Article

Muscle weakness in one or both upper limbs is common in persons with
previous polio, but there is very limited knowledge how it influences daily life.
OBJECTIVE: To assess muscle weakness and self-perceived disability of the upper
limbs in persons with late effects of polio and evaluate their association.
DESIGN: Cross-sectional study. SETTINGS: University hospital outpatient clinic.
PARTICIPANTS: Twenty-eight persons (mean age 67, SD 16 years) with late effects
of polio in their upper limbs. MAIN OUTCOME MEASURES:
A fixed dynamometer (Biodex
System 3 PRO dynamometer (Biodex Medical Systems Inc, Shirley, NY) was used to
measure isometric shoulder abduction and elbow flexion, as well as isokinetic
concentric elbow flexion and extension. A hand-held dynamometer (Grippit,
Hagersten, Sweden) was used to measure isometric grip strength. The Disabilities
of Arm, Shoulder and Hand (DASH) questionnaire was used to assess self-perceived
disability of the upper limbs. The relationships between the measures were
analyzed with the Spearman rank correlation coefficients (rho). RESULTS: The
participants were 20%-31% weaker in their more-affected upper limb compared with
their less-affected limb. The DASH score was on average 33.5 (SD 18.6),
indicating a mild-to-moderate disability of their upper limbs. Changing a
lightbulb overhead, carrying a heavy object, and performing recreational
activities that required muscle force with the arms were perceived as most
difficult. The correlations (rho) between the muscle strength measurements and
DASH scores ranged from -0.46 (95% confidence interval [95% CI] -0.10 to -0.71)
to -0.61 (95% CI -0.31 to -0.80) for the more affected upper limb, and from -0.54
(95% CI -0.21 to -0.76) to -0.68 (95% CI -0.41 to -0.84) for the less affected
upper limb (P < .05-.01). CONCLUSIONS: Persons with previous polio and muscle
weakness in their upper limbs perceive difficulties to use their arms in daily
life, especially when performing activities above their head and strenuous
household or leisure activities. The fair-to-moderate correlations of muscle
strength with self-perceived disability imply that the weakness can only
partially explain the perceived disabilities of arm, shoulder and hand. Other
factors are therefore important to consider in the rehabilitation of persons with
late effects of polio and upper limb disability.
CI - Copyright (c) 2016 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS