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Tuijtelaars J, Brehm MA, Twisk JWR, Nollet F. Two-year course of walking adaptability in persons living with late effects of polio. J Rehabil Med 2024; 56:jrm14727. [PMID: 38497608 DOI: 10.2340/jrm.v56.14727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 01/23/2024] [Indexed: 03/19/2024] Open
Abstract
OBJECTIVE To evaluate the 2-year course of walking adaptability in persons with late effects of polio. DESIGN Prospective cohort study. PATIENTS A total of 48 persons with late effects of polio (69% female, mean age 63.1 years) with a fall history and/or fear of falling. METHODS Walking adaptability (i.e. variable target-stepping and reactive obstacle-avoidance) was assessed on an interactive treadmill at baseline, 1 year and 2 years. Further, leg-muscle strength and balance were assessed at baseline. The course of walking adaptability was analysed with linear mixed models. Based on median values, subgroups were defined for low vs high baseline walking-adaptability and for clinical characteristics. Tme by subgroup interactions were analysed. RESULTS Variable target-stepping and reactive obstacle-avoidance did not change (p > 0.285). Reactive obstacle-avoidance improved for persons with a high balance score at baseline (p = 0.037), but not for those with lower scores (p = 0.531). No other time by subgroup interactions were found (p > 0.126). CONCLUSION Walking adaptability did not change in persons with late effects of polio over 2 years, and walking adaptability course did not differ between subgroups stratified for walking adaptability determinants, except for balance. Since falls are a major problem among persons with late effects of polio, future studies should investigate whether walking adaptability declines over a longer time and which persons are most at risk.
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Affiliation(s)
- Jana Tuijtelaars
- Department of Rehabilitation Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands; Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands
| | - Merel-Anne Brehm
- Department of Rehabilitation Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands; Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands.
| | - Jos W R Twisk
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam, The Netherlands
| | - Frans Nollet
- Department of Rehabilitation Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands; Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands
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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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de Lira CAB, Minozzo FC, Costa TG, de Oliveira VN, Costa GCT, Oliveira ASB, Quadros AAJ, Vancini RL, Sousa BS, da Silva AC, Andrade MS. Functional exercise capacity in maximal and submaximal activities of individuals with polio sequelae. Eur J Appl Physiol 2023; 123:711-719. [PMID: 36401622 DOI: 10.1007/s00421-022-05095-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 11/10/2022] [Indexed: 11/21/2022]
Abstract
PURPOSE Poliomyelitis is an infectious disease that can cause total paralysis. Furthermore, poliomyelitis survivors may develop new signs and symptoms, including muscular weakness and fatigue, years after the acute phase of the disease, i.e., post-polio syndrome (PPS). Thus, the objective was to compare the functional exercise capacity during maximal and submaximal exercises among individuals with polio sequelae (without PPS diagnosis), PPS, and a control group. METHODS Thirty individuals participated in three groups: a control group (CG, n = 10); a group of individuals with polio sequelae but without PPS diagnosis (PG, n = 10); and a PPS group (PPSG, n = 10). All participants underwent (i) a cardiopulmonary exercise test to determine their maximal oxygen uptake ([Formula: see text]) and (ii) a series of functional field tests (i.e., walking test, sit-to-stand test, and stair climbing test). RESULTS [Formula: see text]O2max was 30% lower in PPSG than in CG and PG. Regarding functional field tests, walking and stair climbing test performances were significantly different among all groups. The PPSG sit-to-stand performance was lower than CG. CONCLUSION The sequelae of paralytic poliomyelitis impair functional exercise capacity obtained from maximal and submaximal tests, especially in patients with PPS. Furthermore, submaximal variables appear to be more negatively impacted than maximal variables.
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Affiliation(s)
- Claudio Andre Barbosa de Lira
- Faculty of Physical Education and Dance, Federal University of Goiás, Avenida Esperança s/n, Campus Samambaia, Goiânia, Brazil.
| | | | - Thalles Guilarducci Costa
- Faculty of Physical Education and Dance, Federal University of Goiás, Avenida Esperança s/n, Campus Samambaia, Goiânia, Brazil
| | - Vinnycius Nunes de Oliveira
- Faculty of Physical Education and Dance, Federal University of Goiás, Avenida Esperança s/n, Campus Samambaia, Goiânia, Brazil
| | - Gustavo Conti Teixeira Costa
- Faculty of Physical Education and Dance, Federal University of Goiás, Avenida Esperança s/n, Campus Samambaia, Goiânia, Brazil
| | | | | | - Rodrigo Luiz Vancini
- Center of Physical Education and Sports, Federal University of Espírito Santo, Vitória, Brazil
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Park JW, Baek SH, Sung JH, Kim BJ. Predictors of Step Length from Surface Electromyography and Body Impedance Analysis Parameters. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22155686. [PMID: 35957243 PMCID: PMC9371228 DOI: 10.3390/s22155686] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/18/2022] [Accepted: 06/10/2022] [Indexed: 05/29/2023]
Abstract
Step length is a critical hallmark of health status. However, few studies have investigated the modifiable factors that may affect step length. An exploratory, cross-sectional study was performed to evaluate the surface electromyography (sEMG) and body impedance analysis (BIA) parameters, combined with individual demographic data, to predict the individual step length using the GAITRite® system. Healthy participants aged 40−80 years were prospectively recruited, and three models were built to predict individual step length. The first model was the best-fit model (R2 = 0.244, p < 0.001); the root mean square (RMS) values at maximal knee flexion and height were included as significant variables. The second model used all candidate variables, except sEMG variables, and revealed that age, height, and body fat mass (BFM) were significant variables for predicting the average step length (R2 = 0.198, p < 0.001). The third model, which was used to predict step length without sEMG and BIA, showed that only age and height remained significant (R2 = 0.158, p < 0.001). This study revealed that the RMS value at maximal strength knee flexion, height, age, and BFM are important predictors for individual step length, and possibly suggesting that strengthening knee flexor function and reducing BFM may help improve step length.
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Affiliation(s)
- Jin-Woo Park
- Department of Neurology, Korea University Anam Hospital, Korea University Medicine, Seoul 02841, Korea; (J.-W.P.); (S.-H.B.); (J.H.S.)
- Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Seol-Hee Baek
- Department of Neurology, Korea University Anam Hospital, Korea University Medicine, Seoul 02841, Korea; (J.-W.P.); (S.-H.B.); (J.H.S.)
| | - Joo Hye Sung
- Department of Neurology, Korea University Anam Hospital, Korea University Medicine, Seoul 02841, Korea; (J.-W.P.); (S.-H.B.); (J.H.S.)
| | - Byung-Jo Kim
- Department of Neurology, Korea University Anam Hospital, Korea University Medicine, Seoul 02841, Korea; (J.-W.P.); (S.-H.B.); (J.H.S.)
- BK21 FOUR Program in Learning Health Systems, Korea University, Seoul 02841, Korea
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The Influence of Walking Limitations on Daily Life: A Mixed-Methods Study of 14 Persons with Late Effects of Polio. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138157. [PMID: 35805815 PMCID: PMC9265635 DOI: 10.3390/ijerph19138157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 06/29/2022] [Accepted: 07/01/2022] [Indexed: 12/04/2022]
Abstract
Reduced walking ability is common in persons with late effects of polio (LEoP). Here, we explored how many walking limitations persons with LEoP perceive, and how these limitations influence daily life, by using a mixed-methods design. Fourteen persons (mean age 70 years, whereof 7 women) with LEoP responded to the Walking Impact Scale (Walk-12), and were interviewed individually. Qualitative data were analysed by systematic text condensation, and each quotation was deductively analysed in relation to the items in Walk-12. Running was perceived as most limited, whereas walking indoors without using support was perceived as least limited. A majority (>70%) were moderately to extremely limited in standing or walking, in walking speed and distance, which affected concentration and effort, as well as gait quality aspects. The limited walking ability intruded on many everyday activities, both indoors and outdoors, which affected social participation negatively. To increase safety when walking and reduce the fall risk, various strategies were adopted such as using aids, walking carefully, and avoiding risky activities. In conclusion, LEoP-related walking limitations influence participants’ activity and participation greatly. By using both the Walk-12 scale and face-to-face interviews, an increased understanding of how walking limitations influence everyday life was achieved.
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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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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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