Muscle Weakness and Perceived Disability of Upper Limbs in Persons With Late Effects of Polio

Expert Consensus on Classification and Performance in Paralympic Powerlifting: A Delphi Study

BACKGROUND

In Paralympic sports, classification ensures fair competition by grouping athletes based on their impairments. The International Paralympic Committee has provided scientific principles to guide evidence-based classification procedures. In Paralympic Powerlifting, athletes compete in one class, divided by sex and bodyweight categories, overlooking impairment impact on performance.

OBJECTIVE

This study aimed to establish a consensus among international Paralympic powerlifting experts regarding classification and performance issues to guide future research.

METHODS

A two-round Delphi study was conducted involving 26 experts. The study sought to identify the adequacy of the current classification and competition systems, explore the impact of various impairments, and lay the initial groundwork for a performance determinants model.

RESULTS

Experts agreed that existing classification and competition systems in Paralympic powerlifting do not align with Paralympic standards. Impairments from neurological conditions and those causing anthropometric changes were suggested to have opposing performance impacts. Initial directions for a performance determinants model were outlined, focusing on arm and bar kinematics, anthropometry, and body composition.

CONCLUSIONS

This study underscores the need for comprehensive research in Paralympic powerlifting, revealing critical discrepancies between current classification system and Paralympic standards. Insights into the multifaceted relationship between impairments and performance are provided to shape the future of Paralympic powerlifting research.

Madelung-type deformity in a female individual from the Merovingian Period in Central Germany: A rare finding or a rare disease?

OBJECTIVE

This paper presents a probable case of Madelung-type deformity of the right lower arm in an individual from the Merovingian burial ground (7th and 8 th century CE) from Gotha-Boilstädt (Germany).

MATERIALS

A female individual with an age-at-death of 40-50 years was investigated.

METHODS

Macroscopic, osteometric and radiographic analyses were performed using standard methods.

RESULTS

The individual exhibits an unusual case of dysmelia of the right upper extremity. The shoulder and upper arm displayed gracile muscle attachment marks and less robustness compared to the left side. The ulna was shortened and distorted and the radius was severely deformed.

CONCLUSIONS

The results indicate that the individual might have been affected by a unilateral Madelung-type deformity. The severity of this case is greater than that reported in the clinical literature.

SIGNIFICANCE

This study places an ancient rare disease into archaeological and paleopathological contexts, allowing for the evaluation of the term "ancient rare disease." It also highlights the importance of reporting rigorously diagnosed cases in order to raise our level of awareness of the incidence and course of this rare condition in the past.

LIMITATIONS

The diagnosis cannot be stated with certainty, and only a handful of possible diagnoses can be offered. Congenital and acquired etiologies must be considered, especially when compared with clinical cases where severity of conditions may be modified by medical intervention.

SUGGESTIONS FOR FURTHER RESEARCH

Genetic analysis might be helpful in the determination of the etiology of the observed Madelung-type deformity.

Post-polio syndrome and the late effects of poliomyelitis: Part 2. treatment, management, and prognosis

Post-polio syndrome (PPS) is characterized by new muscle weakness and/or muscle fatigability that occurs many years after the initial poliomyelitis illness. An individualized approach to rehabilitation management is critical. Interventions may include rehabilitation management strategies, adaptive equipment, orthotic equipment, gait/mobility aids, and a variety of therapeutic exercises. The progression of muscle weakness in PPS is typically slow and gradual; however, there is also variability in both the natural history of weakness and functional prognosis. Further research is required to determine the effectiveness of selected medical treatment. Muscle Nerve 58:760-769, 2018.