CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2016; 74(07): 574-579
DOI: 10.1590/0004-282X20160072
VIEWS AND REVIEWS

Currents issues in cardiorespiratory care of patients with post-polio syndrome

Tópicos atuais no tratamento cardiorrespiratório de pacientes com síndrome pós-poliomielite
Marco Orsini
1   Centro Universitário Augusto Motta, Programa de Pós-Graduação em Ciências da Reabilitação, Rio de Janeiro RJ, Brasil;
2   Universidade Severino Sombra, Faculdade de Medicina, Vassouras RJ, Brasil;
3   Universidade Federal do Rio de Janeiro, Instituto de Psquiatria, Laboratório de Mapeamento Cerebral e EEG, Rio de Janeiro RJ, Brasil;
,
Agnaldo J. Lopes
1   Centro Universitário Augusto Motta, Programa de Pós-Graduação em Ciências da Reabilitação, Rio de Janeiro RJ, Brasil;
,
Fernando S. Guimarães
1   Centro Universitário Augusto Motta, Programa de Pós-Graduação em Ciências da Reabilitação, Rio de Janeiro RJ, Brasil;
,
Marcos R. G. Freitas
4   Universidade Federal Fluminense, Hospital Universitário Antonio Pedro, Niterói RJ, Brasil;
,
Osvaldo J. M. Nascimento
4   Universidade Federal Fluminense, Hospital Universitário Antonio Pedro, Niterói RJ, Brasil;
,
Mauricio de Sant’ Anna Junior
5   Instituto Federal de Educação, Ciência e Tecnologia do Rio de Janeiro, Curso de Fisioterapia, Rio de Janeiro RJ, Brasil;
,
Pedro Moreira Filho
4   Universidade Federal Fluminense, Hospital Universitário Antonio Pedro, Niterói RJ, Brasil;
,
Stenio Fiorelli
2   Universidade Severino Sombra, Faculdade de Medicina, Vassouras RJ, Brasil;
,
Ana Carolina A. F Ferreira
4   Universidade Federal Fluminense, Hospital Universitário Antonio Pedro, Niterói RJ, Brasil;
,
Camila Pupe
4   Universidade Federal Fluminense, Hospital Universitário Antonio Pedro, Niterói RJ, Brasil;
,
Victor H. V. Bastos
6   Universidade Federal do Piauí, Parnaíba PI, Brasil;
,
Bruno Pessoa
4   Universidade Federal Fluminense, Hospital Universitário Antonio Pedro, Niterói RJ, Brasil;
,
Carlos B. Nogueira
4   Universidade Federal Fluminense, Hospital Universitário Antonio Pedro, Niterói RJ, Brasil;
,
Beny Schmidt
6   Universidade Federal do Piauí, Parnaíba PI, Brasil;
,
Olivia G. Souza
4   Universidade Federal Fluminense, Hospital Universitário Antonio Pedro, Niterói RJ, Brasil;
,
Eduardo R Davidovich
4   Universidade Federal Fluminense, Hospital Universitário Antonio Pedro, Niterói RJ, Brasil;
,
Acary S. B. Oliveira
7   Universidade Federal de São Paulo, Departamento de Neurologia, São Paulo SP, Brasil;
,
Pedro Ribeiro
3   Universidade Federal do Rio de Janeiro, Instituto de Psquiatria, Laboratório de Mapeamento Cerebral e EEG, Rio de Janeiro RJ, Brasil;
› Author Affiliations

ABSTRACT

Post-polio syndrome (PPS) is a condition that affects polio survivors years after recovery from an initial acute attack of the poliomyelitis virus. Most often, polio survivors experience a gradual new weakening in muscles that were previously affected by the polio infection. The actual incidence of cardiovascular diseases (CVDs) in individuals suffering from PPS is not known. However, there is a reason to suspect that individuals with PPS might be at increased risk.

Method A search for papers was made in the databases Bireme, Scielo and Pubmed with the following keywords: post polio syndrome, cardiorespiratory and rehabilitation in English, French and Spanish languages. Although we targeted only seek current studies on the topic in question, only the relevant (double-blind, randomized-controlled and consensus articles) were considered.

Results and Discussion Certain features of PPS such as generalized fatigue, generalized and specific muscle weakness, joint and/or muscle pain may result in physical inactivity deconditioning obesity and dyslipidemia. Respiratory difficulties are common and may result in hypoxemia.

Conclusion Only when evaluated and treated promptly, somE patients can obtain the full benefits of the use of respiratory muscles aids as far as quality of life is concerned.

RESUMO

Síndrome pós-polio (SPP) é uma condição que afeta sobreviventes da poliomielite aguda (PAA), anos após a recuperação de um ataque agudo inicial do vírus. Na maioria das vezes, os sobreviventes da polio começam a apresentar nova paresia gradual nos músculos que foram previamente afetados pela infecção. A incidência real de doenças cardiovasculares (DCV) em indivíduos que sofrem de SPP não é conhecida. Entretanto, há indícios para suspeitar de que sujeitos com SPP podem estar em maior risco.

Método Realizou-se uma busca de artigos nas bases de dados: Bireme, Scielo e Pubmed, utilizando as seguintes palavras-chave: síndrome pós-poliomielite, função cardiorrespiratória e reabilitação, nos idiomas Inglês, Francês e Espanhol. Embora tenhamos selecionado um número expressivo de artigos, somente foram considerados os duplo-cegos, randomizados-controlados, além de consensos.

Resultados e Discussão Certas características da SPP, tais como fadiga muscular, paresia, dor muscular e/ou articulares podem resultar em descondicionamento por inatividade física, além de obesidade e dislipidemia. Dificuldades respiratórias são comuns e podem resultar em hipoxemia.

Conclusão Somente quando avaliados e tratados em tempo hábil, alguns pacientes são capazes de obter os benefícios do uso dos músculos respiratórios auxiliares em termos de qualidade de vida.



Publication History

Received: 28 October 2015

Accepted: 06 April 2016

Article published online:
06 September 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 
  • References

  • 1 Bickerstaffe A, Beelen A, Nollet F. Change in physical mobility over 10 years in post-polio syndrome. Neuromuscul Disord. 2015;25(3):225-30. doi:10.1016/j.nmd.2014.11.015
  • 2 Esteban J. [Polio paralytic: new problems: postpolio syndrome]. Rev Esp Salud Publica. 2013; 87(5):517-22. Spanish. doi:10.4321/S1135-57272013000500010
  • 3 Trojan DA, Cashman NR. Post-poliomyelitis syndrome. Muscle Nerve. 2005;319(1):6-19. doi:10.1002/mus.20259
  • 4 Bach JR, Alba AS. Pulmonary dysfunction and sleep disordered breathing as post-polio sequelae: evaluation and management. Orthopedics. 1991;14(12):1329-37. doi:10.3928/0147-7447-19911201-07
  • 5 Trojan DA, Arnold DL, Shapiro S, Bar-Or A, Robinson A, Le Cruguel JP et al. Fatigue in post-poliomyelitis syndrome: association with disease-related, behavioral, and psychosocial factors. PM R. 2009;1(5):442-9. doi:10.1016/j.pmrj.2009.03.003
  • 6 Fischer JR; Headley J.. Post-polio breathing and sleep problems revisited. Post-Polio Health. 2004;20(2):5-7.
  • 7 Garip Y, Eser F, Bodur H, Baskan B, Sivas F, Yilmaz O. Health related quality of life in Turkish polio survivors: impact of post-polio on the health related quality of life in terms of functional status, severity of pain, fatigue, and social, and emotional functioning. Rev Bras Reumatol. 2015. In press. doi:10.1016/j.rbre.2014.12.006
  • 8 Silva TM, Moreira GA, Quadros AAJ, Pradella-Hallinan M, Tufik S, Oliveira ASB. Analysis of sleep characteristics in post-polio syndrome patients. Arq Neuropsiquiatr. 2010;68(4):535-40. doi:10.1590/S0004-282X2010000400011
  • 9 Siegel H, McCutchen C, Dalakas MC, Freeman A, Graham B, Alling D et al. Physiologic events initiating REM sleep in patients with the postpolio syndrome. Neurology. 1999;52(3):516-22. doi:10.1212/WNL.52.3.516
  • 10 Laffont I, Julia M, Tiffreau V, Yelnik A, Herisson C, Pelissier J. Aging and sequelae of poliomyelitis. Ann Phys Rehabil Med. 2010;53(1):24-33. doi:10.1016/j.rehab.2009.10.002
  • 11 Romigi A, Maestri M. Circadian fatigue or unrecognized restless legs syndrome? The post-polio syndrome model. Front Neurol. 2014;5:115. doi:10.3389/fneur.2014.00115
  • 12 Vasconcelos OM, Prokhorenko OA, Salajegheh MK, Kelley KF, Livornese K, Olsen CH et al. Modafinil for treatment of fatigue in post-polio syndrome: a randomized controlled trial. Neurology. 2007;68(20):1680-6. doi:10.1212/01.wnl.0000261912.53959.b4
  • 13 Acler M, Bocci T, Valenti D, Turri M, Priori A, Bertolasi L. Transcranial direct current stimulation (tDCS) for sleep disturbances and fatigue in patients with post-polio syndrome. Restor Neurol Neurosci. 2013;31(5):661-8. doi:10.3233/RNN-130321
  • 14 Gawne AC, Wells KR, Wilson KS. Cardiac risk factors in polio survivors. Arch Phys Med Rehabil. 2003;84(5):694-6. doi:10.1016/S0003-9993(02)04836-0
  • 15 Orsini M, Souza JA, Araújo Leite MA, Teixeira S, Sá Ferreira A, Bastos VH et al. Previous acute polio and post-polio syndrome: recognizing the pathophysiology for the establishment of rehabilitation programs. Neurol Int. 2015;7(1):5452. doi:10.4081/ni.2015.5452
  • 16 Matyja E. [Post-polio syndrome. Part II. Therapeutic management]. Neurol Neurochir Pol. 2012;46(4):372-8. Polish. doi:10.5114/ninp.2012.30270
  • 17 Halstead LS, Rossi CD. New problems in old polio patients: results of a survey of 539 polio survivors. Orthopedics. 1985;8(7):845-50. doi:10.3928/0147-7447-19850701-06
  • 18 Weinberg J, Borg J, Bevegård S, Sinderby C. Respiratory response to exercise in postpolio patients with severe inspiratory muscle dysfunction. Arch Phys Med Rehabil. 1999;80(9):1095-100. doi:10.1016/S0003-9993(99)90067-9
  • 19 Dolmage TE, Avendano MA, Goldstein RS. Respiratory function during wakefulness and sleep among survivors of respiratory and non-respiratory poliomyelitis. Eur Respir J. 1992;5(7):864-70.
  • 20 Lane DJ, Hazleman B, Nichols PJR. Late onset respiratory failure in patients with previous poliomyelitis. Q J Med. 1974;43(172):551-68.
  • 21 Dean E, Ross J, Road JD, Courtenay L, Madill KJ. Pulmonary function in individuals with a history of poliomyelitis. Chest. 1991;100(1):118-23. doi:10.1378/chest.100.1.118
  • 22 Lira CA, Minozzo FC, Sousa BS, Vancini RL, Andrade MS, Quadros AA et al. Lung function in post-poliomyelitis syndrome: a cross-sectional study. J Bras Pneumol. 2013;39(4):455-60. doi:10.1590/S1806-37132013000400009
  • 23 Ward NS, Hill NS. Pulmonary function testing in neuromuscular disease. Clin Chest Med. 2001;22(4):769-81. doi:10.1016/S0272-5231(05)70065-4
  • 24 Midgren B. Lung function and clinical outcome in postpolio patients: a prospective cohort study during 11 years. Eur Respir J. 1997;10(1):146-9. doi:10.1183/09031936.97.10010146
  • 25 Boitano LJ. Management of airway clearance in neuromuscular disease. Respir Care. 2006;51(8):913-22.
  • 26 Bach JR, Gonçalves MR, Hon A, Ishikawa Y, De Vito EL, Prado F et al. Changing trends in the management of end-stage neuromuscular respiratory muscle failure: recommendations of an international consensus. Am J Phys Med Rehabil. 2013;92(3):267-77. doi:10.1097/PHM.0b013e31826edcf1
  • 27 Wolfe LF, Joyce NC, McDonald CM, Benditt JO, Finder J. Management of pulmonary complications in neuromuscular disease. Phys Med Rehabil Clin N Am. 2012;23(4):829-53. doi:10.1016/j.pmr.2012.08.010
  • 28 Bach JR, Bakshiyev R, Hon A. Noninvasive respiratory management for patients with spinal cord injury and neuromuscular disease. Tanaffos. 2012;11(1):7-11.
  • 29 Orsini M, Lopes AJ, Menezes SL, Oliveira AB, Freitas MR, Nascimento OJ et al. Current issues in the respiratory care of patients with amyotrophic lateral sclerosis. Arq Neuropsiquiatr. 2015;73(10):873-6. doi:10.1590/0004-282X20150132
  • 30 Kralingen KW, Ivanyi B, Keimpema AR, Venmans BJ, Visser M, Postmus PE et al. Sleep complaints in postpolio syndrome. Arch Phys Med Rehabil. 1996;77(6):609-11. doi:10.1016/S0003-9993(96)90304-4
  • 31 Steljes DG, Kryger MH, Kirk BW, Millar TW. Sleep in postpolio syndrome. Chest. 1990;98(1):133-40. doi:10.1378/chest.98.1.133
  • 32 Bhat S, Gupta D, Chokroverty S. Sleep disorders in neuromuscular diseases. Neurol Clin. 2012; 30(4):1359-87. doi:10.1016/j.ncl.2012.08.010
  • 33 Aboussouan LS. Sleep-disordered breathing in neuromuscular disease. Am J Respir Crit Care Med. 2015;191(9):979-89. doi:10.1164/rccm.201412-2224CI
  • 34 Kang JH, Lin HC. Comorbidity profile of poliomyelitis survivors in a Chinese population: a population-based study. J Neurol. 2011;258(6):1026-33. doi:10.1007/s00415-010-5875-y
  • 35 Greenland P, Alpert JS, Beller GA, Benjamin EJ, Budoff MJ, Fayad ZA et al. 2010 ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2010;56(25):e50-103. doi:10.1016/j.jacc.2010.09.001
  • 36 Stöllberger C, Blazek G, Wegner C, Finsterer J. Neurological comorbidity affects prognosis in left ventricular hypertrabeculation/noncompaction. Heart Lung. 2012;41(6):594-8. doi:10.1016/j.hrtlng.2012.03.002
  • 37 Nollet F, Beelen A, Sargeant AJ, Visser M, Lankhorst GJ, Jong BA. Submaximal exercise capacity and maximal power output in polio subjects. Arch Phys Med Rehabil. 2001;82(12):1678-85. doi:10.1053/apmr.2001.27390
  • 38 Kriz JL, Jones DR, Speier JL, Canine JK, Owen RR, Serfass RC. Cardiorespiratory responses to upper extremity aerobic training by postpolio subjects. Arch Phys Med Rehabil. 1992;73(1):49-54.
  • 39 Dean E, Ross J. Effect of modified aerobic training on movement energetics in polio survivors. Orthopedics. 1991;14(11):1243-6.
  • 40 Voorn EL, Gerrits KH, Koopman FS, Nollet F, Beelen A. Determining the anaerobic threshold in postpolio syndrome: comparison with current guidelines for training intensity prescription. Arch Phys Med Rehabil. 2014;95(5):935-40. doi:10.1016/j.apmr.2014.01.015
  • 41 Vreede KS, Henriksson J, Borg K, Henriksson M. Gait characteristics and influence of fatigue during the 6-minute walk test in patients with post-polio syndrome. J Rehabil Med. 2013;45(9):924-8. doi:10.2340/16501977-1209