Background

About 6,000 people in Denmark are still suffering from the late effects of polio. Many of these people contact the PTU Clinic to get help with new problems. In recent years, about 100 new polio patients have contacted PTU every year. However, no systematic documentation is available of the treatment of this group of patients.

Purpose

The purpose of this study is to describe the problem areas of newly referred patients and to evaluate the results of the intervention at PTU.

Method

50 newly referred polio patients were included in the study as they were referred to physiotherapy. Data were collected during the period from November 2002 to January 2005. Patients were tested before the treatment started, after 3 months and after 15 months. Tests were based on questionnaires about polio-relevant issues (polio questionnaire), health-related quality of life (SF-36), fatigue (MFI-20), and included a number of performance tests (6-minute Walking Test, 10-metre Walking Test, Timed-stands Test, Functional Reach Test and Staircase Test). Treatment was carried out by the physiotherapists at the Clinic, and according to general practice. The treatment was based on the problems experienced by the individual patient. When needed, patients were referred to PTU' s other staff groups, and patients were also offered subsequent exercise to maintain acquired performance. As something new, a group instruction programme providing information about polio, exercise principles, technical aids etc., was offered to patients and their relatives.

Results

The patient group consisted of 30 women and 20 men with an average age of 58 years, of whom 10 were born outside Denmark. 46% of the patients were still connected to the labour market. All patients, except one, suffered from polio paresis in their legs. Many patients used walking aids, but only one used a wheel chair permanently. The patients' primary problem areas were: difficulties with walking outdoors, walking on stairs, pain and fatigue and worries about the future. It appeared from SF-36 that the physical function level of these patients was reduced, and that they had more pain than the average population. The “Social Function” and “Mental Health” of the patients were equivalent to the average population. According to MFI-20, the patients were more tired than indicated by the normal values. According to the performance tests, the 6-minute walking distance of the group corresponded to 60% of the normal values. The time spent on getting up and sitting down (Timed Stands Test) was nearly twice that of the average population. 26 patients out of 50 had a balance problem.

At the second test 3 months after treatment start, all performance test results showed significant improvement. In addition, the results relating to pain and fatigue had also improved significantly. 35 patients out of 47 felt better or considerably better, all factors considered at the second test.

At the third test 15 months after treatment start, patients maintained the level in most performance tests. As regards pain and fatigue, the significance level was not maintained at the third test, but it did not, however, drop to the initial values.

According to SF-36, the patients' view of their general health condition improved significantly at the second and third tests, even though 15 patients got other competing diseases during the project period.

Conclusion

The study shows that newly referred patients suffering from the late effects of polio and new functional impairments may improve their functioning by means of treatment/exercise, and that the level may, in general, be maintained for up to 15 months. Since not all improvements last, it seems that polio patients ought to have a consultation with a physiotherapist at regular intervals for the purpose of adapting exercise programmes, the use of technical aids or the like.