Poliomyelitis sequela in Pizhou city

Guangxu XU; Shaoqin GU; Jianan LI

ABSTRACT

BACKGROUND:

An epidemic outbreak of poliomyelitis occurred in Pizhou City, Jangsu Province, 15 years ago. It is important to appraise the daily living and function of those survived children.

OBJECTIVE:

To investigate the physical status of the survived children and propose appropriate suggestions on rehabilitation.

DESIGN:

Case-based cross-sectional study based on patients.

SETTING:

Department of Rehabilitative Medicine of First Hospital Affiliated to Nanjing Medical University.

PARTICIPANTS:

Totally 545 patients with poliomyelitis sequela, which was onset in 1989, were found in Qizhou, and 333 of them were randomly selected from the local"New Hope" nursing house and its surrounding areas.All patients were assayed in one week.

METHODS:

The survey included 333 polio victims in the nursing house or from the surrounding areas. The study was conducted by five research groups, with two physiatrists and one therapist in each group. Assessment included muscle strength, joint rang of motion, limb deformities, activities of daily living, previous surgical interventions and orthosis. The distance was measured from the anterior superior iliac to medial malleolus and from nave to the medial malleolus, respectively. Anatomic length and functional length were also measured.MAIN OUTCOME

MEASURES:

Major outcomes included the forms,shapes, or functions of foot, pelvic, hip, knee and ankle joints.

RESULTS:

According to intention-to-treat analyses, 333 patients with poliomyelitis sequela entered the final analysis. Most of them aged from 15 to 17 years old, which accounted for 97%. Totally 135 patients(40.5% )walked independently and 148 (44.4%) walked with-orthsis and/or crutches. The discrepancy was between 0. 5 cm to 13.0 cm. Patients with paraplegia were 112(33.6% ), which was lesser than those with monoplegia (211, 65.8% ). There were 3 cases with quadriplegia and 2 cases with upper limb involvement. Another 46 sufferers had already underwent the scoliosis prthomorphia. There were 254 subjects with orthosis, including 110 knee ankle feet orthosis for both legs and 131 knee ankle feet orthosis for one leg,with 62 at left and 79 at right. Only three ankle-foot orthosis were employed.

CONCLUSION:

Besides the factor of muscle strength, limb teratism is the key factor that causes walking disorders. Physical functions maybe improved through surgical intervention, orthosis modification, and rehabilitation training. Every child who received survey required further rehabilitative therapy. A multi-disciplinary team is essential to achieve a better outcome.