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Rizzo JF, Shah MP, Krasniqi D, Lu YR, Sinclair DA, Ksander BR. The Role of Epigenetics in Accelerated Aging: A Reconsideration of Later-Life Visual Loss After Early Optic Neuropathy. J Neuroophthalmol 2024; 44:16-21. [PMID: 37938114 DOI: 10.1097/wno.0000000000002041] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
BACKGROUND In 2005, we reported 3 patients with bilateral optic nerve damage early in life. These patients had stable vision for decades but then experienced significant bilateral vision loss with no obvious cause. Our hypothesis, novel at that time, was that the late decline of vision was due to age-related attrition of retinal ganglion cells superimposed on a reduced neuronal population due to the earlier injury. EVIDENCE ACQUISITION The field of epigenetics provides a new paradigm with which to consider the normal aging process and the impact of neuronal injury, which has been shown to accelerate aging. Late-in-life decline in function after early neuronal injury occurs in multiple sclerosis due to dysregulated inflammation and postpolio syndrome. Recent studies by our group in mice have also demonstrated the possibility of partial reversal of cellular aging and the potential to mitigate anatomical damage after injury and even improve visual function. RESULTS The results in mice and nonhuman primates published elsewhere have shown enhanced neuronal survival and visual function after partial epigenetic reprogramming. CONCLUSIONS Injury promotes epigenetic aging , and this finding can be observed in several clinically relevant scenarios. An understanding of the epigenetic mechanisms at play opens the opportunity to restore function in the nervous system and elsewhere with cellular rejuvenation therapies. Our earlier cases exemplify how reconsideration of previously established concepts can motivate inquiry of new paradigms.
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Affiliation(s)
- Joseph F Rizzo
- Department of Ophthalmology and the Neuro-Ophthalmology Service (JFR), Massachusetts Eye and Ear and the Harvard Medical School, Boston, Massachusetts; Avedisian and Chobanian School of Medicine (MPS), Boston University, Boston, Massachusetts; Department of Ophthalmology (MPS, DK, BRK), Harvard Medical School, Schepens Eye Research Institute of Mass Eye & Ear, Boston, Massachusetts; Department of Biology (YRL), Whitehead Institute for Biomedical Sciences, MIT, Cambridge, Massachusetts; and Paul F. Glenn Center for Biology of Aging Research (DAS), Department of Genetics, Blavatnik Institute, Harvard Medical School, Boston, Massachusetts
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Pereira Motta M, Oliveira ASB, André Nogueira JA, Vieira de Souza Moscardi AA, Munhoz Teixeira C, Manchim Favaro V, Simcsik AO, Conde S, Patrizi MC, Rinaldi C, Fontani V, Rinaldi S. Improving Strength and Fatigue Resistance in Post-Polio Syndrome Individuals with REAC Neurobiological Treatments. J Pers Med 2023; 13:1536. [PMID: 38003851 PMCID: PMC10672477 DOI: 10.3390/jpm13111536] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 10/23/2023] [Accepted: 10/24/2023] [Indexed: 11/26/2023] Open
Abstract
Post-Polio Syndrome (PPS) is a chronic condition characterized by the emergence of new symptoms and functional decline in individuals who previously had polio. Despite advances in medical understanding, management of PPS remains challenging. This study aimed to evaluate the use of neurobiological modulation treatments using Radio Electric Asymmetric Conveyer (REAC) technology on fatigue and muscle strength. An open-label study was conducted with 17 patients submitted to four neuromodulation protocols: Neuro Postural Optimization (NPO), Neuro Psycho Physical Optimization (NPPO), Neuro Psycho Physical Optimization-Cervico Brachial (NPPO-CB), and Neuromuscular Optimization (NMO). The Time Up and Go (TUG) test, Handgrip Strength Test, and Revised Piper Fatigue Scale (RPFS) were used to assess participants' fatigue and muscle strength, being applied at the beginning and end of each protocol. The results obtained from the improvement in strength, physical endurance, and particularly the RPFS behavioral dimension, affective dimension, and psychological sensory dimension, through the utilization of REAC neurobiological modulation treatments, highlight this correlation. These results suggest that these treatments could be considered as a potential therapeutic approach for PPS.
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Affiliation(s)
- Monalisa Pereira Motta
- Division of Neuromuscular Diseases, Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo 01000-000, Brazil; (M.P.M.); (J.A.A.N.); (C.M.T.); (V.M.F.); (A.O.S.); (S.C.); (M.C.P.)
| | - Acary Souza Bulle Oliveira
- Division of Neuromuscular Diseases, Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo 01000-000, Brazil; (M.P.M.); (J.A.A.N.); (C.M.T.); (V.M.F.); (A.O.S.); (S.C.); (M.C.P.)
| | - Jeyce Adrielly André Nogueira
- Division of Neuromuscular Diseases, Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo 01000-000, Brazil; (M.P.M.); (J.A.A.N.); (C.M.T.); (V.M.F.); (A.O.S.); (S.C.); (M.C.P.)
| | | | - Claudete Munhoz Teixeira
- Division of Neuromuscular Diseases, Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo 01000-000, Brazil; (M.P.M.); (J.A.A.N.); (C.M.T.); (V.M.F.); (A.O.S.); (S.C.); (M.C.P.)
| | - Vanessa Manchim Favaro
- Division of Neuromuscular Diseases, Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo 01000-000, Brazil; (M.P.M.); (J.A.A.N.); (C.M.T.); (V.M.F.); (A.O.S.); (S.C.); (M.C.P.)
| | - Amanda Orasmo Simcsik
- Division of Neuromuscular Diseases, Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo 01000-000, Brazil; (M.P.M.); (J.A.A.N.); (C.M.T.); (V.M.F.); (A.O.S.); (S.C.); (M.C.P.)
| | - Salete Conde
- Division of Neuromuscular Diseases, Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo 01000-000, Brazil; (M.P.M.); (J.A.A.N.); (C.M.T.); (V.M.F.); (A.O.S.); (S.C.); (M.C.P.)
| | - Maria Clara Patrizi
- Division of Neuromuscular Diseases, Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo 01000-000, Brazil; (M.P.M.); (J.A.A.N.); (C.M.T.); (V.M.F.); (A.O.S.); (S.C.); (M.C.P.)
| | - Chiara Rinaldi
- Department of Neuroscience, Psychology, Drug Area, and Child Health (NEUROFARBA), University of Florence, 50134 Florence, Italy;
- Department of Adaptive Neuro Psycho Physio Pathology and Neuro Psycho Physical Optimization, Rinaldi Fontani Institute, 50144 Florence, Italy;
- Department of Regenerative Medicine, Rinaldi Fontani Institute, 50144 Florence, Italy
- Research Department, Rinaldi Fontani Foundation, 50144 Florence, Italy
| | - Vania Fontani
- Department of Adaptive Neuro Psycho Physio Pathology and Neuro Psycho Physical Optimization, Rinaldi Fontani Institute, 50144 Florence, Italy;
- Department of Regenerative Medicine, Rinaldi Fontani Institute, 50144 Florence, Italy
- Research Department, Rinaldi Fontani Foundation, 50144 Florence, Italy
| | - Salvatore Rinaldi
- Department of Adaptive Neuro Psycho Physio Pathology and Neuro Psycho Physical Optimization, Rinaldi Fontani Institute, 50144 Florence, Italy;
- Department of Regenerative Medicine, Rinaldi Fontani Institute, 50144 Florence, Italy
- Research Department, Rinaldi Fontani Foundation, 50144 Florence, Italy
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Wändell P, Borg K, Li X, Carlsson AC, Sundquist J, Sundquist K. The risk of post-polio syndrome among immigrant groups in Sweden. Sci Rep 2023; 13:6044. [PMID: 37055461 PMCID: PMC10098995 DOI: 10.1038/s41598-023-33240-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 04/10/2023] [Indexed: 04/15/2023] Open
Abstract
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.
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Affiliation(s)
- Per Wändell
- Division of Family Medicine and Primary Care, NVS Department, Karolinska Institutet, Alfred Nobels Allé 23, 141 83, Huddinge, Sweden
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Kristian Borg
- Division of Rehabilitation Medicine, Department of Clinical Sciences, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden
| | - Xinjun Li
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Axel C Carlsson
- Division of Family Medicine and Primary Care, NVS Department, Karolinska Institutet, Alfred Nobels Allé 23, 141 83, Huddinge, Sweden.
- Academic Primary Health Care Centre, Region Stockholm, Stockholm, Sweden.
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
- 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
- Department of Functional Pathology, Center for Community-Based Healthcare Research and Education (CoHRE), School of Medicine, Shimane University, Matsue, Japan
| | - Kristina Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
- 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
- Department of Functional Pathology, Center for Community-Based Healthcare Research and Education (CoHRE), School of Medicine, Shimane University, Matsue, Japan
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Mercier MR, Moore HG, Wolfstadt JI, Rubin LE, Grauer JN. Outcomes Following Total Hip Arthroplasty in Patients With Postpolio Syndrome: A Matched Cohort Analysis. J Arthroplasty 2022; 37:1822-1826. [PMID: 35447277 DOI: 10.1016/j.arth.2022.04.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/07/2022] [Accepted: 04/11/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Patients with postpolio syndrome (PPS) may be afflicted by hip arthritis in either the paralytic or contralateral limb. Total hip arthroplasty (THA) may be considered in these patients. However, short-term and long-term outcomes following THA in PPS patients remain poorly characterized. METHODS The PearlDiver MHip administrative database was queried for patients undergoing THA. Patients with a diagnosis of PPS were matched 1:4 with control patients on the basis of age, gender, and comorbidity burden. Incidence of postoperative adverse events and readmission in the 90 days following surgery and occurrence of revision arthroplasty in the five-year postoperative period were assessed between the two cohorts. RESULTS In total, 1,519 PPS patients were matched to 6,076 control patients without PPS. After controlling for patient demographics and comorbidities, PPS patients demonstrated higher 90-day odds of urinary tract infection (odds ratio [OR] = 1.34, P = .016), pneumonia (OR = 2.07, P < .001), prosthetic dislocation (OR = 1.63, P = .018), and readmission (OR = 1.49, P = .002). Five years following surgery, 94.7% of the PPS cohort remained revision-free, compared to 96.7% of the control cohort (P = .001). CONCLUSION Compared to patients without PPS, patients with PPS demonstrated a higher incidence of urinary tract infection, pneumonia, prosthetic dislocation, and hospital readmission. In addition, five-year incidence of revision arthroplasty was significantly higher among the PPS cohort. In light of these increased risks, special considerations should be made in both preoperative planning and postoperative surveillance of PPS patients undergoing THA. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Michael R Mercier
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT
| | | | - Jesse I Wolfstadt
- Granovsky Gluskin Division of Orthopedic Surgery, Sinai Health System, University of Toronto, Toronto, Ontario, Canada
| | - Lee E Rubin
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT
| | - Jonathan N Grauer
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT
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Wendebourg MJ, Weigel M, Richter L, Gocheva V, Hafner P, Orsini AL, Crepulja V, Schmidt S, Huck A, Oechtering J, Blatow M, Haas T, Granziera C, Kappos L, Cattin P, Bieri O, Fischer D, Schlaeger R. Spinal Cord Gray Matter Atrophy is associated with functional decline in Post-Polio Syndrome. Eur J Neurol 2022; 29:1435-1445. [PMID: 35102676 PMCID: PMC9310958 DOI: 10.1111/ene.15261] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 12/30/2021] [Accepted: 01/20/2022] [Indexed: 11/29/2022]
Abstract
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. Methods 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 enlargement level (Tmax) (0.5 × 0.5 mm2 in‐plane resolution). SCGM areas were segmented manually by two independent raters. Muscle strength, self‐reported fatigue, depression and pain measures were assessed. Results Post‐polio syndrome patients showed significantly and preferentially reduced 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. Conclusions Patients with PPS show significant SCGM atrophy that correlates with muscle strength and is associated with PPS‐related functional decline. Our findings suggest a secondary neurodegenerative process underlying SCGM atrophy in PPS that is not explained 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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Affiliation(s)
- Maria Janina Wendebourg
- Neurology Clinic and Policlinic, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland.,ThINK Basel, Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Matthias Weigel
- Neurology Clinic and Policlinic, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland.,ThINK Basel, Department of Biomedical Engineering, University of Basel, Basel, Switzerland.,Division of Radiological Physics, Department of Radiology, University Hospital Basel, Basel, Switzerland.,Department of Biomedical Engineering, University of Basel, Basel, Switzerland.,MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel and University of Basel, Basel, Switzerland
| | - Laura Richter
- Neurology Clinic and Policlinic, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Vanya Gocheva
- Division of Paediatric Neurology, University of Basel Children's Hospital, Basel, Switzerland
| | - Patricia Hafner
- Division of Paediatric Neurology, University of Basel Children's Hospital, Basel, Switzerland
| | - Anna-Lena Orsini
- Division of Paediatric Neurology, University of Basel Children's Hospital, Basel, Switzerland
| | - Valentina Crepulja
- Neurology Clinic and Policlinic, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland.,ThINK Basel, Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Simone Schmidt
- Division of Paediatric Neurology, University of Basel Children's Hospital, Basel, Switzerland
| | - Antal Huck
- Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Johanna Oechtering
- Neurology Clinic and Policlinic, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Maria Blatow
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Tanja Haas
- Division of Radiological Physics, Department of Radiology, University Hospital Basel, Basel, Switzerland.,Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Cristina Granziera
- Neurology Clinic and Policlinic, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland.,ThINK Basel, Department of Biomedical Engineering, University of Basel, Basel, Switzerland.,MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel and University of Basel, Basel, Switzerland
| | - Ludwig Kappos
- Neurology Clinic and Policlinic, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland.,ThINK Basel, Department of Biomedical Engineering, University of Basel, Basel, Switzerland.,MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel and University of Basel, Basel, Switzerland
| | - Philippe Cattin
- Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Oliver Bieri
- Division of Radiological Physics, Department of Radiology, University Hospital Basel, Basel, Switzerland.,Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Dirk Fischer
- Division of Paediatric Neurology, University of Basel Children's Hospital, Basel, Switzerland
| | - Regina Schlaeger
- Neurology Clinic and Policlinic, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland.,ThINK Basel, Department of Biomedical Engineering, University of Basel, Basel, Switzerland.,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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McMahon BJ, Dojeiji S, Leiva RA, Fisher JM. Sixty-nine years after surviving the polio epidemic. CMAJ 2021; 193:E1915-E1917. [PMID: 34930766 PMCID: PMC8687505 DOI: 10.1503/cmaj.210985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Barry J McMahon
- Patient (McMahon), Ottawa, Ont.; Ottawa Hospital Rehabilitation Centre (Dojeiji), Ottawa, Ont.; Bruyère Continuing Care (Leiva); Department of Family Medicine (Dojeiji, Leiva), University of Ottawa, Ottawa, Ont.; Friend (Fisher), Ottawa, Ont
| | - Sue Dojeiji
- Patient (McMahon), Ottawa, Ont.; Ottawa Hospital Rehabilitation Centre (Dojeiji), Ottawa, Ont.; Bruyère Continuing Care (Leiva); Department of Family Medicine (Dojeiji, Leiva), University of Ottawa, Ottawa, Ont.; Friend (Fisher), Ottawa, Ont
| | - Rene A Leiva
- Patient (McMahon), Ottawa, Ont.; Ottawa Hospital Rehabilitation Centre (Dojeiji), Ottawa, Ont.; Bruyère Continuing Care (Leiva); Department of Family Medicine (Dojeiji, Leiva), University of Ottawa, Ottawa, Ont.; Friend (Fisher), Ottawa, Ont
| | - Joan M Fisher
- Patient (McMahon), Ottawa, Ont.; Ottawa Hospital Rehabilitation Centre (Dojeiji), Ottawa, Ont.; Bruyère Continuing Care (Leiva); Department of Family Medicine (Dojeiji, Leiva), University of Ottawa, Ottawa, Ont.; Friend (Fisher), Ottawa, Ont
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Falls in Post-Polio Patients: Prevalence and Risk Factors. BIOLOGY 2021; 10:biology10111110. [PMID: 34827103 PMCID: PMC8614826 DOI: 10.3390/biology10111110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/26/2021] [Accepted: 10/27/2021] [Indexed: 11/16/2022]
Abstract
Simple Summary People with post-polio syndrome (PPS) suffer frequent falls due to muscle weakness and problems with their balance. In order for a rehabilitation clinician to fit the patient with the optimal treatment plan to prevent imbalance and falls, we performed a simple 10-min walking test with 50 PPS patients. We also asked the patients how many falls they had experienced in the last year and they filled out a questionnaire regarding their balance confidence. We found that we can predict the occurrence of falls in PPS patients based on the consistency of their walking pattern. Since it is very easy to measure the walking pattern, our results may help rehabilitation clinicians to identify individuals at risk of fall and reduce the occurrence of falls in this population. Abstract Individuals with post-polio syndrome (PPS) suffer from falls and secondary damage. Aim: To (i) analyze the correlation between spatio-temporal gait data and fall measures (fear and frequency of falls) and to (ii) test whether the gait parameters are predictors of fall measures in PPS patients. Methods: Spatio-temporal gait data of 50 individuals with PPS (25 males; age 65.9 ± 8.0) were acquired during gait and while performing the Timed Up-and-Go test. Subjects filled the Activities-specific Balance Confidence Scale (ABC Scale) and reported number of falls during the past year. Results: ABC scores and number of falls correlated with the Timed Up-and-Go, and gait cadence and velocity. The number of falls also correlated with the swing duration symmetry index and the step length variability. Four gait variability parameters explained 33.2% of the variance of the report of falls (p = 0.006). The gait velocity was the best predictor of the ABC score and explained 24.8% of its variance (p = 0.001). Conclusion: Gait variability, easily measured by wearables or pressure-sensing mats, is an important predictor of falls in PPS population. Therefore, gait variability might be an efficient tool before devising a patient-specific fall prevention program for the PPS patient.
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Samaan A, Escalon MX. Joint and Back Pain: Medications and Role of Injection Therapy for Destructive Joint. Phys Med Rehabil Clin N Am 2021; 32:537-546. [PMID: 34175012 DOI: 10.1016/j.pmr.2021.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Postpolio syndrome (PPS) is a sequela with symptoms that often occur in patients who previously survived poliomyelitis. Pain is a characteristic feature of PPS. Although poliomyelitis is no longer commonly seen in the western world, there is a significant portion of patients living with PPS. Recognizing the signs of PPS is integral in developing treatment plans. Conservative management is routinely considered first-line therapy; however, alternate treatments, pharmacologic and minimally invasive, are used in more refractory cases. Approaching patients living with pain and PPS requires a holistic approach and an understanding of the efficacy of available treatment modalities.
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Affiliation(s)
- Angela Samaan
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1240, New York, NY 10029, USA.
| | - Miguel X Escalon
- Icahn School of Medicine at Mount Sinai, 5 East 98th Street, Sixth Floor, Box 1240B, New York, New York 10029, USA
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9
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Grill B, Cole M. Approach to Fatigue and Energy Conservation. Phys Med Rehabil Clin N Am 2021; 32:493-507. [PMID: 34175009 DOI: 10.1016/j.pmr.2021.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Fatigue, a common complaint in individuals with postpolio syndrome (PPS), is defined as an overwhelming sustained feeling of exhaustion and diminished capacity for physical and mental work. A comprehensive medical work-up is needed to rule out all other causes of fatigue. A sleep study should be considered for individuals with PPS who complain of fatigue. Self-reported outcome measures, such as the Fatigue Severity Scale, are reliable and valid tools to measure fatigue in this population. Fatigue management consists of individualized treatment of underlying medical conditions, energy conservation, pacing techniques, and lifestyle modifications.
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Affiliation(s)
- Beth Grill
- Spaulding Outpatient Center Framingham, 570 Worcester Road, Framingham, MA 01702, USA.
| | - Maria Cole
- Spaulding Outpatient Center Framingham, 570 Worcester Road, Framingham, MA 01702, USA
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10
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Effectiveness of Intravenous Immunoglobulin for Management of Pain in Patients with Postpolio Syndrome. Pain Res Manag 2021; 2021:6637705. [PMID: 33824690 PMCID: PMC8007355 DOI: 10.1155/2021/6637705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 03/17/2021] [Indexed: 11/18/2022]
Abstract
Objective Many patients with postpolio syndrome (PPS) experience pain. In this study, we aimed to review previous studies to investigate the effectiveness of intravenous immunoglobulin (IVIG) for managing pain in patients with PPS. We performed a narrative review. Methods In PubMed, we searched for the keywords ((Immunoglobulin OR IVIG) AND (poliomyelitis OR poliomyelitis syndrome)). We included articles in which IVIG was infused in patients with PPS and pain severity was measured before and after treatment. Results In the results, five articles (4 randomized controlled trials and 1 prospective observational study) were included in this review. Four of the studies reported that IVIG had a positive pain-reducing effect in patients with PPS. In addition, 4 studies evaluated the outcomes related to muscle strength and function. Of these studies, 3 showed some improvement in measurements for muscle strength and function. Conclusion In conclusion, IVIG might be one of the beneficial options for managing pain in PPS. Pain reduction might be responsible for the improvement of muscle strength or function. To confirm the benefits of IVIG in reducing pain, more high-quality studies are required.
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Wang XM, Cong YZ, Qiao GD, Zhang S, Wang LJ. Primary breast cancer patient with poliomyelitis: A case report. World J Clin Cases 2020; 8:6190-6196. [PMID: 33344622 PMCID: PMC7723693 DOI: 10.12998/wjcc.v8.i23.6190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 08/26/2020] [Accepted: 10/20/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Poliomyelitis is an acute infection caused by an enterovirus, which primarily infects the human gastrointestinal tract. In general, patients with polio have no association with the occurrence of cancer. The present case study presents a rare case of poliomyelitis combined with primary breast cancer.
CASE SUMMARY A 61-year-old woman who was diagnosed with poliomyelitis at 5 years old and confirmed invasive breast cancer by core needle biopsy (CNB) after hospitalization. The patient received a modified radical mastectomy and four cycles of chemotherapy with the TC (docetaxel and cyclophosphamide) regimen. The patient was also prescribed endocrine therapy without radiotherapy after chemotherapy. The patient had no evidence of lymphedema in the right upper extremities and no evidence of either regression or distant metastasis at the 1-year follow-up.
CONCLUSION The pectoral muscles of patients with polio are easily damaged in traumatic procedures, such as CNB, local anesthesia for tumor excision, and general anesthesia for surgery. A CNB, modified radical mastectomy, and four cycles of TC chemotherapy were successfully completed for the present case and the adverse reactions were found to be tolerable. This case may indicate the relationship between breast cancer and polio, and the examination and treatment methods used could be used as a guide for similar cases in the future.
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Affiliation(s)
- Xing-Miao Wang
- Department of Breast Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai 264400, Shandong Province, China
| | - Yi-Zi Cong
- Department of Breast Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai 264400, Shandong Province, China
| | - Guang-Dong Qiao
- Department of Breast Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai 264400, Shandong Province, China
| | - Song Zhang
- Department of Breast Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai 264400, Shandong Province, China
| | - Li-Juan Wang
- Department of Radiology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai 264400, Shandong Province, China
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Wang XM, Cong YZ, Qiao GD, Zhang S, Wang LJ. Primary breast cancer patient with poliomyelitis: A case report. World J Clin Cases 2020. [DOI: 10.12998/wjcc.v8.i23.6182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
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13
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Gouveia e Silva EC, Lange B, Bacha JMR, Pompeu JE. Effects of the Interactive Videogame Nintendo Wii Sports on Upper Limb Motor Function of Individuals with Post-Polio Syndrome: A Randomized Clinical Trial. Games Health J 2020; 9:461-471. [DOI: 10.1089/g4h.2019.0192] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Affiliation(s)
- Erika Christina Gouveia e Silva
- Neuroscience and Behaviour post graduation program of the Institute of Psicology of the University of Sao Paulo, Sao Paulo, Brazil
| | - Belinda Lange
- College of Nursing & Health Sciences, Flinders University, Adelaide, Australia
| | - Jéssica Maria Ribeiro Bacha
- Rehabilitation Science Post Graduation Program of the Department of Physical Therapy, Speech and Occupational Therapy of the School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
| | - José Eduardo Pompeu
- Department of Physical Therapy, Speech and Occupational Therapy of the School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
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Sherf RM, Cantrell D, Or K, Marcus E, Shapira A, Benbassat C, Ish-Shalom S, Koren R. The Risk of Bone Fractures in Post-Poliomyelitis Patients Transitioning to Middle Adulthood. Endocr Pract 2020; 26:1277-1285. [PMID: 33471657 DOI: 10.4158/ep-2020-0102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 06/01/2020] [Indexed: 11/15/2022]
Abstract
ObjectiveWhile osteoporotic fractures are reported in up to 40% of adults with post-poliomyelitis syndrome (PPS), clinical guidelines regarding bone mineral density (BMD) and indications for treatment are scarce. We investigated the characteristics of PPS patients, focusing on fractures and osteoporosis as the primary outcomes. METHODS A cross-sectional retrospective data analysis from medical records of 204 PPS patients regarding their clinical characteristics and long-term outcome, with emphasis on bone metabolism status. RESULTS Our cohort included 53% women; mean age was 65 years at study entry and 1.7 years at the diagnosis of acute poliomyelitis. The lower limb was involved in 97.5% of patients, and the BMD in the affected limb tended to be lower than the unaffected, with a mean T-score of -1.64 vs. -1.19, respectively (P = .06). Recurrent falls were documented in 39.2% of patients, and osteoporosis in 20.6%, being more frequent in women (P = .003) and patients with fractures (P = .002). At least one fracture occurred in 52.2% of patients, and more than one in 40.3%. The median age for the first fracture was 57.5 years (range, 30 to 83 years), and most fractures occurred in the affected limb (73.2%). CONCLUSIONS Underdiagnosis and delayed treatment of osteoporosis in late-adulthood post-poliomyelitis patients underlie the need for comprehensive clinical guidelines to manage these patients, including recommendations on bone health assessment, medical treatment, and their inclusion as a high-risk group for bone fractures.
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Affiliation(s)
- Rutie Mamlok Sherf
- Internal Medicine A, Shamir Medical Center (formerly Assaf Harofeh), Zerifin
| | - Dror Cantrell
- Endocrine Institute, Shamir Medical Center (formerly Assaf Harofeh), Zerifin; Internal Medicine C, Shamir Medical Center (formerly Assaf Harofeh), Zerifin
| | - Karen Or
- Internal Medicine A, Shamir Medical Center (formerly Assaf Harofeh), Zerifin; Endocrine Institute, Shamir Medical Center (formerly Assaf Harofeh), Zerifin
| | - Efrat Marcus
- Endocrine Institute, Shamir Medical Center (formerly Assaf Harofeh), Zerifin
| | - Alex Shapira
- Polio Clinic Department of Orthopedics, Shamir Medical Center (formerly Assaf Harofeh), Zerifin
| | - Carlos Benbassat
- Endocrine Institute, Shamir Medical Center (formerly Assaf Harofeh), Zerifin; Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv.
| | | | - Ronit Koren
- Endocrine Institute, Shamir Medical Center (formerly Assaf Harofeh), Zerifin; Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv
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Sawada K, Horii M, Imoto D, Ozaki K, Toyama S, Saitoh E, Mikami Y, Kubo T. Usefulness of Electromyography to Predict Future Muscle Weakness in Clinically Unaffected Muscles of Polio Survivors. PM R 2020; 12:692-698. [DOI: 10.1002/pmrj.12281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 10/24/2019] [Indexed: 11/09/2022]
Affiliation(s)
- Koshiro Sawada
- Department of Rehabilitation Medicine, Graduate School of Medical ScienceKyoto Prefectural University of Medicine Kyoto Japan
| | - Motoyuki Horii
- Department of Rehabilitation Medicine, Graduate School of Medical ScienceKyoto Prefectural University of Medicine Kyoto Japan
| | - Daisuke Imoto
- Department of Rehabilitation Medicine, Graduate School of Medical ScienceKyoto Prefectural University of Medicine Kyoto Japan
| | - Kenichi Ozaki
- Department of Rehabilitation Medicine 1School of Medicine, Fujita Health University Toyoake Japan
| | - Shogo Toyama
- Department of Rehabilitation Medicine, Graduate School of Medical ScienceKyoto Prefectural University of Medicine Kyoto Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine 1School of Medicine, Fujita Health University Toyoake Japan
| | - Yasuo Mikami
- Department of Rehabilitation Medicine, Graduate School of Medical ScienceKyoto Prefectural University of Medicine Kyoto Japan
| | - Toshikazu Kubo
- Department of Rehabilitation Medicine, Graduate School of Medical ScienceKyoto Prefectural University of Medicine Kyoto Japan
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Corticomotor Excitability in Two Kinds of Motor Neuron Diseases: A Study on the Patients With Amyotrophic Lateral Sclerosis and Poliomyelitis Survivors. J Clin Neurophysiol 2020; 38:448-455. [DOI: 10.1097/wnp.0000000000000707] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Pattern of muscle involvement according to needle electromyography findings in clinically unaffected extremities of polio survivors with lower extremity weaknesses. JOURNAL OF SURGERY AND MEDICINE 2019. [DOI: 10.28982/josam.612567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Oluwasanmi OJ, Mckenzie DA, Adewole IO, Aluka CO, Iyasse J, Olunu E, Fakoya AO. Postpolio Syndrome: A Review of Lived Experiences of Patients. Int J Appl Basic Med Res 2019; 9:129-134. [PMID: 31392174 PMCID: PMC6652271 DOI: 10.4103/ijabmr.ijabmr_333_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Postpolio syndrome (PPS) refers to a group of conditions that are present in patients, years after recovery from initial acute paralytic poliomyelitis. About 15%-80% of 20 million polio survivors worldwide will experience exacerbation of symptoms which typically appear 15-30 years after the resolution of initial poliomyelitis. Symptoms include new muscle weakness, fatigue, myalgia, joint pain, dysphagia, and difficulty breathing. Other reported symptoms include cold intolerance, sleep disorder, dysphonia, loss of stamina, musculoskeletal deformities, cardiovascular disorders, psychosocial problems, and restless legs syndrome. These symptoms are attributed to the superimposed neuronal loss of aging with inflammatory mechanisms, but without any convincing evidence of viral reactivation. Risk factors include female gender, respiratory symptoms, normal aging, permanent disability caused by motor neuron damage, muscle overuse and disuse, aging, and immunologic mechanisms. Hypothyroidism-induced myopathy and fibromyalgia are a differential diagnosis for PPS, and exclusion diagnosis is required as confirmatory criteria for PPS. The symptoms of PPS presented determine the course of management.
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Affiliation(s)
- Oluwaseyi Jacob Oluwasanmi
- Department of Microbiology, All Saints University School of Medicine, Commonwealth of Dominica, Roseau, Dominica
| | - Devaunna Andrene Mckenzie
- Department of Microbiology, All Saints University School of Medicine, Commonwealth of Dominica, Roseau, Dominica
| | - Idowu Oluwasegun Adewole
- Department of Microbiology, All Saints University School of Medicine, Commonwealth of Dominica, Roseau, Dominica
| | - Christian O Aluka
- Department of Microbiology, All Saints University School of Medicine, Commonwealth of Dominica, Roseau, Dominica
| | - James Iyasse
- Department of Microbiology, All Saints University School of Medicine, Commonwealth of Dominica, Roseau, Dominica
| | - Esther Olunu
- Department of Microbiology, All Saints University School of Medicine, Commonwealth of Dominica, Roseau, Dominica
| | - Adegbenro Omotuyi Fakoya
- Department of Anatomical Sciences, University of Medicine and Health Sciences, Basseterre, St. Kitts and Nevis
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Chu ECP, Lam KKW. Post-poliomyelitis syndrome. Int Med Case Rep J 2019; 12:261-264. [PMID: 31496835 PMCID: PMC6690913 DOI: 10.2147/imcrj.s219481] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Accepted: 07/31/2019] [Indexed: 12/30/2022] Open
Abstract
Most developed countries eliminated paralytic poliomyelitis (polio) in the 1970s to 1980s. It was believed that after recovery from acute paralytic poliomyelitis, the physical condition of survivors would remain stable for the rest of their lives. However, the elimination of polio does not equate the end of medical management of polio. Hundreds of thousands of polio survivors worldwide are still at risk of developing the late effects of the disease. Here, we report a case of post-polio syndrome who attended our clinic for the presence of new weakness and neuromuscular problems six decades after recovery from paralytic polio. It is essential that health professionals be aware of these conditions and have an understanding of the underlying pathophysiology of the symptoms. ![]()
Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/c0XVX_xPOhE
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Affiliation(s)
- Eric Chun Pu Chu
- New York Chiropractic and Physiotherapy Center, New York Medical Group, Hong Kong, People's Republic of China
| | - Kary Ka Wai Lam
- Downtown Chiropractic Limited, Hong Kong, People's Republic of China
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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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Li Hi Shing S, Chipika RH, Finegan E, Murray D, Hardiman O, Bede P. Post-polio Syndrome: More Than Just a Lower Motor Neuron Disease. Front Neurol 2019; 10:773. [PMID: 31379723 PMCID: PMC6646725 DOI: 10.3389/fneur.2019.00773] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 07/02/2019] [Indexed: 12/13/2022] Open
Abstract
Post-polio syndrome (PPS) is a neurological condition that affects polio survivors decades after their initial infection. Despite its high prevalence, the etiology of PPS remains elusive, mechanisms of progression are poorly understood, and the condition is notoriously under-researched. While motor dysfunction is a hallmark feature of the condition, generalized fatigue, sleep disturbance, decreased endurance, neuropsychological deficits, sensory symptoms, and chronic pain are also often reported and have considerable quality of life implications in PPS. The non-motor aspects of PPS are particularly challenging to evaluate, quantify, and treat. Generalized fatigue is one of the most distressing symptoms of PPS and is likely to be multifactorial due to weight-gain, respiratory compromise, poor sleep, and polypharmacy. No validated diagnostic, monitoring, or prognostic markers have been developed in PPS to date and the mainstay of therapy centers on symptomatic relief and individualized rehabilitation strategies such as energy conservation and muscle strengthening exercise regimes. Despite a number of large clinical trials in PPS, no effective disease-modifying pharmacological treatments are currently available.
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Affiliation(s)
- Stacey Li Hi Shing
- Computational Neuroimaging Group, Academic Unit of Neurology, Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Rangariroyashe H Chipika
- Computational Neuroimaging Group, Academic Unit of Neurology, Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Eoin Finegan
- Computational Neuroimaging Group, Academic Unit of Neurology, Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Deirdre Murray
- Computational Neuroimaging Group, Academic Unit of Neurology, Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Orla Hardiman
- Computational Neuroimaging Group, Academic Unit of Neurology, Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Peter Bede
- Computational Neuroimaging Group, Academic Unit of Neurology, Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
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Gensowski M, Nielsen TH, Nielsen NM, Rossin-Slater M, Wüst M. Childhood health shocks, comparative advantage, and long-term outcomes: Evidence from the last Danish polio epidemic. JOURNAL OF HEALTH ECONOMICS 2019; 66:27-36. [PMID: 31100634 DOI: 10.1016/j.jhealeco.2019.03.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 03/26/2019] [Accepted: 03/29/2019] [Indexed: 06/09/2023]
Abstract
This paper examines the long-term effects of childhood disability on individuals' educational and occupational choices, late-career labor market participation, and mortality. We merge medical records on children hospitalized with poliomyelitis during the 1952 Danish epidemic to census and administrative data, and exploit quasi-random variation in paralysis incidence in this population. While childhood disability increases the likelihood of early retirement and disability pension receipt at age 50, paralytic polio survivors are more likely to obtain a university degree and to go on to work in white-collar and computer-demanding jobs than their non-paralytic counterparts. Our results are consistent with individuals making educational and occupational choices that reflect a shift in the comparative advantage of cognitive versus physical skills. We also find that paralytic polio patients from low socioeconomic status backgrounds are more likely to die prematurely than their non-paralytic counterparts, whereas there is no effect on mortality among polio survivors from more advantaged backgrounds.
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Affiliation(s)
- Miriam Gensowski
- University of Copenhagen, Department of Economics & CEBI, Denmark, and IZA, Germany.
| | | | | | | | - Miriam Wüst
- University of Copenhagen, Department of Economics and The Danish Centre for Social Science Research (VIVE), Øster Farimagsgade 5, DK 1353, Copenhagen K, Denmark.
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Gawel M, Zalewska E, Szmidt-Salkowska E, Lipowska M, Lusakowska A, Kaminska AM, Kostera-Pruszczyk A. Motor Unit Number Index (MUNIX) as a biomarker of motor unit loss in post-polio syndrome versus needle EMG. J Electromyogr Kinesiol 2019; 46:35-40. [DOI: 10.1016/j.jelekin.2019.03.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 02/16/2019] [Accepted: 03/08/2019] [Indexed: 12/14/2022] Open
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24
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Grill B, Levangie PK, Cole M, Rosenberg D, Jensen L. Bone Mineral Density Among Individuals With Residual Lower Limb Weakness After Polio. PM R 2019; 11:470-475. [DOI: 10.1016/j.pmrj.2018.08.387] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 08/18/2018] [Indexed: 10/28/2022]
Affiliation(s)
- Beth Grill
- Spaulding Outpatient Center Framingham MA
| | - Pamela K. Levangie
- MGH Institute of Health ProfessionsBoston, MA; and 500 Lexington Street, Unit 3 Woburn, MA 01801
| | - Maria Cole
- Spaulding Outpatient Center Framingham MA
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Da Silva CP, Miller LA, Morrel EC, Wang W. Predictive Abilities of Balance Confidence and Fear of Falling Measures on Falls in Polio Survivors. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2019. [DOI: 10.1080/02703181.2019.1610542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Carolyn P. Da Silva
- School of Physical Therapy, Texas Woman’s University, Houston, Texas, USA
- TIRR-Memorial Hermann Rehabilitation and Research Out-Patient Medical Specialty Clinic, Post-Polio Clinic, Houston, Texas, USA
| | - Lesley A. Miller
- School of Physical Therapy, Texas Woman’s University, Houston, Texas, USA
- Physical Therapy Department, Lyndon B Johnson Hospital, Houston, Texas, USA
| | - Emily C. Morrel
- School of Physical Therapy, Texas Woman’s University, Houston, Texas, USA
- Vitalico, Houston, Texas, USA
| | - Wanyi Wang
- Center for Research Design and Analysis, Office of Research and Sponsored Programs, Texas Woman's University, Houston, Texas, USA
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Yedavalli VS, Patil A, Shah P. Amyotrophic Lateral Sclerosis and its Mimics/Variants: A Comprehensive Review. J Clin Imaging Sci 2018; 8:53. [PMID: 30652056 PMCID: PMC6302559 DOI: 10.4103/jcis.jcis_40_18] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 08/12/2018] [Indexed: 12/16/2022] Open
Abstract
Motor neuron diseases (MNDs) are a debilitating subset of diseases, which result in progressive neuronal destruction and eventual loss of voluntary muscular function. These entities are often challenging to distinguish and accurately diagnose given overlapping clinical pictures and overall rarity. This group of diseases has a high morbidity and mortality rate overall and delineating each type of disease can help guide appropriate clinical management and improve quality of life for patients. Of all MNDs, amyotrophic lateral sclerosis (ALS) is by far the most common comprising 80%–90% of cases. However, other mimics and variants of ALS can appear similar both clinically and radiographically. In this review, we delve into the epidemiological, physiological, neuroimaging, and prognostic characteristics and management of ALS and its most common MND mimics/variants. In doing so, we hope to improve accuracy in diagnosis and potential management for this rare group of diseases.
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Affiliation(s)
- Vivek S Yedavalli
- Department of Neuroradiology and Neurointervention, Stanford University, Palo Alto, California, USA
| | - Abhijit Patil
- Department of Radiology, Advocate Illinois Masonic Medical Center, Chicago, Illinois, USA
| | - Parinda Shah
- Department of Radiology, Advocate Illinois Masonic Medical Center, Chicago, Illinois, USA
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Mobility and participation among ageing powered wheelchair users: using a lifecourse approach. AGEING & SOCIETY 2018. [DOI: 10.1017/s0144686x18001228] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractAbout 65 million people use wheelchairs worldwide. Powered wheelchairs offer independent mobility for those who find it difficult to propel a manual wheelchair. Previous studies have described powered wheelchairs as a mixed blessing for the users in terms of usability, accessibility, safety, cost and stigma; however, few studies have explored their impact on mobility and participation over time. Therefore, as part of a larger longitudinal study, we used a combined retrospective and prospective lifecourse perspective to explore the experiences of older adult powered wheelchair users. Based on the interpretive description approach, 19 participants took part in a series of semi-structured interviews over a two-year period about their mobility, social participation and ageing process. The participants were powered wheelchair users, at least 50 years of age, recruited in Vancouver, Montreal and Quebec City (Canada). We identified three themes that highlighted how the powered wheelchair experience was integrated into the life continuum of the users. ‘It's my legs’ emphasised how powered wheelchairs are a form of mobility that not only enables users to take part in activities, but also impacts their identities, past and present. ‘Wheels of change’ explored the dynamic nature of powered wheelchair use and changes related to ageing. ‘Getting around’ illustrated how users’ mobility was affected by the interaction with their physical and social environments. Developing public policies to advance social and environmental changes could help countries to ensure equity of access and social inclusion of those ageing with disabilities.
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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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29
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Lo JK, Robinson LR. Postpolio syndrome and the late effects of poliomyelitis. Part 1. pathogenesis, biomechanical considerations, diagnosis, and investigations. Muscle Nerve 2018; 58:751-759. [DOI: 10.1002/mus.26168] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 05/06/2018] [Accepted: 05/08/2018] [Indexed: 01/18/2023]
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 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 Canada
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Zúñiga-Cerón LF, Saavedra-Torres JS, Zamora-Bastidas TO, Pinzón-Fernández MV. Post-polio syndrome, report of two cases. CASE REPORTS 2018. [DOI: 10.15446/cr.v4n2.68235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
El síndrome pospoliomielitis se reconoce como un trastorno neurológico que aparece décadas después de un episodio agudo de poliomielitis y disminuye la capacidad funcional hasta afectar las actividades cotidianas. El evento ocurre en un 20-80% de las personas que fueron afectadas por el virus de la poliomielitis, es más frecuente en las mujeres y existe una relación directa entre el riesgo de padecer este síndrome y el grado de severidad de las secuelas de la polio. El objetivo de este artículo es la presentación de dos casos clínicos de pacientes que presentaron este síndrome después de cerca de cuarenta años de haber presentado un episodio de poliomielitis. Se cuestiona el concepto de la poliomielitis como una enfermedad estática; además, en los casos presentados esta patología constituye un proceso de difícil diagnóstico y manejo. El impacto psicológico y funcional en los pacientes se asume como un reto para el profesional de salud, puesto que se deben identificar las necesidades clínicas y reducir las barreras asistenciales existentes en la actualidad.
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Nolvi M, Brogårdh C, Jacobsson L, Lexell J. Sense of Coherence in persons with late effects of polio. NeuroRehabilitation 2018; 42:103-111. [PMID: 29400675 DOI: 10.3233/nre-172198] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Sense of Coherence (SOC) is important for successful adaptation and mental well-being in people with life-long medical conditions. Late effects of polio (LEoP) often lead to a life-long disability, but no study has assessed SOC in this population. OBJECTIVE To assess SOC in persons with LEoP and to explore the association between SOC, demographics (age, gender, marital status and level of education) and variables related to LEoP (age at polio onset, number of years from polio until onset of LEoP and self-rated disability). METHOD Ninety-three community-dwelling persons with clinically verified LEoP responded to a postal survey with the Sense of Coherence Scale (SOC-13). A hierarchical multiple regression analysis was performed to explore the associations with SOC. RESULTS SOC varied considerably among the participants. The mean and median SOC-13 total sum score was 71.8 and 76 points, which is similar to age-matched non-disabled people. The number of years before onset of LEoP and self-rated disability together with the participants' marital status and level of education explained 37% (p < 0.001) of the variance in SOC. CONCLUSION Persons with LEoP have a level of SOC indicating that they generally have the ability to understand, handle and being motivated when dealing with stressful events and problems arising in their lives as a result of their disability. Being married and having a higher education, living many years before onset of LEoP and perceiving a mild to moderate disability contributed to a strong SOC.
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Affiliation(s)
- Maria Nolvi
- Department of Health Sciences, Rehabilitation Medicine Research Group, Lund University, Sweden
| | - Christina Brogårdh
- Department of Health Sciences, Physiotherapy Research Group, Lund University, Sweden.,Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden
| | - Lars Jacobsson
- Department of Health Sciences, Rehabilitation Medicine Research Group, Lund University, Sweden.,Department of Health Science, Luleå University of Technology, Luleå, Sweden.,Department of Rehabilitation Medicine, Sunderby Hospital, Luleå, Sweden
| | - Jan Lexell
- Department of Health Sciences, Rehabilitation Medicine Research Group, Lund University, Sweden.,Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden.,Department of Health Science, Luleå University of Technology, Luleå, Sweden.,Department of Rehabilitation Medicine, Sunderby Hospital, Luleå, Sweden
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Post-polio Syndrome. Neuromuscul Disord 2018. [DOI: 10.1007/978-981-10-5361-0_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Pastuszak Ż, Piusińska-Macoch R, Stępień A, Czernicki Z. Repetitive transcranial magnetic stimulation in treatment of post polio syndrome. Neurol Neurochir Pol 2017; 52:281-284. [PMID: 29279133 DOI: 10.1016/j.pjnns.2017.10.013] [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] [Received: 08/28/2017] [Revised: 10/21/2017] [Accepted: 10/24/2017] [Indexed: 12/01/2022]
Abstract
BACKGROUND Post polio syndrome is a rare disease that occurs decades after polio virus infection. Repetitive transcranial magnetic stimulation (rTMS) is a treatment option with proved effectiveness in drug resistant depression. Possibly it can be helpful in therapy of other neurological diseases including post polio syndrome. OBJECTIVE To describe a case of patient diagnosed with post polio syndrome who was treated with rTMS stimulation with a good effect. METHODS Patient had rTMS stimulation of left prefrontal cortex twice a week for an eight weeks. Patient's health status was evaluated before treatment, after last rTMS session and after three months from the end of the treatment. RESULTS Improvement of fatigue score, mood disturbances and motor functions was observed after treatment. CONCLUSION rTMS can be an effective method in treatment of post polio syndrome but further studies with larger group need to be done to confirm that data.
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Affiliation(s)
- Żanna Pastuszak
- Department of Neurosurgery, Mossakowski Medical Research Centre, Polish Academy of Sciences, A. Pawińskiego 5, 02-106 Warsaw, Poland.
| | - Renata Piusińska-Macoch
- Department of Neurology, Military Institute of Medicine, Szaserów 128, 04-141 Warsaw, Poland
| | - Adam Stępień
- Department of Neurology, Military Institute of Medicine, Szaserów 128, 04-141 Warsaw, Poland
| | - Zbigniew Czernicki
- Department of Neurosurgery, Warsaw University of Medicine, Cegłowska 80, 01-809 Warsaw, Poland
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Shoseyov D, Cohen-Kaufman T, Schwartz I, Portnoy S. Comparison of activity and fatigue of the respiratory muscles and pulmonary characteristics between post-polio patients and controls: A pilot study. PLoS One 2017; 12:e0182036. [PMID: 28750019 PMCID: PMC5531432 DOI: 10.1371/journal.pone.0182036] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 07/11/2017] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES To compare pulmonary function measures, maximal respiratory pressure and fatigue of respiratory muscles between patients with Post-Polio Syndrome (PPS) and controls. DESIGN Cross-sectional study. PATIENTS Patients with PPS (N = 12; age 62.1±11.6 years) able to walk for 6 minutes without human assistance; age-matched controls with no history of polio or pulmonary dysfunction (N = 12; age 62.2±6.5 years). MEASUREMENTS A body plethysmograph was used to quantify Residual Volume (RV), Total Lung Capacity (TLC), and Thoracic Gas Volume (TGV) etc. A manometer was used to measure Maximal Inspiratory Pressure (MIP) and Maximal Expiratory Pressure. A spirometer was used to measure Maximal Voluntary Ventilation (MVV). Surface electromyography (sEMG) recorded diaphragmatic muscle activity while performing MVV. RESULTS The control group had significantly higher TGV and showed improvement in MIP following the effort (difference of 5.5±4.0cmH2O) while the PPS group showed deterioration in MIP (difference of -2.5±5.0cmH2O). Subjects with scoliosis had significantly higher RV/TLC values compared with subjects without scoliosis. The 25th frequency percentile of the sEMG signal acquired during MVV was reduced in the PPS group. CONCLUSIONS Maximal respiratory pressure test and sEMG measurements may identify fatigue of respiratory muscles in patients with PPS. Early diagnosis of respiratory impairment may delay respiratory decline and future need of invasive respiratory aids.
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Affiliation(s)
- David Shoseyov
- Pediatric department, Hadassah Mount Scopus, Jerusalem, Israel
| | - Tali Cohen-Kaufman
- Physical Medicine and Rehabilitation department, Hadassah Mount Scopus, Jerusalem, Israel
- Department of Physiotherapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Isabella Schwartz
- Physical Medicine and Rehabilitation department, Hadassah Mount Scopus, Jerusalem, Israel
| | - Sigal Portnoy
- Physical Medicine and Rehabilitation department, Hadassah Mount Scopus, Jerusalem, Israel
- Department of Occupational Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Measuring Physical and Cognitive Fatigue in People With Post-Polio Syndrome: Development of the Neurological Fatigue Index for Post-Polio Syndrome (NFI-PP). PM R 2017; 10:129-136. [DOI: 10.1016/j.pmrj.2017.06.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 06/07/2017] [Accepted: 06/17/2017] [Indexed: 11/24/2022]
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Post-Polio Syndrome, Implications for Geriatric Care. CURRENT GERIATRICS REPORTS 2017. [DOI: 10.1007/s13670-017-0194-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Buttaro MA, Slullitel PA, García Mansilla AM, Carlucci S, Comba FM, Zanotti G, Piccaluga F. Long-term Outcome of Unconstrained Primary Total Hip Arthroplasty in Ipsilateral Residual Poliomyelitis. Orthopedics 2017; 40:e255-e261. [PMID: 27841928 DOI: 10.3928/01477447-20161108-03] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 09/28/2016] [Indexed: 02/03/2023]
Abstract
Incapacitating articular sequelae in the hip joint have been described for patients with late effects of poliomyelitis. In these patients, total hip arthroplasty (THA) has been associated with a substantial rate of dislocation. This study was conducted to evaluate the long-term clinical and radiologic outcomes of unconstrained THA in this specific group of patients. The study included 6 patients with ipsilateral polio who underwent primary THA between 1985 and 2006. Patients with polio who underwent THA on the nonparalytic limb were excluded. Mean follow-up was 119.5 months (minimum, 84 months). Clinical outcomes were evaluated with the modified Harris Hip Score (mHHS) and the visual analog scale (VAS) pain score. Radiographs were examined to identify the cause of complications and determine the need for revision surgery. All patients showed significantly better functional results when preoperative and postoperative mHHS (67.58 vs 87.33, respectively; P=.002) and VAS pain score (7.66 vs 2, respectively; P=.0003) were compared. Although 2 cases of instability were diagnosed, only 1 patient needed acetabular revision as a result of component malpositioning. None of the patients had component loosening, osteolysis, or infection. Unconstrained THA in the affected limb of patients with poliomyelitis showed favorable long-term clinical results, with improved function and pain relief. Nevertheless, instability may be a more frequent complication in this group of patients compared with the general population. [Orthopedics. 2017; 40(2):e255-e261.].
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Young CA, Quincey AMC, Wong SM, Tennant A. Quality of life for post-polio syndrome: a patient derived, Rasch standard scale. Disabil Rehabil 2016; 40:597-602. [DOI: 10.1080/09638288.2016.1260650] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Carolyn A. Young
- Department of Neurology, Walton Centre NHS Trust, Lower Lane, Liverpool, UK
| | | | - Samantha M. Wong
- Department of Neurology, Walton Centre NHS Trust, Lower Lane, Liverpool, UK
| | - Alan Tennant
- ICF Unit, Swiss Paraplegic Research, Nottwil, Switzerland
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Bertolasi L, Danese A, Monaco S, Turri M, Borg K, Werhagen L. Polio Patients in Northern Italy, a 50 Year Follow-up. Open Neurol J 2016; 10:77-82. [PMID: 27651845 PMCID: PMC5012079 DOI: 10.2174/1874205x01610010077] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2016] [Revised: 05/24/2016] [Accepted: 06/09/2016] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Poliomyelitis was before the immunization an important medical problem. Nowadays polio prior patients (PP) suffer from polio sequelae or have developed post-polio-syndrome (PPS) with increasing paresis, pain and fatigue. OBJECTIVES To analyze the medical situation 50 years after acute polio. The degree of paresis was compared between the recovery 1952-1961 and 2012.The prevalence of patients fulfilling the criteria for PPS was estimated. METHOD The study was performed in Italy. Included were PP with rehabilitation after acute polio 1952-1961 and in 2012. During the years PP underwent yearly evaluation. A thorough neurological examination was performed in 2012. A telephone interview with questions concerning pain, paresis, fatigue, walking aids and concomitant diseases was performed in 2012. The patients were divided in two groups, if they fulfilled the criteria for PPS or not. RESULTS Included were 67(94%) patients receiving rehabilitation after acute poliomyelitis and 2012. 78% were walkers, half of the PPS used wheelchair. Eight out of ten suffered from pain. Four out of ten fulfilled the PPS criteria. Pain was slightly more common in PPS. CONCLUSION Female gender, fatigue and wheelchair dependency were significantly more common in PPS while pain was common in both groups.
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Affiliation(s)
- L. Bertolasi
- Section of Neurology, Department of Neurological, Neurophysiological, Morphological and Motor Sciences, University of Verona, Verona, Italy
| | - A Danese
- Section of Neurology, Department of Neurological, Neurophysiological, Morphological and Motor Sciences, University of Verona, Verona, Italy
| | - S Monaco
- Section of Neurology, Department of Neurological, Neurophysiological, Morphological and Motor Sciences, University of Verona, Verona, Italy
| | - M Turri
- Section of Neurology, Department of Neurological, Neurophysiological, Morphological and Motor Sciences, University of Verona, Verona, Italy
| | - K Borg
- Division of Rehabilitation Medicine, Department of Clinical Sciences, Karolinska Institut at Danderyds Hospital, Stockholm, Sweden
| | - L Werhagen
- Division of Rehabilitation Medicine, Department of Clinical Sciences, Karolinska Institut at Danderyds Hospital, Stockholm, Sweden
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Brogårdh C, Flansbjer UB, Lexell J. Determinants of Falls and Fear of Falling in Ambulatory Persons With Late Effects of Polio. PM R 2016; 9:455-463. [DOI: 10.1016/j.pmrj.2016.08.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 08/03/2016] [Accepted: 08/10/2016] [Indexed: 10/21/2022]
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Murray D, Hardiman O, Campion A, Vance R, Horgan F, Meldrum D. The effects of a home-based arm ergometry exercise programme on physical fitness, fatigue and activity in Polio survivors: a randomised controlled trial. Clin Rehabil 2016; 31:913-925. [DOI: 10.1177/0269215516661225] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: To investigate the effect of an eight-week home-based arm ergometry aerobic exercise programme on physical fitness, fatigue, activity and quality of life in Polio Survivors. Design: An assessor blinded randomised controlled trial. Setting: Home-based exercise. Subjects: Fifty-five Polio survivors randomised to exercise or control groups. Intervention: Home-based arm ergometry at an intensity of 50%-70% maximum heart rate, compared with usual physiotherapy care. Main measures: The Six-minute Arm Test, Fatigue Severity Scale, Physical Activity Scale for Individuals with Physical Disabilities and SF-36. Assessments were completed at baseline and at eight weeks. Results: There was no significant difference in the primary outcome, exercising heart rate during the Six-minute Arm Test, between the groups at follow-up [97.6 (SD10.1) compared to 102.4 (SD13.7) beats per minute ( P=0.20)]. Blood pressure was significantly lower in the intervention group at follow-up [systolic blood pressure 132(18.6)mmHg compared to 144.1(14.6)mmHg ( P=0.002)]. There were no between group differences in the Fatigue Severity Scale ( P=0.25) or Physical Activity Scale for Individuals with Physical Disabilities ( P=0.49), with a small difference in SF-36 physical component score ( P=0.04). Conclusions: This home-based arm ergometry programme successfully facilitated aerobic exercise in Polio Survivors, but did not result in a significant change in physical fitness, measured by the Six-minute Arm Test.
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Affiliation(s)
- D Murray
- Physiotherapy Department, Beaumont Hospital, Beaumont, Dublin 9, Ireland
| | - O Hardiman
- University of Dublin Trinity College, Dublin, Ireland
| | - A Campion
- Physiotherapy Department, Beaumont Hospital, Beaumont, Dublin 9, Ireland
| | - R Vance
- Physiotherapy Department, Beaumont Hospital, Beaumont, Dublin 9, Ireland
| | - F Horgan
- School of Physiotherapy, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - D Meldrum
- School of Physiotherapy, Royal College of Surgeons in Ireland, Dublin, Ireland
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Werhagen L, Borg K. Survey of young patients with polio and a foreign background at a Swedish post-polio outpatient clinic. Neurol Sci 2016; 37:1597-601. [DOI: 10.1007/s10072-016-2629-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 06/03/2016] [Indexed: 11/28/2022]
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Generali JA, Cada DJ. Pyridostigmine: Postpoliomyelitis Syndrome. Hosp Pharm 2016; 51:367-9. [DOI: 10.1310/hpj5105-367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This Hospital Pharmacy feature is extracted from Off-Label Drug Facts, a publication available from Wolters Kluwer Health. Off-Label Drug Facts is a practitioner-oriented resource for information about specific drug uses that are unapproved by the US Food and Drug Administration. This new guide to the literature enables the health care professional or clinician to quickly identify published studies on off-label uses and determine if a specific use is rational in a patient care scenario. References direct the reader to the full literature for more comprehensive information before patient care decisions are made. Direct questions or comments regarding Off-Label Drug Uses to jgeneral@ku.edu .
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Affiliation(s)
- Joyce A. Generali
- Hospital Pharmacy, and Emeritus, Department of Pharmacy Practice, University of Kansas, School of Pharmacy, Kansas City/Lawrence, Kansas
| | - Dennis J. Cada
- Founder and Contributing Editor, The Formulary, and Editor, Off-Label Drug Facts
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Vreede KS, Sunnerhagen KS. Characteristics of Patients at First Visit to a Polio Clinic in Sweden. PLoS One 2016; 11:e0150286. [PMID: 26981623 PMCID: PMC4794193 DOI: 10.1371/journal.pone.0150286] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 02/11/2016] [Indexed: 11/18/2022] Open
Abstract
AIM Describe polio patients visiting a polio clinic in Sweden, a country where vaccination was introduced in 1957. DESIGN A consecutive cohort study. PATIENTS Prior polio patients. METHODS All patients (n = 865) visiting the polio clinic at Sahlgrenska University Hospital, Gothenburg Sweden, between 1994 and 2012 were included in this study. Data at first visit regarding patient characteristics, polio classification, data of electromyography, origin, assistive devices and gait speed as well as muscle strength were collected for these patients. Twenty-three patients were excluded because no polio diagnosis could be established. A total of 842 patients with confirmed polio remained in the study. RESULTS More than twenty percent of the patients were from countries outside the Nordic region and considerably younger than those from the Nordic region. The majority of the emigrants were from Asia and Africa followed by Europe (outside the Nordic region). Of all patients included ninety-seven percent (n = 817) had polio in the lower extremity and almost 53% (n = 444) had polio in the upper extremity while 28% (n = 238) had polio in the trunk, according to clinical classification of polio. Compared with a sample of the normal population, the polio patients walked 61-71% slower, and were 53-77% weaker in muscle strength of the knee and foot as well as grip strength. CONCLUSION The younger patients with polio emigrating from countries with different cultures may lead to a challenge for the multi professional teams working with post-polio rehabilitation and are of importance when planning for the care of polio patients the coming years.
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Affiliation(s)
- Katarina Skough Vreede
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- * E-mail:
| | - Katharina S. Sunnerhagen
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Abstract
BACKGROUND Postpolio syndrome (PPS) may affect survivors of paralytic poliomyelitis and is characterised by a complex of neuromuscular symptoms leading to a decline in physical functioning. The effectiveness of pharmacological treatment and rehabilitation management in PPS is not yet established. This is an update of a review first published in 2011. OBJECTIVES To systematically review the evidence from randomised and quasi-randomised controlled trials for the effect of any pharmacological or non-pharmacological treatment for PPS compared to placebo, usual care or no treatment. SEARCH METHODS We searched the following databases on 21 July 2014: Cochrane Neuromuscular Disease Group Specialized Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, PsycINFO and CINAHL Plus. We also checked reference lists of all relevant articles, searched the Database of Abstracts of Reviews of Effects (DARE), the Health Technology Assessment (HTA) Database and trial registers and contacted investigators known to be involved in research in this area. SELECTION CRITERIA Randomised and quasi-randomised trials of any form of pharmacological or non-pharmacological treatment for people with PPS. The primary outcome was self perceived activity limitations and secondary outcomes were muscle strength, muscle endurance, fatigue, pain and adverse events. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by The Cochrane Collaboration. MAIN RESULTS We included 10 pharmacological (modafinil, intravenous immunoglobulin (IVIg), pyridostigmine, lamotrigine, amantadine, prednisone) and three non-pharmacological (muscle strengthening, rehabilitation in a warm climate (that is temperature ± 25°C, dry and sunny) and a cold climate (that is temperature ± 0°C, rainy or snowy), static magnetic fields) studies with a total of 675 participants with PPS in this review. None of the included studies were completely free from any risk of bias, the most prevalent risk of bias being lack of blinding.There was moderate- and low-quality evidence that IVIg has no beneficial effect on activity limitations in the short term and long term, respectively, and inconsistency in the evidence for effectiveness on muscle strength. IVIg caused minor adverse events in a substantial proportion of the participants. Results of one trial provided very low-quality evidence that lamotrigine might be effective in reducing pain and fatigue, resulting in fewer activity limitations without generating adverse events. Data from two single trials suggested that muscle strengthening of thumb muscles (very low-quality evidence) and static magnetic fields (moderate-quality evidence) are safe and beneficial for improving muscle strength and pain, respectively, with unknown effects on activity limitations. Finally, there was evidence varying from very low quality to high quality that modafinil, pyridostigmine, amantadine, prednisone and rehabilitation in a warm or cold climate are not beneficial in PPS. AUTHORS' CONCLUSIONS Due to insufficient good-quality data and lack of randomised studies, it was impossible to draw definite conclusions about the effectiveness of interventions for PPS. Results indicated that IVIg, lamotrigine, muscle strengthening exercises and static magnetic fields may be beneficial but need further investigation to clarify whether any real and meaningful effect exists.
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Affiliation(s)
- Fieke Sophia Koopman
- Department of Rehabilitation, University of Amsterdam Academic Medical Center, PO Box 22660, Amsterdam, North Holland, Netherlands, 1100 DD
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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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Bridgens R. Does a subgroup of postpolio patients need different management? Disabil Health J 2015; 8:305-8. [PMID: 25899845 DOI: 10.1016/j.dhjo.2015.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 12/10/2014] [Accepted: 02/13/2015] [Indexed: 10/23/2022]
Abstract
Throughout the 30 years of postpolio syndrome (PPS) research, there have been many puzzling anomalies in the data and not enough information to make sense of them. It is therefore welcome that Winberg et al have examined physical activity in relation to life satisfaction, sex and age. They hypothesized that activity would decrease with age and found the opposite. This result is not so surprising as Ostlund et al found that vitality was associated with older age and that younger age was associated with more pain, increasing physical fatigue, decreasing sleep quality and reducing activity. This commentary will examine past postpolio research with unexpected results in order to describe a subgroup of patients who may be more susceptible to overusing muscles and have particular exercise and activity needs.
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Affiliation(s)
- Ruth Bridgens
- 66 High Street, Marshfield, Chippenham, Wiltshire SN 14 8LP, UK.
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Intra-rater Reliability of Arm and Hand Muscle Strength Measurements in Persons With Late Effects of Polio. PM R 2015; 7:1035-1041. [DOI: 10.1016/j.pmrj.2015.03.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Revised: 02/12/2015] [Accepted: 03/16/2015] [Indexed: 11/23/2022]
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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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