France (56%) differed from the other subjects with regard to age (58.4 versus 41.5), professional status and frequency of PPS (30.9% versus 12.6%). CONCLUSION These polio survivors were not particularly aged and they had often experienced functional worsening. The evolution of their disease shall represent a public health issue over the decades to come.
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Affiliation(s)
- A P Yelnik
- Service de médecine physique et de réadaptation, université Paris Diderot, UMR 8194 Paris Descartes, AP-HP, groupe hospitalier St.-Louis-Lariboisière-F.-Widal, 200, rue du Faubourg-Saint-Denis, 75010 Paris, France.
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Ramos PE, Abe GC, Pradella-Hallinan M, Quadros AAJ, Schmidt B, Oliveira ASB. Effects of Dăoyĭn Qìgōng in postpolio syndrome patients with cold intolerance. ARQUIVOS DE NEURO-PSIQUIATRIA 2012; 70:680-5. [PMID: 22990723 DOI: 10.1590/s0004-282x2012000900006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2012] [Accepted: 04/25/2012] [Indexed: 11/22/2022]
Abstract
UNLABELLED Postpolio syndrome (PPS) is characterized by progressive muscle weakness due to former infection with poliomyelitis and can be associated with other symptoms such as cold intolerance (CI). Dăoyĭn Qìgōng (DQ) is a technique in Traditional Chinese Medicine that impacts the circulation of energy and blood. OBJECTIVE It was to verify the effects of DQ in PPS patients complaining of cold intolerance. METHODS Ten PPS patients were assessed using the visual analogue scale (VAS) adapted for CI before and after intervention with DQ; patients practiced it in a sitting position for 40 minutes, 3 times per week over 3 consecutive months. Patients were reassessed three months after ceasing DQ. RESULTS There was a statistically significant difference in local and systemic VAS-Cold both at the end of DQ training and three months past the end of this. CONCLUSION The DQ technique ameliorated CI complaints in patients with PPS.
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Affiliation(s)
- Paulo Eduardo Ramos
- Department of Neurology and Neurosurgery, Department of Clinical Neurology, Division of Neuromuscular Disease Research, Clinic of Traditional Chinese Medicine, Universidade Federal de São Paulo, São Paulo SP, Brazil
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