ArticlesRisk of falling: Predictors based on reduced strength in persons previously affected by polio☆,☆☆,★,★★,♢,♢♢
Section snippets
Participants
A convenience sample of prior polio subjects was recruited from members of the Post-Polio Network and attendees of the Post-Polio Clinic, Prince Henry Hospital, Sydney, Australia.12 All were living independently in the community at the time of assessment. The sample comprised 21 men and 19 women with a mean age ± standard deviation (SD) of 50.7±10.6 years (range, 28-71y). Mean age of polio onset was 8.1±6.6 years (range, 1-31y), and the period since initial infection was 43.6±9.5 years (range,
Comparisons between the prior polio and control subjects
Table 1 shows the mean and SDs for the physiologic measures for the men and women with prior polio and the control women.Empty Cell Prior Polio Men (n=21) Prior Polio Women (n=19) Control Women (n=38) Vision Visual acuity (min) .93±.37 .88±.22 .92±.31 Contrast sensitivity (dB) 21.0±2.2 21.6±2.1 22.4±1.1 Peripheral sensation Proprioception (deg difference) 2.8±3.4 1.2±0.9 1.5±1.5 Touch (log100.1mm pressure) 4.31±.37 4.28±.61* 3.93±.44 Strength (Nm/weight
Discussion
As anticipated, the prior polio subjects showed significant weakness in muscle groups of the lower limb. The female prior polio subjects had less than half the knee extension and ankle dorsiflexion strength of age-matched controls. The muscle groups in the lower limb of the male prior polio subjects were also weak, with knee and ankle strength levels only slightly and insignificantly higher than the levels found in the women with prior polio. This finding further shows the striking effects of
Conclusion
The present investigation of a group patients who had prior polio provides an appropriate model for studying the importance of muscle weakness as a risk factor for falling. Weakness was identified as having both a direct association with falls and an indirect effect mediated through increased postural sway.
Acknowledgements
We thank Dr. Jill Middleton for assistance with subject recruitment. The assistance of the Post-Polio Network and the Australian National Health and Medical Research Council is greatly appreciated.
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2022, Gait and PostureCitation Excerpt :Most aging polio survivors suffer from lower-limb muscle weakness [1], which progresses due to post-polio syndrome [2,3] and results in gait and balance problems [4,5]. In this population, both leg muscle weakness and balance problems are associated with falls [5–7], resulting in an increased fall rate compared with healthy individuals over 55 years of age [8]. Falls may lead to fear of falling [4,7], and reduced independent mobility [7], which, in turn, increases fall risk [6].
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Supported by the Australian National Health and Medical Research Council.
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No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the author are associated.
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Reprint requests to Stephen Lord, PhD, Prince of Wales Medical Research Institute, Barker St, Randwick, NSW 2031, Australia, e-mail: [email protected].
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