Resultados de um programa de exercício físico combinado na força muscular e capacidade funcional de um indivíduo com síndrome Pós-Poliomielite: relato de caso / Effects of a combined exercise program in muscle strength and functional capacity in a individual with Postpoliomyelitis syndrome: case report

A Poliomielite Anterior Aguda (PAA) é uma patologia causada por um enterovírus, que predominantemente prejudica os neurônios motores inferiores, o que causa a paralisia muscular flácida e assimétrica, principalmente nos membros inferiores e que, tardiamente causa sintomas neuromusculares e declínio funcional denominados como Síndrome Pós-Poliomielite (SPP). Objetivo: Aplicar um programa de exercícios combinado e verificar os resultados na força muscular e capacidade funcional de um indivíduo idoso, com SPP. Métodos: A amostra foi composta por 1 mulher, idade 66 anos, com SPP, hipertensão arterial sistêmica, dislipidemia, hipotireoidismo. A força muscular foi mensurada por meio do teste de 7 ­ 10 repetições máximas (RM). A distância percorrida ao pedalar foi realizada por meio do Teste 12 minutos adaptado e o equilíbrio dinâmico foi avaliado por meio do Timed Up & Go Test. Os exercícios foram realizados em 2 séries de 10 repetições, com intensidade de 60% de 1 RM, por 24 semanas. Resultados: Após 24 semanas, a força muscular de MMII apresentou aumento de 333,3% e a força de MMSS 216,5%. O equilíbrio dinâmico melhorou 34,3%. A distância percorrida ao pedalar aumentou 11,8%. Conclusão: Os dados por nós obtidos sugerem que pessoas com SPP, mesmo que idosas, poderão se beneficiar de um programa de exercícios para aumento da força muscular e melhora da capacidade funcional, porém é importante que outros estudos sejam desenvolvidos para verificar esses resultados em um número maior de pessoas.

Postpoliomyelitis Syndrome is a enterovirus pathology, which predominantly damages the lower muscles, which cause flaccid and asymmetric muscle paralysis, based on lower and late neuromuscular and functional symptoms denominate Postpoliomyelitis Syndrome (PPS). Objective: To apply a combined exercise program and to verify the results on the muscle strength and functional capacity of an elderly individual with PPS. Methods: The sample was one women, 66 years old, with comorbities hypertension, dyslipidemia, hypothyroidism. Muscle strength was measured by 7 - 10 maximal repetitions (MR) test. The distance traveled pedaling was performed by Adapted 12-minute Test and the balance was evaluated by Timed Up & Go Test. The muscle strength training was intensity 60% of a one maximum repetition. Results: After 24 weeks, the muscular strength of lower limbs increased 333.3% and the upper limbs, 216.5%. The balance improved 34.3%. The distance traveled pedaling increased 11.8%. Conclusion: The results suggest that individuals with PPS, even if elderly, may benefit from an exercise program to increase muscle strength and improve functional capacity, but it is important that other studies are developed to verify these results in a larger number of individuals.

Falls in Korean Polio Survivors: Incidence, Consequences, and Risk Factors

Falls and fall-related injuries are important issue among polio survivors. The purpose of this study was to determine the incidence of, and consequences and factors associated with falls among Korean polio survivors. A total of 317 polio survivors participated in this study. All participants completed a questionnaire including fall history, symptoms related to post-polio syndrome and other information through a telephone interview. Among them, 80 participants visited our clinic for additional physical measurements and tests. Of the 317 respondents, 68.5% reported at least one fall in the past year. Of the fallers, 42.5% experienced at least one fall during one month. Most falls occurred during ambulation (76.6%), outside (75.2%) and by slipping down (29.7%). Of fallers, 45% reported any injuries caused by falls, and 23.3% reported fractures specifically. Female sex, old age, low bone mineral density, the presence of symptoms related to post-polio syndrome (PPS), poor balance confidence, short physical performance battery and weak muscle strength of knee extensor were not significantly associated with falls. Only leg-length discrepancy using spine-malleolar distance (SMD) was a significant factor associated with falls among Korean polio survivors. Our findings suggest that malalignment between the paralytic and non-paralytic limb length should be addressed in polio survivors for preventing falls.

Differential diagnosis between post-poliosyndrome symptoms and temporomandibular disorder – Clinical case

Post-poliomyelitis syndrome (PPS) is characterized by the delayed appearance of new neuromuscular symptoms in patients several years after their acute poliomyelitis paralysis. Clinical features of PPS include fatigue, joint and muscle pain, new muscular weakness and bulbar symptoms. The diagnosis is essentially clinical after excluding other neurological, orthopedic or rheumatologic problems. Temporomandibular disorders (TMD) are usually diagnosed by means of comprehensive review of patient history and clinical examination and the symptoms are pain/ discomfort in the jaw, mainly in the region of the temporomandibular joints (TMJs) and/or masticatory muscles, limitation of mandibular function and/or TMJ sounds. In the same way as PPS, the diagnosis of TMD is challenging. This study reports the case of a patient that presented thesymptoms of both conditions in the stomatognathic system, and discusses how to achieve the differential diagnosis for proper management of the cases.

Poliomielite e síndrome pós-pólio

A cirurgia, agressiva, por vezes abusiva, em pleno inverno paulistano, predispunha à polioencefalite, à perda da consciência! Não bastante, identificavam-se mais fatores desencadeantes: injeções intramusculares, apendicectomias, insolação, exposição ao frio... A carga dos vírus selvagens em circulação na população era fora do comum. Iceberg, o melhor exemplo para estimativa de sua densidade; a ponta, as ocorrências paralíticas; a base, submersa, a imensidade das formas inaparentes.Denominação paralisia infantil? Impropriedade. Adultos ? populares ou famosos ? padeceram da enfermidade.A raiva muda ? forma clínica paralítica da raiva humana ?, figurava entre opções na discussão de casos. Nada simples distinguir enfermidades com sintomas afins.Trata-se agora de rediscutir a estratégia para assegurar de vez a erradicação.A modalidade atual de queixas,retroativas,é a "síndrome pós-pólio".

Síndrome pós-poliomielite / Post-poliomyelitis syndrome

A poliomielite é uma doença erradicada no Brasil, desde os anos 80, mas atualmente estão aparecendo novos sintomas relacionados a essa patologia, a síndrome pós-polio, que é caracterizada por uma nova desordem neurológica. Esses sintomas aparecem 30 a 40 anos após a infecção aguda da poliomielite e, como é uma patologia recente, há poucos estudos e casos diagnosticados. O objetivo deste estudo é descrever o aparecimento do caso dessa síndrome, através do relato de caso de uma paciente que realiza tratamento fisioterapêutico na clínica de Fisioterapia do Hospital Regional de Araranguá, localizado na cidade de Araranguá/SC, em agosto de 2006. Conforme a literatura, os sinais e sintomas que foram relatados pelo estudo são considerados como uma conseqüência tardia da infecção aguda da poliomielite, devido à degeneração dos brotamentos dos axônios atingidos pela poliomielite há 40 anos.

The poliomyelitis disease was eradicated in Brazil in the eighties, but now new symptoms related to this pathology are rising, like the post-polio syndrome, which is characterized by a new neurological disorder. These symptoms rise 30 to 40 years after the acute poliomyelitis infection and, as it is a recent pathology, studies and diagnosed cases are scarce. The objective of this study was to describe the onset of this syndrome, through the case of a patient attended in a Physical Therapy Clinic of a Regional Hospital of Araranguá, located in the city of Araranguá/SC, Brazil, in August 2006. According to literature, signs and symptoms reported in the study are considered as the consequence of acute poliomyelitis infection, due to degeneration of budding axons damaged by the poliomyelitis 40 years ago.