Postpoliomyelitis Syndrome Clinical Trial
Official title:
The Impact of an Arm Ergometry Training Programme on Cardiovascular Fitness, Energy Cost of Walking and Fatigue in Prior Polio Patients
The aim of this study is to investigate the effect of upper limb cardiovascular training on fitness, energy cost of walking, fatigue and pain in polio survivors. Polio survivors often have difficulty accessing aerobic forms of exercise due to limitations in mobility, pain associated with walking and fatigue. This can result in becoming physically unfit and places polio survivors at risk of secondary heath problems due to inactivity. A large percentage of polio survivors have lower limb involvement but have strong arms. The participants in this study will exercise at home using simple arm cycles for 8 weeks. They will attend for assessment on two occasions. All exercise will be prescribed by a Physiotherapist and includes measures to ensure safety while exercising at home.
The American College of Sports Medicine (ACSM) recommendations state that stable muscle
groups should be utilised for exercise in polio survivors and that patients with severe
atrophic polio or with recent weakness should not exercise, while March of Dimes (2001)
recommend not exercising muscle groups where new weakness is being experienced. Floor or
treadmill walking or lower limb cycling may also aggravate pain in those with lower limb
weakness and altered lower limb biomechanics.
Training with an upper limb ergometer is likely to be an appropriate form of exercise in
patients with good, stable upper limb strength. One small, but well designed, trial of upper
limb ergometry over 16 weeks resulted in a 19% increase in maximal oxygen uptake (VO2max) in
10 postpolio subjects exercising 3 times per week (Kriz et al 1992). ACSM recommend using a
Schwinn Air-DyneTM four limb exerciser; however this is an expensive and bulky piece of
equipment and is unlikely to be feasible for ongoing use by community dwelling polio
survivors.
A small upper limb ergometer may be a cost effective, accessible option for exercise for
community dwelling polio survivors. A closely monitored and carefully prescribed
cardiovascular fitness programme may enable polio survivors, who have gained control of
symptoms of fatigue and pain through changes in lifestyle and activity, to increase fitness
and perhaps subsequently reduce energy cost of walking.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Crossover Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
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