PHYSICAL ACTIVITY AND SELF-REPORTED IMPAIRMENTS IN PERSONS WITH POST-POLIO SYNDROME IN GUJARAT, INDIA

M. Sheth¹, S. Sharma²

Background: India was one of the toughest places globally to eradicate polio.Many polio survivors have experienced late-onset neuromuscular symptoms like fatigue, pain, new and unusual muscular deficits along with decreased functional abilities.These symptoms have been termed Post Poliomyelitis Syndrome(PPS).According to WHO,only 38% of disabled people meet recommendations for physical activity(PA) compared to 49% in healthy individuals. Many PPS patients may have difficulties in achieving desired levels of PA.

Purpose: Knowledge of amount and type of PA in persons with PPS is scarce in India and assessing their PA can lead to a better understanding of their lifestyle and enable in creating management strategies for the same.This study intended to determine the level of PA in PPS using physical activity and disability survey(PADS) and self-reported impairments using self-reported impairments scale(SIPP) and also find an association between these health-related determinants.

Methods: This cross-sectional survey was conducted in Gujarat,India using convenience sampling. Eighty individuals having PPS according to Halstead criteria-Self-reported history of prior poliomyelitis, period of neurological stability usually 15 years or more preceding the onset of new weakness, gradual or abrupt onset of new weakness or abnormal muscle fatigability with or without generalized fatigue, muscle atrophy and pain, aged between 18-65 years, having locomotor ability were included. People using psychotrophic drugs, having respiratory/cardiac problems or cognitive impairments were excluded.Outcome measures used were Physical Activity and Disability Survey (PADS) questionnaire to assess Physical Activity and the Self-reported Impairments in Persons with Poliomyelitis(SIPP) for impairments.

Results: Participants were active for 70 minutes/day, household-PA being higher,followed by leisure time-PA.Mean score of severity of impairments was 19.59+2.43(95% CI: 13.00-30.00).PA as a whole significantly and positively correlated with impairments(r=-0.531, p<0.01), which also accounts for 27.3% variance on regression analysis.

Conclusion(s): Physical Activity levels in Post-polio Syndrome are mainly in the form of household and leisure activities contributing to reasonable PA across the day. PA moderately correlates with severity of impairments suggesting the need of structured exercises in form of low physical activity spread across the day.Also self-reported impairments were a significant predictor of physical activity, followed by age.

Implications: Findings of this study can help in rehabilitation of PPS, in that those who are physically active can be advised to divide their total PA into meaningful parts throughout the day.Implications can be drawn from this study in terms of planning wisely and intervening judiciously,since maintaining balance between muscle use and activity is critical in energy preservation of those with PPS.Also, since it correlates with impairments, it can be useful to reduce the impact of these impairments if physical activity is distributed during the day. Besides this, the findings can provide meaningful insights to further research and opening up avenues in clinical practice. Much can be achieved by sharing this data with policy makers, enhancing the dimension and overall quality of life among this population. These can help while screening polio survivors in the clinical setting and can serve as a guide to individual goal setting and treatment planning to reduce self-reported impairments and the impact on daily life.

Funding, acknowledgements: None

Keywords: Physical activity, post-polio syndrome, impairments

Topic: Health promotion & wellbeing/healthy ageing/physical activity

Did this work require ethics approval? Yes

Institution: C M Patel college of Physiotherapy

Committee: Institutional Ethics Committee - C M Patel college of Physiotherapy

Ethics number: (IEC-CMPP/01/2017-18)