Restricted accessResearch articleFirst published online 2017-7
The effects of a home-based arm ergometry exercise programme on physical fitness,fatigue and activity in Polio survivors: a randomised controlled trial
To investigate the effect of an eight-week home-based arm ergometry aerobic exercise programme on physical fitness, fatigue, activity and quality of life in Polio Survivors.
Design:
An assessor blinded randomised controlled trial.
Setting:
Home-based exercise.
Subjects:
Fifty-five Polio survivors randomised to exercise or control groups.
Intervention:
Home-based arm ergometry at an intensity of 50%-70% maximum heart rate, compared with usual physiotherapy care.
Main measures:
The Six-minute Arm Test, Fatigue Severity Scale, Physical Activity Scale for Individuals with Physical Disabilities and SF-36. Assessments were completed at baseline and at eight weeks.
Results:
There was no significant difference in the primary outcome, exercising heart rate during the Six-minute Arm Test, between the groups at follow-up [97.6 (SD10.1) compared to 102.4 (SD13.7) beats per minute (P=0.20)]. Blood pressure was significantly lower in the intervention group at follow-up [systolic blood pressure 132(18.6)mmHg compared to 144.1(14.6)mmHg (P=0.002)]. There were no between group differences in the Fatigue Severity Scale (P=0.25) or Physical Activity Scale for Individuals with Physical Disabilities (P=0.49), with a small difference in SF-36 physical component score (P=0.04).
Conclusions:
This home-based arm ergometry programme successfully facilitated aerobic exercise in Polio Survivors, but did not result in a significant change in physical fitness, measured by the Six-minute Arm Test.
HowardRSWilesCMSpencerGT. The late sequelae of poliomyelitis. Q J Med1988; 66:219–232.
2.
HalsteadL. Diagnosing Postpolio Syndrome: Inclusion and exclusion criteria. In: SilverJKGawneAC (eds) Postpolio Syndrome. Philadelphia: Hanley and Brufus, 2004. p. 1–20.
3.
HoremansHLBussmannJBBeelenAStamHJNolletF. Walking in postpoliomyelitis syndrome: the relationships between time-scored tests, walking in daily life and perceived mobility problems. J Rehabil Med2005; 37:142–146.
4.
KleinMGBraitmanLECostelloRKeenanMAEsquenaziA. Actual and perceived activity levels in polio survivors and older controls: a longitudinal study. Arch Phys Med Rehabil2008; 89:297–303.
5.
FarbuEGilhusNE. Education, occupation, and perception of health amongst previous polio patients compared to their siblings. Eur J Neurol2002; 9:233–241.
6.
NielsenNMRostgaardKAskgaardDSkinhojPAabyP. Life-long morbidity among Danes with poliomyelitis. Archives of physical medicine and rehabilitation2004; 85:385–391.
7.
GylfadottirSDallimoreMDeanE. The relation between walking capacity and clinical correlates in survivors of chronic spinal poliomyelitis. Arch Phys Med Rehabil2006; 87:944–952.
8.
AlschulerKNGibbonsLERosenbergDEEhdeDMVerrallAMBamerAM. Body mass index and waist circumference in persons aging with muscular dystrophy, multiple sclerosis, post-polio syndrome, and spinal cord injury. Disability and health journal2012; 5:177–184.
9.
StrohscheinFJKellyCGClarkeAGWestburyCFShuaibAChanKM. Applicability, validity, and reliability of the Piper Fatigue Scale in postpolio patients. American journal of physical medicine & rehabilitation/Association of Academic Physiatrists2003; 82:122–119.
10.
ChangKHLaiCHChenSCHsiaoWTLiouTHLeeCM. Body composition assessment in Taiwanese individuals with poliomyelitis. Archives of physical medicine and rehabilitation2011; 92:1092–1097.
11.
DanaeiGDingELMozaffarianDTaylorBRehmJMurrayCJ. The preventable causes of death in the United States: comparative risk assessment of dietary, lifestyle, and metabolic risk factors. PLoS medicine2009; 6:e1000058.
NelsonMERejeskiWJBlairSNDuncanPWJudgeJOKingAC. Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Medicine and science in sports and exercise2007; 39:1435–1445.
14.
DeanERossJ. Modified aerobic walking program: effect on patients with postpolio syndrome symptoms. Archives of physical medicine and rehabilitation1988; 69:1033–1038.
15.
OncuJDurmazBKarapolatH. Short-term effects of aerobic exercise on functional capacity, fatigue, and quality of life in patients with post-polio syndrome. Clinical rehabilitation2009; 23:155–163.
16.
DeanERossJ. Effect of modified aerobic training on movement energetics in polio survivors. Orthopedics1991; 14:1243–1246.
17.
JonesDRSpeierJCanineKOwenRStullGA. Cardiorespiratory responses to aerobic training by patients with postpoliomyelitis sequelae. Jama1989; 261:3255–3258.
18.
ErnstoffBWetterqvistHKvistHGrimbyG. Endurance training effect on individuals with postpoliomyelitis. Archives of physical medicine and rehabilitation1996; 77:843–848.
19.
KoopmanFSVoornELBeelenABleijenbergGde VisserMBrehmMA. No Reduction of Severe Fatigue in Patients With Postpolio Syndrome by Exercise Therapy or Cognitive Behavioral Therapy: Results of an RCT. Neurorehabil Neural Repair2016; 30:402–410.
20.
KrizJLJonesDRSpeierJLCanineJKOwenRRSerfassRC. Cardiorespiratory responses to upper extremity aerobic training by postpolio subjects. Archives of physical medicine and rehabilitation1992; 73:49–54.
21.
WillenCSunnerhagenKSGrimbyG. Dynamic water exercise in individuals with late poliomyelitis. Archives of physical medicine and rehabilitation2001; 82:66–72.
22.
KoopmanFSBeelenAGilhusNEde VisserMNolletF. Treatment for postpolio syndrome. Cochrane database of systematic reviews2015; 5:CD007818.
23.
KleinMGBraitmanLECostelloRKeenanMAEsquenaziA. Actual and Perceived Activity Levels in Polio Survivors and Older Controls: A Longitudinal Study. Archives of physical medicine and rehabilitation2008; 89:297–303.
24.
BirkTJ. Polio and Post-Polio Syndrome. In: American College of Sports Medicine JLD, MooreGPainterPRobertsS (eds). ACSM’s Exercise Management for Persons with Chronic Diseases and Disabilities-3rd Edition, 2009. p. 327–335.
25.
ValentLDallmeijerAHoudijkHSlootmanHJJanssenTWVan Der WoudeLH. Effects of hand cycle training on wheelchair capacity during clinical rehabilitation in persons with a spinal cord injury. Disability and rehabilitation2010; 32:2191–2200.
26.
ValentLDallmeijerAHoudijkHTalsmaEvan der WoudeL. The effects of upper body exercise on the physical capacity of people with a spinal cord injury: a systematic review. Clinical rehabilitation2007; 21:315–330.
27.
BeckerHStuifbergenA. What makes it so hard? Barriers to health promotion experienced by people with multiple sclerosis and polio. Family & community health2004; 27:75–85.
28.
SchulzKFAltmanDGMoherD. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. International journal of surgery2010; 9:672–677.
29.
MurrayDMeldrumDMoloneyRCampionAHorganFHardimanO. The effects of a home-based arm ergometry exercise programme on physical fitness, fatigue and activity in polio survivors: protocol for a randomised controlled trial. BMC neurology2012; 12:157.
30.
The British Columbia Ministry for Health. Physical Activity Readiness Medical Examination PARmed-X. 2002. Available at: www.csep.ca/forms (accessed 10 March 2009).
31.
KruppLBLaRoccaNGMuir-NashJSteinbergAD. The fatigue severity scale. Application to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol1989; 46:1121–1123.
32.
BorgGA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc1982; 14:377–381.
33.
VoornELGerritsKHKoopmanFSNolletFBeelenA. Determining the anaerobic threshold in postpolio syndrome: comparison with current guidelines for training intensity prescription. Archives of physical medicine and rehabilitation2014; 95:935–940.
34.
HolATEngJJMillerWCSprouleSKrassioukovAV. Reliability and validity of the six-minute arm test for the evaluation of cardiovascular fitness in people with spinal cord injury. Archives of physical medicine and rehabilitation2007; 88:489–495.
35.
MurrayD. An evaluation of impairment, mobility and quality of life in Polio survivors, change in muscle strength over time and the effects of an arm ergometry aerobic exercise programme. Dublin: Royal College of Surgeons in Ireland, 2014.
36.
LexellJEDownhamDY. How to assess the reliability of measurements in rehabilitation. American journal of physical medicine & rehabilitation/Association of Academic Physiatrists2005; 84:719–723.
37.
FergussonDAaronSDGuyattGHebertP. Post-randomisation exclusions: the intention to treat principle and excluding patients from analysis. BMJ2002; 325:652–654.
FranklinBA. Exercise testing, training and arm ergometry. Sports medicine1985; 2:100–119.
41.
JNC7. National High Blood Pressure Education Programme.The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. National Institutes of Health, Publication no. 03-5233, December2003.
42.
NolletFBeelenAPrinsMHDe VisserMSargeantAJLankhorstGJ. Disability and functional assessment in former polio patients with and without postpolio syndrome. Archives of physical medicine and rehabilitation1999; 80:136–143.
43.
March of Dimes. Post-Polio Syndrome: Identifying Best Practices in Diagnosis & Care. March of Dimes International Conference on Post polio Syndrome. 2001. Available from: http://www.marchofdimes.com/files/PPSreport.pdf (accessed 12 May 2009).
44.
FarbuEGilhusNEBarnesMPBorgKde VisserMDriessenA. EFNS guideline on diagnosis and management of post-polio syndrome. Report of an EFNS task force. Eur J Neurol2006; 13:795–801.
45.
WashburnRAZhuWMcAuleyEFrogleyMFigoniSF. The physical activity scale for individuals with physical disabilities: development and evaluation. Archives of physical medicine and rehabilitation2002; 83:193–200.
46.
van den Berg-EmonsRJL’OrtyeAABuffartLMNieuwenhuijsenCNooijenCFBergenMP. Validation of the Physical Activity Scale for individuals with physical disabilities. Archives of physical medicine and rehabilitation2011; 92:923–928.
47.
SkoughKBromanLBorgK. Test-retest reliability of the 6-min walk test in patients with postpolio syndrome. International journal of rehabilitation research Internationale Zeitschrift fur Rehabilitationsforschung2013; 36:140–5.
48.
MacGregorJ. The evaluation of patient performance using long-term ambulatory monitoring technique in the domiciliary environment. Physiotherapy1981; 67:30–33.
49.
DworkinRHTurkDCRevickiDAHardingGCoyneKSPeirce-SandnerS. Development and initial validation of an expanded and revised version of the Short-form McGill Pain Questionnaire (SF-MPQ-2). Pain2009; 144:35–42.
50.
MeldrumDCahalaneEConroyRFitzgeraldDHardimanO. Maximum voluntary isometric contraction: reference values and clinical application. Amyotroph Lateral Scler2007; 8:47–55.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
