RESUMEN
Post-polio syndrome (PPS) brings new challenges for polio survivors, including muscle decline, pain, depression, and diminished quality of life. This study explored the potential of REAC neuromodulatory treatments to ease pain, improve mood, and enhance quality of life in PPS patients. 17 individuals with PPS (average age 54.8) received three REAC treatments: Neuro Postural Optimization, Neuro Psycho Physical Optimization, and Neuro Psycho Physical Optimization-Cervico Brachial. Pain, depression, anxiety, stress, and quality of life were assessed before and after using established scales. REAC treatments significantly reduced pain across various dimensions, along with depression, anxiety, and stress levels. Additionally, patients reported improved physical and psychological quality of life. This study suggests REAC neuromodulatory treatments as a promising non-invasive option to improve pain, emotional well-being, and quality of life in individuals with PPS.
Asunto(s)
Ansiedad , Depresión , Síndrome Pospoliomielitis , Calidad de Vida , Estrés Psicológico , Humanos , Síndrome Pospoliomielitis/psicología , Síndrome Pospoliomielitis/fisiopatología , Masculino , Femenino , Persona de Mediana Edad , Ansiedad/psicología , Depresión/psicología , Estrés Psicológico/psicología , Anciano , Adulto , Dolor/psicología , Manejo del Dolor/métodos , Desensibilización y Reprocesamiento del Movimiento Ocular/métodosRESUMEN
OBJECTIVE: Few studies have quantified the prevalence of restless legs syndrome (RLS) in patients with post-polio syndrome (PPS). Our objective was to assess the prevalence and severity of RLS in patients with PPS and to examine the demographic characteristics of this population. METHOD: This was a cross-sectional study conducted from April 2010 to May 2012 at the outpatient Neuromuscular Disorders clinic of Universidade Federal de São Paulo, São Paulo, Brazil. We evaluated 119 patients with PPS, consecutively recruited, and investigated for RLS based on the diagnostic criteria established by the International Restless Legs Syndrome Study Group (IRLSSG). Patients were evaluated with the Brazilian version of the IRLSSG severity scale. RESULTS: The prevalence of RLS was 36% (n = 43; 32 women and 11 men). The ages at onset of RLS (median = 41 years) and PPS (median = 41 years) were concurrent, and the correlation between onset of symptoms of RLS and onset of symptoms of PPS was positive and very strong (Spearman r = 0.93, p = 0.01). The median RLS severity was 23 (range, 20-28). Low educational achievement and depression were predictive of RLS development. CONCLUSION: In the largest population of patients with PPS studied to date, our results indicate a high prevalence of RLS, marked disease severity, and concomitant onset of both conditions in many patients with PPS. Further studies are needed to elucidate a possible pathophysiologic mechanism linking these two conditions. We suggest that all post-polio patients with sensory and motor complaints in the legs be investigated for RLS.
Asunto(s)
Síndrome Pospoliomielitis/complicaciones , Síndrome Pospoliomielitis/epidemiología , Síndrome de las Piernas Inquietas/complicaciones , Síndrome de las Piernas Inquietas/epidemiología , Adulto , Brasil , Comorbilidad , Estudios Transversales , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Síndrome Pospoliomielitis/fisiopatología , Prevalencia , Síndrome de las Piernas Inquietas/fisiopatología , Índice de Severidad de la EnfermedadRESUMEN
METHODS: The Baecke questionnaire for the evaluation of habitual physical activity (HPA), assessment of quality of life (WHOQOL-Bref), and the Fatigue Severity Scale were administered to patients with PPS, poliomyelitis sequelae (PS) and to a control group (CG). Participated in the study 116 individuals (PPS=52,PS= 28,CG=36). RESULTS: Patients with PPS tended to increase their HPA from 10 to 20 years of age, compared with those in the PS group and the CG. In the period from 21 to 30 years of age, there was significant increase in the PPS group's occupational physical activity compared to the PS group, and the occupational physical activity (21-30 years of age) correlated with the onset of symptoms of PPS. CONCLUSION: Patients with PPS had a higher energy expenditure during life, especially in occupational physical activity at ages 21-30 years, suggesting this decade is critical for the development of PPS.
Asunto(s)
Metabolismo Energético/fisiología , Actividad Motora/fisiología , Síndrome Pospoliomielitis/fisiopatología , Adolescente , Adulto , Estudios de Casos y Controles , Niño , Fatiga/etiología , Fatiga/fisiopatología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Síndrome Pospoliomielitis/complicaciones , Estudios Retrospectivos , Encuestas y Cuestionarios , Adulto JovenRESUMEN
ABSTRACT The objective of this study was to identify energy expenditure, retrospectively, in individuals with post-poliomyelitis syndrome (PPS) in the Brazilian population. Methods The Baecke questionnaire for the evaluation of habitual physical activity (HPA), assessment of quality of life (WHOQOL-Bref), and the Fatigue Severity Scale were administered to patients with PPS, poliomyelitis sequelae (PS) and to a control group (CG). Participated in the study 116 individuals (PPS=52,PS= 28,CG=36). Results Patients with PPS tended to increase their HPA from 10 to 20 years of age, compared with those in the PS group and the CG. In the period from 21 to 30 years of age, there was significant increase in the PPS group’s occupational physical activity compared to the PS group, and the occupational physical activity (21-30 years of age) correlated with the onset of symptoms of PPS. Conclusion Patients with PPS had a higher energy expenditure during life, especially in occupational physical activity at ages 21-30 years, suggesting this decade is critical for the development of PPS.
RESUMO O objetivo deste estudo foi identificar o gasto energético, retrospectivamente, em indivíduos com síndrome pós-poliomielite (SPP) na população brasileira. Métodos Foi utilizado o questionário Baecke para avaliação da atividade física habitual (AFH) nos pacientes com SPP, sequela de poliomielite (SP) e grupo controle (GC). Participaram do estudo 116 indivíduos (SPP = 52, SP = 28, GC = 36). Resultados Pacientes com SPP tendem a aumentar a AFH dos 10 aos 20 anos, comparados com os grupos SP e GC. No período dos 21 aos 30 anos, houve aumento significativo da atividade física ocupacional do grupo SPP em relação ao grupo SP e a atividade física ocupacional (21-30 anos) correlacionou-se com o aparecimento dos sintomas da SPP. Conclusão Pacientes com SPP apresentam maior gasto de energia durante a vida, especialmente na atividade física ocupacional nas idades 21-30 anos, sugerindo que esta década é crítica para o desenvolvimento da SPP.
Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Adulto , Persona de Mediana Edad , Adulto Joven , Síndrome Pospoliomielitis/fisiopatología , Metabolismo Energético/fisiología , Actividad Motora/fisiología , Estudios de Casos y Controles , Encuestas y Cuestionarios , Estudios Retrospectivos , Síndrome Pospoliomielitis/complicaciones , Fatiga/etiología , Fatiga/fisiopatologíaRESUMEN
OBJECTIVE: To determine the impact of postpolio-syndrome on quality of life in polio survivors. METHODS: Forty polio survivors were included in the study. Twenty-one patients fulfilling the Halstead's postpolio-syndrome criteria participated in postpolio-syndrome group. The remaining nineteen patients formed non-postpolio-syndrome group. Control group was composed of forty healthy subjects. Quality of life was evaluated by Nottingham Health Profile, depression by Beck Depression Scale and fatigue by Fatigue Symptom Inventory. Isometric muscle strength was measured by manual muscle testing. RESULTS: Total manual muscle testing score was 26.19±13.24 (median: 29) in postpolio-syndrome group and 30.08±8.9 (median: 32) in non-postpolio-syndrome group. Total manual muscle testing scores of non-postpolio-syndrome group were significantly higher than that of postpolio-syndrome group. Patients with postpolio-syndrome reported significantly higher levels of fatigue and reduced quality of life in terms of physical mobility, pain and energy when compared with patients without postpolio-syndrome and control group. It was not reported a statistically significant difference in social and emotional functioning and sleep quality between postpolio-syndrome, non-postpolio-syndrome and control groups. Also it was not found any statistically significant difference in Beck Depression Scale scores among the groups. CONCLUSIONS: Postpolio-syndrome has a negative impact on quality of life in terms of functional status, severity of pain and energy. The identification, early recognition and rehabilitation of postpolio-syndrome patients may result in an improvement in their quality of life.
Asunto(s)
Depresión/psicología , Fatiga/psicología , Dolor/psicología , Poliomielitis/fisiopatología , Síndrome Pospoliomielitis/psicología , Calidad de Vida , Conducta Social , Sobrevivientes/psicología , Actividades Cotidianas/psicología , Adulto , Depresión/epidemiología , Evaluación de la Discapacidad , Fatiga/epidemiología , Femenino , Estudios de Seguimiento , Encuestas Epidemiológicas , Humanos , Relaciones Interpersonales , Masculino , Persona de Mediana Edad , Dolor/epidemiología , Poliomielitis/epidemiología , Poliomielitis/psicología , Poliomielitis/rehabilitación , Síndrome Pospoliomielitis/epidemiología , Síndrome Pospoliomielitis/fisiopatología , Síndrome Pospoliomielitis/rehabilitación , Índice de Severidad de la Enfermedad , Turquía/epidemiologíaRESUMEN
ABSTRACT Objective: To determine the impact of postpolio-syndrome on quality of life in polio survivors. Methods: Forty polio survivors were included in the study. Twenty-one patients fulfilling the Halstead's postpolio-syndrome criteria participated in postpolio-syndrome group. The remaining nineteen patients formed non-postpolio-syndrome group. Control group was composed of forty healthy subjects. Quality of life was evaluated by Nottingham Health Profile, depression by Beck Depression Scale and fatigue by Fatigue Symptom Inventory. Isometric muscle strength was measured by manual muscle testing. Results: Total manual muscle testing score was 26.19 ± 13.24 (median: 29) in postpolio-syndrome group and 30.08 ± 8.9 (median: 32) in non-postpolio-syndrome group. Total manual muscle testing scores of non-postpolio-syndrome group were significantly higher than that of postpolio-syndrome group. Patients with postpolio-syndrome reported significantly higher levels of fatigue and reduced quality of life in terms of physical mobility, pain and energy when compared with patients without postpolio-syndrome and control group. It was not reported a statistically significant difference in social and emotional functioning and sleep quality between postpolio-syndrome, non-postpolio-syndrome and control groups. Also it was not found any statistically significant difference in Beck Depression Scale scores among the groups. Conclusions: Postpolio-syndrome has a negative impact on quality of life in terms of functional status, severity of pain and energy. The identification, early recognition and rehabilitation of postpolio-syndrome patients may result in an improvement in their quality of life.
RESUMO Objetivo: Determinar o impacto da síndrome pós-pólio na qualidade de vida nos sobreviventes da pólio. Métodos: Quarenta sobreviventes da pólio foram incluídos no estudo. Participaram do grupo de síndrome pós-pólio 21 pacientes que atenderam aos critérios de síndrome pós-pólio de Halstead. Os 19 restantes formaram o grupo não síndrome pós-pólio. O grupo controle foi composto por 40 indivíduos saudáveis. A qualidade de vida foi avaliada pelo Nottingham Health Profile, a depressão pela Escala de Depressão de Beck e a fadiga pelo Inventário de Sintomas de Fadiga. A força muscular isométrica foi medida por teste muscular manual. Resultados: O escore total do teste muscular manual foi 26,19 ± 13,24 (mediana: 29) no grupo de síndrome pós-pólio e 30,08 ± 8,9 (mediana: 32) no grupo não síndrome pós-pólio. Escores totais de teste muscular manual de grupo não síndrome pós-pólio foram significativamente maiores do que os do grupo de síndrome pós-pólio. Os pacientes com síndrome pós-pólio relataram níveis significativamente maiores de fadiga e qualidade de vida reduzida em termos de mobilidade física, dor e energia quando comparados com pacientes sem síndrome pós-pólio e grupo controle. Não se relatou uma diferença estatisticamente significativa no funcionamento social e emocional e na qualidade do sono entre grupos de síndrome pós-pólio, não síndrome pós-pólio e controle. Além disso, não se encontrou diferença estatisticamente significativa nos escores da Escala de Depressão de Beck entre os grupos. Conclusões: A síndrome pós-pólio tem um impacto negativo na qualidade de vida em termos de estado funcional, gravidade da dor e energia. A identificação, o reconhecimento precoce e a reabilitação dos pacientes com síndrome pós-pólio podem resultar em uma melhoria da qualidade de vida.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Dolor/psicología , Poliomielitis/fisiopatología , Calidad de Vida , Conducta Social , Síndrome Pospoliomielitis/psicología , Sobrevivientes/psicología , Depresión/psicología , Fatiga/psicología , Dolor/epidemiología , Poliomielitis/psicología , Poliomielitis/rehabilitación , Poliomielitis/epidemiología , Turquía/epidemiología , Índice de Severidad de la Enfermedad , Actividades Cotidianas/psicología , Estudios de Seguimiento , Encuestas Epidemiológicas , Síndrome Pospoliomielitis/fisiopatología , Síndrome Pospoliomielitis/rehabilitación , Síndrome Pospoliomielitis/epidemiología , Depresión/epidemiología , Evaluación de la Discapacidad , Fatiga/epidemiología , Relaciones Interpersonales , Persona de Mediana EdadRESUMEN
METHOD: A search for papers was made in the databases Bireme, Scielo and Pubmed with the following keywords: post polio syndrome, cardiorespiratory and rehabilitation in English, French and Spanish languages. Although we targeted only seek current studies on the topic in question, only the relevant (double-blind, randomized-controlled and consensus articles) were considered. RESULTS AND DISCUSSION: Certain features of PPS such as generalized fatigue, generalized and specific muscle weakness, joint and/or muscle pain may result in physical inactivity deconditioning obesity and dyslipidemia. Respiratory difficulties are common and may result in hypoxemia. CONCLUSION: Only when evaluated and treated promptly, somE patients can obtain the full benefits of the use of respiratory muscles aids as far as quality of life is concerned.
Asunto(s)
Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/terapia , Síndrome Pospoliomielitis/complicaciones , Síndrome Pospoliomielitis/rehabilitación , Enfermedades Respiratorias/etiología , Enfermedades Respiratorias/terapia , Enfermedades Cardiovasculares/fisiopatología , Prueba de Esfuerzo , Humanos , Debilidad Muscular/fisiopatología , Síndrome Pospoliomielitis/fisiopatología , Enfermedades Respiratorias/fisiopatología , Factores de Riesgo , Trastornos del Sueño-Vigilia/etiología , Trastornos del Sueño-Vigilia/fisiopatologíaRESUMEN
ABSTRACT Post-polio syndrome (PPS) is a condition that affects polio survivors years after recovery from an initial acute attack of the poliomyelitis virus. Most often, polio survivors experience a gradual new weakening in muscles that were previously affected by the polio infection. The actual incidence of cardiovascular diseases (CVDs) in individuals suffering from PPS is not known. However, there is a reason to suspect that individuals with PPS might be at increased risk. Method A search for papers was made in the databases Bireme, Scielo and Pubmed with the following keywords: post polio syndrome, cardiorespiratory and rehabilitation in English, French and Spanish languages. Although we targeted only seek current studies on the topic in question, only the relevant (double-blind, randomized-controlled and consensus articles) were considered. Results and Discussion Certain features of PPS such as generalized fatigue, generalized and specific muscle weakness, joint and/or muscle pain may result in physical inactivity deconditioning obesity and dyslipidemia. Respiratory difficulties are common and may result in hypoxemia. Conclusion Only when evaluated and treated promptly, somE patients can obtain the full benefits of the use of respiratory muscles aids as far as quality of life is concerned.
RESUMO Síndrome pós-polio (SPP) é uma condição que afeta sobreviventes da poliomielite aguda (PAA), anos após a recuperação de um ataque agudo inicial do vírus. Na maioria das vezes, os sobreviventes da polio começam a apresentar nova paresia gradual nos músculos que foram previamente afetados pela infecção. A incidência real de doenças cardiovasculares (DCV) em indivíduos que sofrem de SPP não é conhecida. Entretanto, há indícios para suspeitar de que sujeitos com SPP podem estar em maior risco. Método Realizou-se uma busca de artigos nas bases de dados: Bireme, Scielo e Pubmed, utilizando as seguintes palavras-chave: síndrome pós-poliomielite, função cardiorrespiratória e reabilitação, nos idiomas Inglês, Francês e Espanhol. Embora tenhamos selecionado um número expressivo de artigos, somente foram considerados os duplo-cegos, randomizados-controlados, além de consensos. Resultados e Discussão Certas características da SPP, tais como fadiga muscular, paresia, dor muscular e/ou articulares podem resultar em descondicionamento por inatividade física, além de obesidade e dislipidemia. Dificuldades respiratórias são comuns e podem resultar em hipoxemia. Conclusão Somente quando avaliados e tratados em tempo hábil, alguns pacientes são capazes de obter os benefícios do uso dos músculos respiratórios auxiliares em termos de qualidade de vida.
Asunto(s)
Humanos , Enfermedades Respiratorias/etiología , Enfermedades Respiratorias/terapia , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/terapia , Síndrome Pospoliomielitis/complicaciones , Síndrome Pospoliomielitis/rehabilitación , Enfermedades Respiratorias/fisiopatología , Trastornos del Sueño-Vigilia/etiología , Trastornos del Sueño-Vigilia/fisiopatología , Enfermedades Cardiovasculares/fisiopatología , Factores de Riesgo , Síndrome Pospoliomielitis/fisiopatología , Debilidad Muscular/fisiopatología , Prueba de EsfuerzoRESUMEN
OBJECTIVE: To compare lung function between patients with post-poliomyelitis syndrome and those with sequelae of paralytic poliomyelitis (without any signs or symptoms of post-poliomyelitis syndrome), as well as between patients with post-poliomyelitis syndrome and healthy controls. METHODS: Twenty-nine male participants were assigned to one of three groups: control; poliomyelitis (comprising patients who had had paralytic poliomyelitis but had not developed post-poliomyelitis syndrome); and post-poliomyelitis syndrome. Volunteers underwent lung function measurements (spirometry and respiratory muscle strength assessment). RESULTS: The results of the spirometric assessment revealed no significant differences among the groups except for an approximately 27% lower mean maximal voluntary ventilation in the post-poliomyelitis syndrome group when compared with the control group (p = 0.0127). Nevertheless, the maximal voluntary ventilation values for the post-poliomyelitis group were compared with those for the Brazilian population and were found to be normal. No significant differences were observed in respiratory muscle strength among the groups. CONCLUSIONS: With the exception of lower maximal voluntary ventilation, there was no significant lung function impairment in outpatients diagnosed with post-poliomyelitis syndrome when compared with healthy subjects and with patients with sequelae of poliomyelitis without post-poliomyelitis syndrome. This is an important clinical finding because it shows that patients with post-poliomyelitis syndrome can have preserved lung function.
Asunto(s)
Pulmón/fisiopatología , Fuerza Muscular/fisiología , Síndrome Pospoliomielitis/fisiopatología , Músculos Respiratorios/fisiopatología , Capacidad Vital/fisiología , Estudios de Casos y Controles , Estudios Transversales , Volumen Espiratorio Forzado/fisiología , Humanos , Masculino , Ventilación Voluntaria Máxima/fisiología , Persona de Mediana Edad , Factores de Riesgo , EspirometríaRESUMEN
OBJECTIVE: It was to evaluate the degree of fatigue in patients with paralytic poliomyelitis (PP) and with post-polio syndrome (PPS), and correlate it with parameters of sleep and the circadian cycle. METHODS: Thirty patients, 17 female (56.7%), participated in the study: they answered the Revised Piper Fatigue Scale and performed a nocturnal polysomnographic study. Eleven had PP (mean age±standard deviation of 47.9±6.4 years), and 19 had PPS (mean age±standard deviation of 46.4±5.6 years). RESULTS: Our study showed that fatigue was worse in the afternoon in the PP Group and had a progressive increase throughout the day in the PPS Group. We also observed compromised quality of sleep in both groups, but no statically significant difference was found in the sleep parameters measured by polysomnography. CONCLUSION: Fatigue has a well-defined circadian variation, especially in PPS Group. Poor sleep quality is associated with fatigue and, therefore, sleep disturbances should be evaluated and treated in this group of PPS.
Asunto(s)
Ritmo Circadiano/fisiología , Fatiga/fisiopatología , Poliomielitis/fisiopatología , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Polisomnografía , Síndrome Pospoliomielitis/fisiopatología , Valores de Referencia , Sueño/fisiología , Encuestas y Cuestionarios , Factores de TiempoRESUMEN
Objective It was to evaluate the degree of fatigue in patients with paralytic poliomyelitis (PP) and with post-polio syndrome (PPS), and correlate it with parameters of sleep and the circadian cycle. Methods Thirty patients, 17 female (56.7%), participated in the study: they answered the Revised Piper Fatigue Scale and performed a nocturnal polysomnographic study. Eleven had PP (mean age±standard deviation of 47.9±6.4 years), and 19 had PPS (mean age±standard deviation of 46.4±5.6 years). Results Our study showed that fatigue was worse in the afternoon in the PP Group and had a progressive increase throughout the day in the PPS Group. We also observed compromised quality of sleep in both groups, but no statically significant difference was found in the sleep parameters measured by polysomnography. Conclusion Fatigue has a well-defined circadian variation, especially in PPS Group. Poor sleep quality is associated with fatigue and, therefore, sleep disturbances should be evaluated and treated in this group of PPS. .
Objetivo Foi avaliar o grau de fadiga em pacientes com poliomielite paralítica (PP) e com síndrome pós-poliomielite (SPP), e correlaciona-lo com parâmetros de sono e ciclo circadiano. Método Trinta pacientes, 17 do sexo feminino (56,7%), participaram do estudo: responderam à Escala de Fadiga de Piper Revisada e submeteram-se à avaliação polissonográfica noturna. Onze apresentavam PP (média de idade±desvio padrão de 47,9±6,4 anos), e 19 apresentavam SPP (média de idade±desvio padrão de 46,4±5,6 anos). Resultados Nosso estudo mostrou que a fadiga é pior no período da tarde no grupo com PP e piora progressivamente ao longo do dia no grupo SPP. Observamos também comprometimento na qualidade do sono em ambos os grupos. Contudo, os parâmetros do sono avaliados pela polissonografia não demonstraram diferenças estatísticas significantes entre os grupos PP e SPP. Conclusão A fadiga apresenta variação circadiana bem definida, especialmente nos pacientes do grupo SPP. Pobre qualidade do sono está associada com fadiga e, portanto, distúrbios do sono deveriam ser mais bem avaliados e tratados no grupo de pacientes com SPP. .
Asunto(s)
Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Ritmo Circadiano/fisiología , Fatiga/fisiopatología , Poliomielitis/fisiopatología , Polisomnografía , Síndrome Pospoliomielitis/fisiopatología , Valores de Referencia , Encuestas y Cuestionarios , Sueño/fisiología , Factores de TiempoRESUMEN
OBJECTIVE: To compare lung function between patients with post-poliomyelitis syndrome and those with sequelae of paralytic poliomyelitis (without any signs or symptoms of post-poliomyelitis syndrome), as well as between patients with post-poliomyelitis syndrome and healthy controls. METHODS: Twenty-nine male participants were assigned to one of three groups: control; poliomyelitis (comprising patients who had had paralytic poliomyelitis but had not developed post-poliomyelitis syndrome); and post-poliomyelitis syndrome. Volunteers underwent lung function measurements (spirometry and respiratory muscle strength assessment). RESULTS: The results of the spirometric assessment revealed no significant differences among the groups except for an approximately 27% lower mean maximal voluntary ventilation in the post-poliomyelitis syndrome group when compared with the control group (p = 0.0127). Nevertheless, the maximal voluntary ventilation values for the post-poliomyelitis group were compared with those for the Brazilian population and were found to be normal. No significant differences were observed in respiratory muscle strength among the groups. CONCLUSIONS: With the exception of lower maximal voluntary ventilation, there was no significant lung function impairment in outpatients diagnosed with post-poliomyelitis syndrome when compared with healthy subjects and with patients with sequelae of poliomyelitis without post-poliomyelitis syndrome. This is an important clinical finding because it shows that patients with post-poliomyelitis syndrome can have preserved lung function. .
OBJETIVO: Comparar a função pulmonar de pacientes com síndrome pós-poliomielite à de pacientes com sequelas de poliomielite paralítica (sem quaisquer sinais ou sintomas de síndrome pós-poliomielite) e à de sujeitos saudáveis. MÉTODOS: Vinte e nove sujeitos do sexo masculino foram divididos em três grupos: controle, poliomielite (pacientes que sofreram de poliomielite paralítica, mas que não apresentaram síndrome pós-poliomielite) e síndrome pós-poliomielite. Os voluntários foram submetidos a avaliações da função pulmonar (espirometria e avaliação da força muscular respiratória). RESULTADOS: Os resultados da espirometria não revelaram diferenças significantes entre os grupos, à exceção da ventilação voluntária máxima, cuja média no grupo síndrome pós-poliomielite foi aproximadamente 27% mais baixa que no grupo controle (p = 0,0127). No entanto, os valores de ventilação voluntária máxima observados no grupo pós-poliomielite foram comparados aos da população brasileira e se apresentaram dentro da faixa normal. Não foram observadas diferenças significantes entre os grupos no tocante à força muscular respiratória. CONCLUSÕES: À exceção da ventilação voluntária máxima mais baixa, não houve comprometimento significante da função pulmonar em pacientes ambulatoriais com diagnóstico de síndrome pós-poliomielite quando comparados a pacientes com sequelas de poliomielite, mas sem a síndrome pós-poliomielite e a sujeitos ...
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Pulmón/fisiopatología , Fuerza Muscular/fisiología , Síndrome Pospoliomielitis/fisiopatología , Músculos Respiratorios/fisiopatología , Capacidad Vital/fisiología , Estudios de Casos y Controles , Estudios Transversales , Volumen Espiratorio Forzado/fisiología , Ventilación Voluntaria Máxima/fisiología , Factores de Riesgo , EspirometríaRESUMEN
A Síndrome Pós-Pólio (SPP) caracteriza-se por um novo episódio de fraqueza muscular e/ou fadiga muscular anormal em indivíduos que apresentaram poliomielite anterior aguda (PAA) anos antes. Ainda são poucos os relatos na literatura sobre o gerenciamento da dor na SSP. O objetivo deste trabalho é analisar o controle da dor na síndrome pós-pólio por meio de um relato de caso. Um homem de 57 anos com SPP foi submetido a 24 sessões de fisioterapia para controle do quadro álgico na síndrome, baseada em recursos eletrotermofototerápicos e cinesioterapia. Para análise da dor pré e pós-intervenção fisioterapêutica foram aplicados dois instrumentos: a Escala Analógica Visual (EVA) e a Intensidade de Dor Presente (ID). O quadro álgico no joelho direito sofreu redução de grau 8 para 4 pela EVA e grau 5 para 2 pela ID, enquanto a dor no tornozelo direito reduziu de grau 2 pela EVA e grau 1 pela ID para zero em ambas as escalas. A dor é apontada como um sintoma predominante por muitos pacientes com SPP. O sujeito deste relato, após o programa de tratamento, apresentou melhora expressiva da dor. Entretanto, devido à escassez da literatura sobre dados substanciais referentes ao seu gerenciamento, especialmente na fisioterapia, novos estudos devem ser propostos para gerar maior fundamentação teórica à abordagem fisioterapêutica na SPP.
The Post-polio Syndrome (PPS) is characterized by a new episode of muscular weakness and/or abnormal muscular fatigue in subjects that presented acute previous polio (APP) years ago. There still are few studies about the pain management at PPS. The aim of this study is to analyze pain´s management in PPS by a case report. A men with PPS, 57 years, was submitted to 24 sessions of physical therapy for pain´s control in PPS, based at electro-thermo physical therapy features and therapeutics exercises. For pain´s analysis, pre and post physical therapy interventions were applied two instruments: the Analogic Visual Scale (AVS) and Present Pain Intensity (PPI). The pain in right knee was reduced from grade 8 to 4 on AVS, grade 5 to 2 on PPI, while the pain in his right ankle decreased from grade 2 on AVS and 1 on PPI to zero in both scales. The pain is the predominant symptom for many patients with PPS. This relate, the patient after program of treatment presented an improvement of pain. However, because of there are few studies in the literature about the pain management, especially in physical therapy, new studies must be proposed to generate more theorical at Physical therapy intervention in PSS.
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Fatiga Muscular , Dimensión del Dolor , Modalidades de Fisioterapia , Síndrome Pospoliomielitis/fisiopatologíaRESUMEN
BACKGROUND: Few studies have described the occurrence of restless legs syndrome in post-polio syndrome. METHODS: We studied 10 consecutive patients with post-polio syndrome and symptoms of restless legs syndrome. We look at demographic, clinical and laboratorial data. RESULTS: A remarkable finding was the concomitant onset of symptoms of both diseases, suggesting a possible underlying mechanism. Severity of restless legs symptoms was moderate to very severe. CONCLUSION: Epidemiological studies with larger samples are needed to better establish the relationship and the incidence of restless legs syndrome in post-polio syndrome.
Asunto(s)
Síndrome Pospoliomielitis/complicaciones , Síndrome de las Piernas Inquietas/complicaciones , Adulto , Femenino , Humanos , Masculino , Síndrome Pospoliomielitis/fisiopatología , Síndrome de las Piernas Inquietas/fisiopatologíaRESUMEN
UNLABELLED: The main post-polio syndrome (PPS) symptoms are new weakness, new atrophy, fatigue, pain and sleep disturbances. Polysomnography is the gold standard for sleep analysis. OBJECTIVE: To analyze sleep patterns in PPS patients. METHOD: Sixty patients (mean age 46.8+/-11.3 years) at the Federal University of São Paulo (UNIFESP/EPM) complaining of sleep disturbances were evaluated by means of polysomnography, performed at the Sleep Institute. RESULTS: Sleep efficiency was lower due to high sleep latency and arousal index. The apnea and hypopnea index (AHI) and the periodic limb movements (PLM) index were higher. Sleep architecture was also impaired. There were no abnormalities of oxygen saturation, carbon dioxide levels, respiratory rate or heart rate. CONCLUSION: New post-polio sleep disturbances were isolated symptoms. It appears that these symptoms were not due to post-polio features, but rather, that they were due to dysfunction of the surviving motor neurons in the brainstem. Abnormal dopamine production, which is responsible for many sleep-related breathing disorders and abnormal movements, may also have been implicated in the present findings.
Asunto(s)
Síndrome Pospoliomielitis/complicaciones , Trastornos del Sueño-Vigilia/diagnóstico , Trastornos del Sueño-Vigilia/etiología , Adulto , Dióxido de Carbono/sangre , Femenino , Frecuencia Cardíaca/fisiología , Humanos , Masculino , Persona de Mediana Edad , Oximetría , Polisomnografía , Síndrome Pospoliomielitis/fisiopatología , Trastornos del Sueño-Vigilia/fisiopatologíaRESUMEN
The main post-polio syndrome (PPS) symptoms are new weakness, new atrophy, fatigue, pain and sleep disturbances. Polysomnography is the gold standard for sleep analysis. OBJECTIVE: To analyze sleep patterns in PPS patients. METHOD: Sixty patients (mean age 46.8±11.3 years) at the Federal University of São Paulo (UNIFESP/EPM) complaining of sleep disturbances were evaluated by means of polysomnography, performed at the Sleep Institute. RESULTS: Sleep efficiency was lower due to high sleep latency and arousal index. The apnea and hypopnea index (AHI) and the periodic limb movements (PLM) index were higher. Sleep architecture was also impaired. There were no abnormalities of oxygen saturation, carbon dioxide levels, respiratory rate or heart rate. CONCLUSION: New post-polio sleep disturbances were isolated symptoms. It appears that these symptoms were not due to post-polio features, but rather, that they were due to dysfunction of the surviving motor neurons in the brainstem. Abnormal dopamine production, which is responsible for many sleep-related breathing disorders and abnormal movements, may also have been implicated in the present findings.
Dentre as manifestações clínicas da síndrome pós poliomielite (SPP) destacam-se nova fraqueza, fadiga, dor, nova atrofia e transtornos do sono. A polissonografia de noite inteira permanece sendo padrão ouro para análise do sono e diagnóstico de transtornos do sono. OBJETIVO: Verificar os transtornos de sono nos pacientes com SPP. MÉTODO: 60 pacientes com SPP (media de idade 46,8±11,3 anos), da UNIFESP/EPM,que apresentavam queixas sobre sono realizaram uma noite de polissonografia no Instituto do Sono. RESULTADOS: A eficiência do sono é diminuída em decorrência do aumento da latência do sono e do índice de despertar. O índice de apnéia e hipopnéia (IAH) e o índice de movimentos periódicos dos membros (iPLM) estão aumentados. A arquitetura do sono é prejudicada por essas alterações. Não há alterações da saturação da oxi-hemoglobina, do gás carbônico exalado, da freqüência respiratória e cardíaca. CONCLUSÃO: Novas alterações do sono são sintomas isolados desta população. Parece que esses sintomas não ocorrem devido a outras características da SPP, mas decorrem de disfunções nos neurônios do tronco encefálico e alterações da produção de dopamina que provocam os distúrbios respiratórios do sono e os movimentos periódicos dos membros.
Asunto(s)
Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Síndrome Pospoliomielitis/complicaciones , Trastornos del Sueño-Vigilia/diagnóstico , Trastornos del Sueño-Vigilia/etiología , Dióxido de Carbono/sangre , Frecuencia Cardíaca/fisiología , Oximetría , Polisomnografía , Síndrome Pospoliomielitis/fisiopatología , Trastornos del Sueño-Vigilia/fisiopatologíaRESUMEN
Proceed to a comparative analysis of the electromyographic (EMG) activity of the muscles rectus femoris, vastus medialis and vastus lateralis, and to assess muscle strength and fatigue after maximal isometric contraction during knee extension. Eighteen patients with post-polio syndrome, age and weight matched, were utilized in this study. The signal acquisition system utilized consisted of three pairs of surface electrodes positioned on the motor point of the analyzed muscles. It was possible to observe with the results of this study a decreased endurance on initial muscle contraction and during contraction after 15 minutes of the initial maximal voluntary contraction, along with a muscle fatigue that was assessed through linear regression executed with Pearson's test. There were significant differences among the comparative analysis of EMG activity of the muscles rectus femoris, vastus medialis and vastus lateralis after maximal isometric contraction during knee extension. Initial muscle contraction and contraction after a 15 minute-rest from initial contraction decreased considerably, indicating a decreased endurance on muscle contraction, concluding that a lower limb muscle fatigue was present on the analyzed PPS patients.
Asunto(s)
Electromiografía , Fatiga Muscular/fisiología , Músculo Esquelético/fisiología , Síndrome Pospoliomielitis/fisiopatología , Adulto , Femenino , Humanos , Contracción Isométrica/fisiología , Articulación de la Rodilla/fisiología , Modelos Lineales , Masculino , Músculo Esquelético/inervación , Resistencia Física/fisiología , TorqueRESUMEN
The aim of this study was to compare basal metabolic rate (BMR) of post-polio syndrome (PPS) patients with healthy individuals and to determine its correlation to body composition. BMR (kcal/day) was determined by indirect calorimetry and body composition by dual energy X-ray absorptiometry. BMR was lower in the PPS patient group than in the control group, although it was similar in both groups when adjusted for body surface area, total body mass (TBM), lean body mass (LBM) and fat-free mass (FFM). PPS patients also showed reduced TBM, LBM and FFM in relation to controls. As muscle energy expenditure while at rest contributes only 20% to the BMR, a proportional reduction in BMR and FFM or LBM could suggest that muscle mass or other factors may interfere more than predicted. It was concluded that the prediction of BMR from the Harris-Benedict equation in PPS patients must be carefully reviewed.
Asunto(s)
Metabolismo Basal/fisiología , Composición Corporal/fisiología , Síndrome Pospoliomielitis/metabolismo , Síndrome Pospoliomielitis/fisiopatología , Absorciometría de Fotón/métodos , Adulto , Índice de Masa Corporal , Calorimetría Indirecta/métodos , Estudios de Casos y Controles , Humanos , Masculino , Matemática , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Sensibilidad y EspecificidadRESUMEN
Powered orthosis is a special class of gait assist device that employs a mechanical or electromechanical actuator to enhance movement of hip, knee, or ankle articulations. Pneumatic artificial muscle (PAM) has been suggested as a pneumatic actuator because its performance is similar to biological muscle. The electromyography (EMG) signal interpretation is the most popular and simplest method to establish the patient voluntary control of the orthosis. However, this technique is not suitable for patients presenting neurological lesions causing absence or very low quality of EMG signal. For those cases, an alternative control strategy should be provided. The aim of the present study is to develop a gait assistance orthosis for lower limb powered by PAMs controlled by a voluntary activation method based on the angular behavior of hip joint. In the present study, an orthosis that has been molded in a patient was employed and, by taking her anthropometric parameters and movement constraints, the adaptation of the existing orthosis to the powered orthosis was planned. A control system was devised allowing voluntary control of a powered orthosis suitable for patients presenting neurological lesions causing absence or very low quality of EMG signal. A pilot clinical study was reported where a patient, victim of poliovirus, successfully tested a hip orthosis especially modified for the gait test evaluation in the parallel bar system. The hip orthosis design and the control circuitry parameters were able to be set to provide satisfactory and comfortable use of the orthosis during the gait cycle.