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Shiri S, Marmor A, Jalagil M, Levine H, Schwartz I, Meiner Z. Psychological Health in Late Effects of Poliomyelitis: Ten-Year Follow-Up. Healthcare (Basel) 2023; 11:3144. [PMID: 38132034 PMCID: PMC10743143 DOI: 10.3390/healthcare11243144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 11/22/2023] [Accepted: 12/08/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Individuals with late effects of poliomyelitis (LEoP) cope with various physical and psychological symptoms throughout their entire life which become more severe as they are ageing. OBJECTIVES To perform a 10-year follow-up of the functional status and levels of psychological health of individuals with LEoP and to examine the associations of hope levels, work status, health perceptions, and life satisfaction with functional and psychological changes. DESIGN A within-subject 10-year follow-up study. PARTICIPANTS Eighty-two individuals with LEoP who participated in a previous study 10 years ago. METHODS Outcome measures included the functional status of individuals with LEoP assessed by the activities of daily living (ADL) questionnaire, emotional distress based on the Global Health Questionnaire (GHQ), hope based on the Hope Scale, life satisfaction as measured by the Satisfaction with Life Scale (SWLS), and subjective health perception. The McNemar test, paired t-test, Spearman's correlation coefficient, and linear regression were used for statistical analysis. RESULTS The mean age was 66.9 ± 8.5 years with a male-female ratio of 0.52. A significant functional deterioration was noticed during the follow-up years. Yet, the functional deterioration was not associated with changes in psychological health. Psychological health was associated with elevated levels of hope and life satisfaction. Individuals with LEoP who continued to work demonstrated higher psychological health, higher levels of hope, and greater life satisfaction. CONCLUSIONS Individuals with LEoP demonstrated significant psychological health, manifested in their ability to block emotional distress and maintain life satisfaction despite the deterioration in their functional status. Hope and psychological health were associated with increased life satisfaction. Work appeared to be a significant source of psychological health in this population.
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Affiliation(s)
- Shimon Shiri
- Faculty of Medicine, The Hebrew University, Jerusalem 91120, Israel; (A.M.); (M.J.); (I.S.); (Z.M.)
- The Departments of Physical Medicine & Rehabilitation, Hadassah Mount Scopus Hospital, Jerusalem 91120, Israel
| | - Anat Marmor
- Faculty of Medicine, The Hebrew University, Jerusalem 91120, Israel; (A.M.); (M.J.); (I.S.); (Z.M.)
- The Departments of Physical Medicine & Rehabilitation, Hadassah Mount Scopus Hospital, Jerusalem 91120, Israel
| | - Morad Jalagil
- Faculty of Medicine, The Hebrew University, Jerusalem 91120, Israel; (A.M.); (M.J.); (I.S.); (Z.M.)
- The Departments of Physical Medicine & Rehabilitation, Hadassah Mount Scopus Hospital, Jerusalem 91120, Israel
| | - Hagai Levine
- Hadassah Braun School of Public Health, The Hebrew University, Jerusalem 91120, Israel;
| | - Isabella Schwartz
- Faculty of Medicine, The Hebrew University, Jerusalem 91120, Israel; (A.M.); (M.J.); (I.S.); (Z.M.)
- The Departments of Physical Medicine & Rehabilitation, Hadassah Mount Scopus Hospital, Jerusalem 91120, Israel
| | - Zeev Meiner
- Faculty of Medicine, The Hebrew University, Jerusalem 91120, Israel; (A.M.); (M.J.); (I.S.); (Z.M.)
- The Departments of Physical Medicine & Rehabilitation, Hadassah Mount Scopus Hospital, Jerusalem 91120, Israel
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2
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Punsoni M, Lakis NS, Mellion M, de la Monte SM. Post-Polio Syndrome Revisited. Neurol Int 2023; 15:569-579. [PMID: 37092507 PMCID: PMC10123742 DOI: 10.3390/neurolint15020035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/11/2023] [Accepted: 03/27/2023] [Indexed: 04/25/2023] Open
Abstract
Post-polio syndrome (PPS) is characterized by recrudescence or worsening of motor neuron disease symptoms decades after recovery from acute paralytic poliovirus infection, i.e., poliomyelitis. PPS afflicts between 25% and 40% of poliomyelitis survivors and mimics motor neuron diseases (MNDs), such as amyotrophic lateral sclerosis (ALS), due to its selective impairment, degeneration, or death of motor neurons in the brainstem and spinal cord. Herein, we report a case of PPS in a 68-year-old man with a remote history of bulbar and cervical cord involvement by poliomyelitis, review the relevant literature, and contrast the salient histopathologic features that distinguish our case of PPS from ALS.
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Affiliation(s)
- Michael Punsoni
- Division of Neuropathology, Departments of Pathology and Laboratory Medicine, Neurology, and Neurosurgery, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI 02903, USA
| | - Nelli S Lakis
- Division of Neuropathology, Departments of Pathology and Laboratory Medicine, Neurology, and Neurosurgery, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI 02903, USA
| | - Michelle Mellion
- Division of Neuropathology, Departments of Pathology and Laboratory Medicine, Neurology, and Neurosurgery, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI 02903, USA
| | - Suzanne M de la Monte
- Division of Neuropathology, Departments of Pathology and Laboratory Medicine, Neurology, and Neurosurgery, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI 02903, USA
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3
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The Meaning of Sense of Coherence (SOC) in Persons with Late Effects of Polio-A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106314. [PMID: 35627852 PMCID: PMC9140657 DOI: 10.3390/ijerph19106314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/19/2022] [Accepted: 05/21/2022] [Indexed: 11/22/2022]
Abstract
Sense of Coherence (SOC), comprising comprehensibility, manageability and meaningfulness, is important for the sense of living a good life with Late Effects of Polio (LEoP). However, there is a lack of knowledge about the meaning of these three components. The aim of this study was to explore in-depth the meaning of SOC among persons living with LEoP, in terms of comprehensibility, manageability and meaningfulness. A directed content analysis was performed based on individual interviews with 7 men and 7 women with LEoP (mean age 73 years). SOC in persons with LEoP existed in two overarching themes that were closely intertwined: a state of motion and a state of being. The state of motion comprised active approaches, choices and actions, and was a process aimed at achieving a stronger comprehensibility, manageability and meaningfulness. The state of being comprised the comprehensibility, manageability and meaningfulness that the persons currently experienced. A profound understanding of SOC as both a state of motion and state being is essential for rehabilitation professionals when providing self-management support to persons living with LEoP. This understanding can increase their sense of living a good life and also be used in the rehabilitation of other life-long conditions.
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4
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Nolvi M, Brogårdh C, Jacobsson L, Lexell J. Sense of coherence and coping behaviours in persons with late effects of polio. Ann Phys Rehabil Med 2021; 65:101577. [PMID: 34624546 DOI: 10.1016/j.rehab.2021.101577] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 07/12/2021] [Accepted: 09/02/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Sense of coherence (SOC), comprising "comprehensibility", "manageability" and "meaningfulness", is important for successful adaptation in persons with late effects of polio (LEoP) and can be used as an estimate of the ability to cope with stressors. Coping behaviours are the actions a person performs to reduce stress and can be divided into problem-focused coping, emotion-focused coping and less useful coping. Our knowledge is very limited of what coping behaviours persons with LEoP use to manage their life situation as well as the association between SOC and coping behaviours. OBJECTIVE The aims of this cross-sectional study were to assess coping behaviours and to explore the association between SOC and coping behaviours in persons with LEoP. METHODS In total, 93 ambulant persons (52% women, mean [SD] age 74 [8] years) with clinically and electromyographically verified LEoP responded to a postal survey with the Sense of Coherence Scale 13 items (SOC-13) and the Brief Cope Scale. Three linear regression analyses were used to explore the association between SOC and problem-focused coping, emotion-focused coping and less useful coping, controlling for age and sex. RESULTS The most-used coping behaviours belonged to the categories problem-focused and emotion-focused coping. We found a significant negative association between SOC and less useful coping; less useful coping explained 34% of the variance of SOC (adj R2 = 0.34, p < 0.001), whereas age and sex were not significant in the analyses. CONCLUSIONS Persons with LEoP primarily use problem-focused and emotion-focused coping behaviours, which suggests that generally they have adapted well to their disability. Regardless of age and sex, persons with lower SOC scores use less useful coping behaviours, which suggests that they are not as well adapted. These results can facilitate the development of rehabilitation interventions that help persons with LEoP adapt to their situation with a life-long disability.
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Affiliation(s)
- Maria Nolvi
- Department of Health Sciences, Lund University, Lund, Sweden; Department of Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden.
| | - Christina Brogårdh
- Department of Health Sciences, Lund University, Lund, Sweden; Department of Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden
| | - Lars Jacobsson
- Department of Health Sciences, Lund University, Lund, Sweden; Department of Rehabilitation Medicine, Sunderby Hospital, Luleå, Sweden
| | - Jan Lexell
- Department of Health Sciences, Lund University, Lund, Sweden; Department of Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden
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5
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Jörgensen S, Hedgren L, Sundelin A, Lexell J. Global and domain-specific life satisfaction among older adults with long-term spinal cord injury. J Spinal Cord Med 2021; 44:322-330. [PMID: 31099721 PMCID: PMC7952060 DOI: 10.1080/10790268.2019.1610618] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE Although life expectancy after spinal cord injury (SCI) has increased, knowledge of life satisfaction and associated factors among older adults with long-term SCI is still very limited. The objective of this study was, therefore, to assess global and domain-specific life satisfaction among older adults with long-term SCI and investigate the association with sociodemographics, injury characteristics and secondary health conditions. DESIGN Cross-sectional cohort study. Data from the Swedish Aging with Spinal Cord Injury Study (SASCIS). SETTING Community settings in southern Sweden. PARTICIPANTS Seventy-eight individuals (32% women, injury levels C1-L3, American Spinal Injury Association Impairment Scale (AIS) A-D) mean age 68 years, mean time since injury 31 years. INTERVENTIONS Not applicable. OUTCOME MEASURES The Life Satisfaction Questionnaire (LiSat-11). RESULTS The participants were at least rather satisfied with most of the 11 life domains. They rated the lowest satisfaction with sexual life, activities of daily living and somatic health. Having a partner and being vocationally active was associated with greater satisfaction with life as a whole and with several other life domains. Participants with AIS D injuries were less satisfied with their somatic health than those with tetraplegia AIS A-C and paraplegia AIS A-C injuries. More secondary health conditions were negatively associated with satisfaction in five life domains. CONCLUSION Life satisfaction can be affected many years after SCI. The social context, participation in meaningful activities and minimizing secondary health conditions seem to be important for maintaining life satisfaction in older adults with a long-term injury.
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Affiliation(s)
- Sophie Jörgensen
- Department of Health Sciences, Lund University, Lund, Sweden
- Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden
| | - Linn Hedgren
- Department of Health Sciences, Lund University, Lund, Sweden
| | - Anna Sundelin
- Department of Health Sciences, Lund University, Lund, Sweden
| | - Jan Lexell
- Department of Health Sciences, Lund University, Lund, Sweden
- Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden
- Department of Neuroscience, Rehabilitation Medicine, Uppsala University, Uppsala, Sweden
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6
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Ekstrand E, Lexell J, Brogårdh C. Life Satisfaction in Persons With Late Effects of Polio: A Test-Retest Reliability Study. PM R 2020; 12:997-1002. [PMID: 31944564 DOI: 10.1002/pmrj.12325] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 01/10/2020] [Indexed: 11/05/2022]
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.
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Affiliation(s)
- Elisabeth Ekstrand
- Department of Health Sciences, Lund University, Lund, Sweden.,Department of Hand Surgery, Skåne University Hospital, Malmö, Sweden
| | - Jan Lexell
- Department of Health Sciences, Lund University, Lund, Sweden.,Department of Neurology, Rehabilitation Medicine, Memory Disorders and Geriatrics, Skåne University Hospital, Lund, Sweden
| | - Christina Brogårdh
- Department of Health Sciences, Lund University, Lund, Sweden.,Department of Neurology, Rehabilitation Medicine, Memory Disorders and Geriatrics, Skåne University Hospital, Lund, Sweden
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7
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Quality of life assessment scales in polio survivors: a scoping review. Qual Life Res 2019; 28:2341-2357. [DOI: 10.1007/s11136-019-02185-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2019] [Indexed: 01/22/2023]
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8
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Sjödahl Hammarlund C, Lexell J, Brogårdh C. Growing up with a disability following paralytic poliomyelitis: experiences from persons with late effects of polio. Disabil Rehabil 2019; 43:960-966. [PMID: 31382857 DOI: 10.1080/09638288.2019.1647296] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE To describe the experiences of growing up after acute paralytic poliomyelitis and strategies used to adapt to the new situation. METHODS Seven women and seven men (mean age 70 years, min-max 61-78 years) with late effects of polio, who had contracted paralytic polio in their childhood. Data were collected using semi-structured interviews, transcribed verbatim, and analyzed by systematic text condensation. RESULTS Memories of contracting acute paralytic poliomyelitis involved being immobilized and sent away from home for surgical and physiotherapeutic treatment. Growing up in a social context that was often tough and unfriendly resulted in the development of strategies, such as optimistic thinking, trying to blend in, trusting one's ability to manage, and to handle the preconceptions and expectations of others. At the onset of late effects of polio, some of these strategies were still functioning, whereas overachieving, disregarding pain, and weariness were not. CONCLUSION The challenges of growing up with a disability following paralytic polio led to the development of various psychological strategies for managing daily life. By understanding these experiences and strategies, knowledge may be gained in assisting rehabilitation professionals to better support persons with late effects of polio in adapting to the new situation.Implications for rehabilitationAt the onset of late effects of polio, strategies developed earlier in life, such as overachieving, disregarding pain, and weariness, may not function anymore.Understanding the experiences of growing up with poliomyelitis can support rehabilitation professionals to provide targeted interventions for people with late effects of polio and enable them to develop new adaptive strategies.Developing new strategies, such as accepting increased symptoms, and augmenting self-esteem and self-efficacy, may improve daily functioning among people with late effects of polio.
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Affiliation(s)
- Catharina Sjödahl Hammarlund
- Department of Health Sciences, Lund University, Lund, Sweden.,The PRO-CARE Group, School of Health and Society, Kristianstad University, Kristianstad, Sweden
| | - Jan Lexell
- Department of Health Sciences, Lund University, Lund, Sweden.,Department of Neuroscience, Rehabilitation Medicine, Uppsala University, Uppsala, Sweden
| | - Christina Brogårdh
- Department of Health Sciences, Lund University, Lund, Sweden.,Department of Neurology, Rehabilitation Medicine, Memory Disorders and Geriatrics, Skåne University Hospital, Lund, Sweden
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9
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Nolvi M, Brogårdh C, Jacobsson L, Lexell J. Sense of Coherence and the Association with Sociodemographics and Disability Related Factors in Persons with Late Effects of Polio. PM R 2019; 12:154-160. [PMID: 31102303 DOI: 10.1002/pmrj.12190] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 05/14/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND Sense of Coherence (SOC) is important for successful adaptation in persons with life-long disabilities. A previous study has shown that persons with Late Effects of Polio (LEoP) have a level of SOC indicating that they generally have the ability to understand, handle, and have the motivation to deal with stressful events and problems arising in their lives. However, no study has explored the associations between SOC, sociodemographics, and disability-related factors in persons with LEoP. OBJECTIVE To explore the associations between SOC, sociodemographics, and disability-related factors in persons with LEoP. DESIGN A cross-sectional design. SETTING University hospital outpatient clinic. STUDY PARTICIPANTS Ninety-three persons (mean age 74 years, 52% women) with LEoP. MAIN OUTCOME MEASUREMENTS Swedish versions of the Sense of Coherence scale (SOC-13), Self-reported Impairments in Persons with Late Effects of Polio (SIPP) scale, Reintegration to Normal Living Index (RNL-I) (subscales "Daily Functioning" and "Perceptions of Self"), and Satisfaction With Life Scale (SWLS). METHODS The participants responded to a postal survey with background information and the four rating scales. To determine factors associated with SOC, a hierarchical regression analysis was performed with SOC as the dependent variable. RESULTS Higher age, less bothered by symptoms of LEoP, better perceptions of self, and higher life satisfaction were significantly associated with a greater SOC score. The final model explained 60% of the variance in the SOC (R2 Adj = 0.60, P < .001). CONCLUSIONS The strong association between SOC, higher age, and disability-related factors is important to consider in the rehabilitation of persons with LEoP. This knowledge can assist rehabilitation professionals to plan interventions that enable people with LEoP to develop strategies to better manage their daily life. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Maria Nolvi
- Department of Health Sciences, Lund University, Lund, Sweden.,Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden
| | - Christina Brogårdh
- Department of Health Sciences, Lund University, Lund, Sweden.,Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden
| | - Lars Jacobsson
- Department of Health Sciences, Lund University, Lund, Sweden.,Department of Rehabilitation, Sunderby Hospital, Luleå, Sweden
| | - Jan Lexell
- Department of Health Sciences, Lund University, Lund, Sweden.,Department of Neuroscience, Rehabilitation Medicine, Uppsala University, Uppsala, Sweden
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10
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Lexell J, Jonasson SB, Brogardh C. Psychometric Properties of Three Fatigue Rating Scales in Individuals With Late Effects of Polio. Ann Rehabil Med 2018; 42:702-712. [PMID: 30404419 PMCID: PMC6246856 DOI: 10.5535/arm.2018.42.5.702] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 03/05/2018] [Indexed: 11/15/2022] Open
Abstract
Objective To evaluate the psychometric properties of the Fatigue Severity Scale (FSS), the Fatigue Impact Scale (FIS), and the Multidimensional Fatigue Inventory (MFI-20) in persons with late effects of polio (LEoP). More specifically, we explored the data completeness, scaling assumptions, targeting, reliability, and convergent validity. Methods A postal survey including FSS, FIS, and MFI-20 was administered to 77 persons with LEoP. Responders received a second survey after 3 weeks to enable test-retest reliability analyses. Results Sixty-one persons (mean age, 68 years; 54% women) responded to the survey (response rate 79%). Data quality of the rating scales was high (with 0%–0.5% missing item responses), the corrected item-total correlations exceeded 0.4 and the scales showed very little floor or ceiling effects (0%–6.6%). All scales had an acceptable reliability (Cronbach’s α ≥0.95) and test-retest reliability (intraclass correlation coefficient, ≥0.80). The standard error of measurement and the smallest detectable difference were 7%–10% and 20%–28% of the possible scoring range. All three scales were highly correlated (Spearman’s correlation coefficient rs=0.79–0.80; p<0.001). Conclusion The FSS, FIS, and MFI-20 exhibit sound psychometric properties in terms of data completeness, scaling assumptions, targeting, reliability, and convergent validity, suggesting that these three rating scales can be used to assess fatigue in persons with LEoP. As FSS has fewer items and therefore is less time consuming it may be the preferred scale. However, the choice of scale depends on the research question and the study design.
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Affiliation(s)
- Jan Lexell
- Department of Health Sciences, Lund University, Lund, Sweden.,Department of Neuroscience, Rehabilitation Medicine, Uppsala University, Uppsala, Sweden.,Department of Health Science, Lulea University of Technology, Lulea, Sweden.,Department of Neurology and Rehabilitation Medicine, Skane University Hospital, Lund, Sweden
| | - Stina B Jonasson
- Department of Health Sciences, Lund University, Lund, Sweden.,Department of Neurology and Rehabilitation Medicine, Skane University Hospital, Lund, Sweden
| | - Christina Brogardh
- Department of Health Sciences, Lund University, Lund, Sweden.,Department of Neurology and Rehabilitation Medicine, Skane University Hospital, Lund, Sweden
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11
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Lo JK, Robinson LR. Post-polio syndrome and the late effects of poliomyelitis: Part 2. treatment, management, and prognosis. Muscle Nerve 2018; 58:760-769. [PMID: 29752826 DOI: 10.1002/mus.26167] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 05/06/2018] [Accepted: 05/08/2018] [Indexed: 12/16/2022]
Abstract
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.
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Affiliation(s)
- Julian K Lo
- Sunnybrook Health Sciences Centre, Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada
| | - Lawrence R Robinson
- Sunnybrook Health Sciences Centre, Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada
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12
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Markovic G, Bartfai A, Ekholm J, Nilsson C, Schult ML, Löfgren M. Daily management of attention dysfunction two–four years after brain injury and early cognitive rehabilitation with attention process training: a qualitative study. Neuropsychol Rehabil 2018; 30:523-544. [DOI: 10.1080/09602011.2018.1482770] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Gabriela Markovic
- Department of Clinical Sciences, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden
- Department of Rehabilitation Medicine, Danderyd University Hospital, Stockholm, Sweden
| | - Aniko Bartfai
- Department of Clinical Sciences, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden
- Department of Rehabilitation Medicine, Danderyd University Hospital, Stockholm, Sweden
| | - Jan Ekholm
- Department of Clinical Sciences, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden
| | - Charlotte Nilsson
- Department of Rehabilitation Medicine, Danderyd University Hospital, Stockholm, Sweden
| | - Marie-Louise Schult
- Department of Clinical Sciences, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden
- Department of Rehabilitation Medicine, Danderyd University Hospital, Stockholm, Sweden
| | - Monika Löfgren
- Department of Clinical Sciences, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden
- Department of Rehabilitation Medicine, Danderyd University Hospital, Stockholm, Sweden
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13
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Flansbjer UB, Lexell J, Brogårdh C. Predictors of changes in gait performance over four years in persons with late effects of polio. NeuroRehabilitation 2018; 41:403-411. [PMID: 28946571 DOI: 10.3233/nre-162057] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Reduced gait performance is common in persons with late effects of polio. OBJECTIVE To identify predictors of change in gait performance over four years in persons with late effects of polio. METHODS Gait performance was assessed annually in 51 ambulatory persons (mean age 64 years, SD 6) by the Timed "Up & Go" (TUG), Comfortable and Fast Gait Speed (CGS, FGS), and 6-Minute Walk Test (6MWT). Isokinetic knee extensor and flexor muscle strength was measured with a Biodex dynamometer. Mixed Linear Models were used to analyze changes in gait performance and to identify any predictors of change among the covariates gender, age, body mass index, time with new symptoms, baseline reduction in gait performance and knee muscle strength. RESULTS There were significant linear effects over time (reduction per year) for three gait performance tests; CGS (0.8%; p < 0.05), FGS (1.7%; p < 0.001), and 6MWT (0.7%; p < 0.05) with significant random effects for all tests. The strongest predictor of a change in gait performance was the individual variations in the knee flexor strength (p < 0.001). CONCLUSION The small gradual reduction in gait performance over time in persons with late effects of polio is primarily determined by the individual variations in the knee flexor strength.
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Affiliation(s)
| | - Jan Lexell
- Department of Health Sciences, Lund University, Lund, Sweden.,Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden.,Department of Health Science, Luleå University of Technology, Luleå, Sweden
| | - Christina Brogårdh
- Department of Health Sciences, Lund University, Lund, Sweden.,Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden
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14
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Sjödahl Hammarlund C, Lexell J, Brogårdh C. Perceived consequences of ageing with late effects of polio and strategies for managing daily life: a qualitative study. BMC Geriatr 2017; 17:179. [PMID: 28793865 PMCID: PMC5551026 DOI: 10.1186/s12877-017-0563-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 07/24/2017] [Indexed: 01/08/2023] Open
Abstract
Background New or increased impairments may develop several decades after an acute poliomyelitis infection. These new symptoms, commonly referred to as late effects of polio (LEoP), are characterised by muscular weakness and fatigue, generalised fatigue, pain at rest or during activities and cold intolerance. Growing older with LEoP may lead to increased activity limitations and participation restrictions, but there is limited knowledge of how these persons perceive the practical and psychological consequences of ageing with LEoP and what strategies they use in daily life. The aim of this qualitative study was therefore to explore how ageing people with LEoP perceive the their situation and what strategies they use for managing daily life. Methods Seven women and seven men (mean age 70 years) were interviewed. They all had a confirmed history of acute poliomyelitis and new impairments after a stable period of at least 15 years. Data were transcribed verbatim and analysed using systematic text condensation. Results The latent analysis resulted in three categories ‘Various consequences of ageing with LEoP’, ‘Limitations in everyday activities and participation restrictions’, and ‘Strategies for managing daily life when ageing with LEoP’ and 12 subcategories. The new impairments led to decreased physical and mental health. The participants perceived difficulties in performing everyday activities such as managing work, doing chores, partaking in recreational activities and participating in social events, thereby experiencing emotional and psychological distress. They managed to find strategies that mitigated their worries and upheld their self-confidence, for example finding practical solutions, making social comparisons, minimising, and avoidance. Conclusion Ageing with LEoP affected daily life to a great extent. The participants experienced considerable impact of the new and increased impairments on their life situation. Consequently, their ability to participate in various social activities also became restricted. Social comparisons and practical solutions are strategies that facilitate adaptation and acceptance of the new situation due to LEoP. This emphasises the need to design rehabilitation interventions that focus on coping, empowerment and self-management for people ageing with LEoP.
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Affiliation(s)
- Catharina Sjödahl Hammarlund
- Department of Health Sciences, Lund University, Box 157, SE-221 00, Lund, Sweden. .,The PRO-CARE Group, School of Health and Society, Kristianstad University, Kristianstad, Sweden.
| | - Jan Lexell
- Department of Health Sciences, Lund University, Box 157, SE-221 00, Lund, Sweden.,Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden.,Department of Health Science, Luleå University of Technology, Luleå, Sweden
| | - Christina Brogårdh
- Department of Health Sciences, Lund University, Box 157, SE-221 00, Lund, Sweden.,Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden
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Brogårdh C, Lexell J. Test-Retest Reliability of the Self-Reported Impairments in Persons With Late Effects of Polio (SIPP) Rating Scale. PM R 2016; 8:399-404. [DOI: 10.1016/j.pmrj.2015.09.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Revised: 07/31/2015] [Accepted: 09/25/2015] [Indexed: 10/22/2022]
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16
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Flansbjer UB, Brogårdh C, Horstmann V, Lexell J. Men With Late Effects of Polio Decline More Than Women in Lower Limb Muscle Strength: A 4-Year Longitudinal Study. PM R 2015; 7:1127-1136. [DOI: 10.1016/j.pmrj.2015.05.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 03/20/2015] [Accepted: 05/01/2015] [Indexed: 12/26/2022]
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17
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Winberg C, Flansbjer UB, Rimmer JH, Lexell J. Relationship Between Physical Activity, Knee Muscle Strength, and Gait Performance in Persons With Late Effects of Polio. PM R 2014; 7:236-44. [DOI: 10.1016/j.pmrj.2014.09.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 09/04/2014] [Accepted: 09/05/2014] [Indexed: 11/29/2022]
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18
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Winberg C, Flansbjer UB, Carlsson G, Rimmer J, Lexell J. Physical activity in persons with late effects of polio: A descriptive study. Disabil Health J 2014; 7:302-8. [DOI: 10.1016/j.dhjo.2014.02.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Revised: 01/29/2014] [Accepted: 02/05/2014] [Indexed: 10/25/2022]
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19
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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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