The purpose of this investigation was to study subjective symptoms, medical and social situation, pulmonary function and physical work capacity over a period of 3-5 years in patients with post-polio syndrome. We assessed a consecutive series of 68 patients admitted to our hospital because of post-polio syndrome, and re-assessed 63 of these patients 3-5 years later; 43 women and 20 men with mean age 55 +/- 10 (1 SD) years at the second evaluation. The patients answered a questionnaire about their subjective symptoms and medical and social situation, and underwent spirometry and symptom-limited exercise stress testing. Most patients experienced more serious symptoms and physical disability connected with their polio, while the majority reported that their psychological health was unchanged or had improved. Lung function was on average moderately reduced and of restrictive type, and only minor changes were found over the 3-5 years. A pronounced reduction in peak oxygen uptake was seen at the first evaluation, especially in women (59% of predicted). At the second examination, peak oxygen uptake was further reduced, especially in men, more than predicted by increasing age. The body weight and body mass index of the patients increased significantly during the same period. These results indicate that subjective symptoms and physical disability connected with polio increased with increasing age in these patients with post-polio syndrome, and cardio-respiratory deconditioning and weight gain also became more serious problems in most patients. The psychological status of the patients remained stable, however, or improved, possibly due to our comprehensive re-rehabilitation and educational programme.
Comment In: Tidsskr Nor Laegeforen. 1997 Apr 30;117(11):16459198952
Poliomyelitis has almost been eradicated world-wide, but during the last decades polio survivors have noted new problems: late effects of polio and post-polio. In Denmark, 7-8000 polio survivors are disabled by poliomyelitis. Late effects of polio, defined as onset of new symptoms decades after the acute poliomyelitis, include fatigue and overuse muskuloskeletal problems. Post-polio is a sub-category of the late effects of polio and related to impaired neuro-muscular function with unexpected onset, which is not caused by the patient's age. Post-polio is a clinical diagnosis and cannot be verified by a definitive test. The dysfunction of the muscles is caused by loss of motor neurones and reduced neuromuscular reserve capacity, in combination with a disturbed balance between the ongoing reinnervation and denervation at the expense of the reinnervation. Many polio survivors suffering from late effects of polio have a need for multidisciplinary rehabilitation, physiotherapy, reconstruction of orthosis, social counselling, modifications to the home and individual aids.