F-1-03-01
PHYSICAL PERFORMANCE IN PATIENTS WITH LATE POLIO
Katharina Stibrant Sunnerhagen, Asa Cider, Carin Willen (Department of Rehabilitation Medicine, Goeteborg University, Sweden)
AIM: To evaluate muscle performance as well as maximum oxygen uptake in patients with late polio.
MATERIAL: 24 patients (22 to 66 years) with post polio syndrome, 11 men and 13 women. All were walkers with or without assistive devices. None had reduced pulmonary function.
METHOD: Quadriceps strength was evaluated on Kin-Com, to establish torque at different angular velocities. Endurance was evaluated as the time the person could sustain 40% of maximal static strength at 60 degree knee angle. Maximal oxygen uptake was evaluated on a bicycle ergometer with breath by breath analyis of oxygen. The workload started from zero and increased continuously with 10W per minute.
RESULTS: Strength and endurance were reduced compared to a age matched control population. Muscle strength and maximal oxygen uptake correlated. Maximum work in W is lower than expected.
CONCLUSIONS: Muscle strength influences work capacity. The low muscle strength is probably the cause for the reduced work capacity, and not the circulatory system. If this is the cause, then work capacity could be improved by training of the muscles.
F-1-03-02
CRITICAL ILLNESS NEUROPATHY: A NEW REHABILITATION CHALLENGE
Varghese G., Berman, A., Ogle, A., (University of Kansas Medical Center, Kansas City, USA)
Critical illness neuropathy (CIN) is an acute axonal degenerative process that occurs most often in a setting of sepsis, encephalopathy and multiple organ failure. It usually first manifests itself in difficulty weaning from mechanical ventilation, and progresses to a generalized neuropathy. The lower extremities are affected to a great extent, and there is a predilection for the distal muscles. Diagnosis is made by electrodiagnostic study. Several researchers have used muscle biopsy to corroborate these findings. The inciting event, or series of events, has not been identified, although the role of histamines and other humoral factors have been implicated in the past. Prognosis is generally favorable, with complete or partial recovery expected within one of year of onset. We have diagnosed 3 cases of CIN at or medical center in the last 2 years. Two of the patients had extensive burns, and one had multiple injuries. In each case, the neuropathy was preceded by sepsis and organ failure. EMG, performed on each of these patients, demonstrated a primarily axonal process in at least 3 extremities. We report on these individual cases, and their current status. Directions for further research and protocol will be addressed. Finally, the importance of early recognition and involvement by the rehabilitation team will be discussed.
