Abstract
Simple SummaryPeople 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. 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.
Highlights
Fall frequency among individuals with post-polio syndrome (PPS) is estimated at approximately 70%, and one-third of those who fall sustain fragility fractures in the polio-involved limb [1,2]
The novelty of the current study is in its main finding, showing that the risk of falls in PPS patients can be predicted by simple parameters of the gait pattern: Coefficient of Variation (CV) of the stance duration of the weak, CV of double support of the contralateral limb, and double support time of the weak limb
The gait characteristics of our study population are consistent with the results of our previous exploration of PPS gait, where we reported no association between the gait pattern of the PPS patients and sex, age, body mass index (BMI), education, and marital status [16]
Summary
Fall frequency among individuals with post-polio syndrome (PPS) is estimated at approximately 70%, and one-third of those who fall sustain fragility fractures in the polio-involved limb [1,2]. Fall management programs for the PPS population mostly aim to manage asymmetric gait and reduce energy requirements [3]. Gait is mainly improved by assistive devices [4]. Orthoses, balance training, and knee extensor strengthening exercises. Non-fatiguing strengthening and exercises involving isokinetic, isometric, and endurance muscular training, have been demonstrated to improve symptoms of muscular fatigue and pain in patients with PPS [5,6,7]. Reduced energy requirements are advocated to diminish the symptoms of fatigue. This is obtained by pacing strategies, including scheduling rest periods during the day, as well as during activities, and general lifestyle modifications, including weight control and modification of daily activities [8]
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