Ultrasonography Assessment Based on Muscle Thickness and Echo Intensity in Post-Polio Patients.

There is nospecific designed diagnostic test for post-poliomyelitis syndrome. The most important symptoms of this syndrome are new loss of muscle strength and more fatigue. Previous studies have investigated muscle ultrasound parameters to distinguish neuromuscular disease patients from healthy controls. The aim of this study was to investigate if muscle thickness and echo intensity measured by ultrasound can discriminate post-poliomyelitis syndrome patients from healthy controls. A total of 29 post-polio patients and 27 healthy controls participated in this cross-sectional study. Anthropometric measures, muscle thickness, echo intensity using B-mode ultrasound in rectus femoris and biceps brachii muscles, and muscle strength test data were collected. Muscle thickness in rectus femoris was significantly lower in post-poliomyelitis patients than in healthy controls, but not in biceps brachii. Echo intensity in rectus femoris and biceps brachii was higher in post-poliomyelitis syndrome patients than in healthy controls. Correlations were found between muscle thickness and strength in the upper and lower limbs. The results of the present study showed that muscle thickness in rectus femoris and echo intensity in rectus femoris and biceps brachii can discriminate post-poliomyelitis syndrome patients from healthy controls. A better assessment is possible because it can observe differences and relevant parameters in this clinical population.

Proposal for assessment of the predominant symptom and physical function in patients suffering from Long COVID

Long COVID patients present a cluster of symptoms that overlaps with other post-infectious conditions, such as patients diagnosed with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Besides fatigue, one of the most limiting clinical manifestations in ME/CFS is post-exertional malaise (PEM), which Long COVID patients also report. Therefore, there are concerns about treatment approaches in rehabilitation for long COVID patients. Up to date, Long COVID patients present fatigue and respiratory symptoms predominantly. The hypothesis presented in this paper is that the treatment approach for Long COVID patients may depend on the aetiology of their symptoms, which objective tests can assess. And the primary affected system in a given patient may determine the individual response to physical exhaustion. Then, we propose an assessment to confirm the system impaired under the predominant symptom to guide the rehabilitation intervention. Fatigue-related symptoms, PEM, physical deconditioning and response to exertion should be assessed in Long COVID patients with predominant fatigue. In contrast, the respiratory function by spirometry and the diffusion capacity should be objectively assessed in those patients with predominantly respiratory symptoms. Future research should develop and validate patient-reported outcomes or cardiopulmonary exercise testing to objectively assess the symptoms and functional status in Long COVID patients to reinforce the proposed assessment.