Abstract
ObjectivesTo compare pulmonary function measures, maximal respiratory pressure and fatigue of respiratory muscles between patients with Post-Polio Syndrome (PPS) and controls.DesignCross-sectional study.PatientsPatients 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).MeasurementsA 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.ResultsThe 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.ConclusionsMaximal 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.
Highlights
Post-Polio Syndrome (PPS) was described 15 years following the first outbreak of Poliomyelitis, when new neuromuscular symptoms were reported
Subjects with scoliosis had significantly higher Residual Volume (RV)/Total Lung Capacity (TLC) values compared with subjects without scoliosis
The 25th frequency percentile of the Surface electromyography (sEMG) signal acquired during Maximal Voluntary Ventilation (MVV) was reduced in the PPS group
Summary
Post-Polio Syndrome (PPS) was described 15 years following the first outbreak of Poliomyelitis, when new neuromuscular symptoms were reported. PPS is reported to develop in 20–75% of polio survivors, 15 years or more after acute disease [1,2,3,4,5,6,7,8,9,10]. Possible risk factors for PPS are age, genetics, time since the acute poliomyelitis, stress and inactive lifestyle [11]. PPS symptoms mainly comprised of new muscle weakness or deterioration of previously affected muscles, combined with muscle atrophy, fatigue, muscle and joint pain and overall functional deterioration [12]. Lower extremity orthoses, assistive devices, physical therapy and pharmacologic agents may be used [14]
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