Objective To evaluate and assess the effectiveness of muscle strengthening and cardiovascular interventions in improving outcomes in poliomyelitis (polio) survivors. Data sources A systematic literature search was conducted in Medline, PubMed, CINAHL, PsychINFO, Web of Science, and Google Scholar for experimental and observational studies. Study selection and extraction Screening, data-extraction, risk of bias and quality assessment were carried out independently by the authors. The quality appraisal and risk of bias were assessed using the Downs and Black Checklist. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was followed to increase clarity of reporting. Data synthesis A total of 21 studies that met all the inclusion criteria were subjected to statistical analyses according to intervention (muscle strengthening or cardiovascular fitness). A random-effects metaanalysis showed a statistically significant effect for the exercise interventions favouring improvement in outcomes according to the International Classification of Functioning, Disability and Health (ICF). Conclusion This review provides further insight into the effects associated with muscle strengthening and cardiovascular interventions among polio survivors, and helps to further identify the current state of research in this area. Future research is needed, focusing on individualized approaches to exercise with polio survivors and specific exercise prescription recommendations, based on established frameworks, such as the ICF. LAY ABSTRACT Polio survivors are an ageing population and prone to functional decline. Multiple age-related diseases affect this population, in addition to Late Effects of Polio (LEoP). Exercise plays an important role in improving strength and overall cardiovascular fitness in these individuals, and clinicians face challenges when advising polio survivors on the optimal level of exercise to avoid producing pain and/or fatigue. Improvements in strength and cardiovascular fitness have the potential to translate into activities of daily living within this cohort. To our knowledge, this is the first systematic review and meta-analysis using a broad approach (i.e. including both experimental and observational studies) to capture and summarize the research to date regarding the role of muscle strengthening and aerobic conditioning exercise in polio survivors. This review provides valuable information for clinicians, which will help enable the development of specific exercise prescription appropriate to this population.
_AIM: _To determine if the SARC-F questionnaire is a suitable tool to detect sarcopenia in two cohorts: 1) age-matched otherwise healthy older adults; and 2) polio survivors. _DESIGN:_ A cross-sectional study of polio survivors and matched controls was undertaken utilising validated screening tools. _SUBJECTS/PATIENTS:_ 42 older adults living in community South Australia: 12 otherwise healthy older adults and 30 polio survivors. _METHODS: _Sarcopenia assessment was carried out using the SARC-F (strength, assistance walking, rise from a chair, climb stairs, and falls) questionnaire, grip strength to assess muscle strength, bioelectrical impedance (BIA) to measure central muscle mass, and gait speed to assess physical performance, distinguishing between those with primary and polio-related sarcopenia. _RESULTS: _There were significant differences (p<0.001) between the polio affected limb and the non-affected limb for leg circumference. SARC-F positive subjects had significant reductions in muscle strength and gait speed but not muscle mass. The presence of polio-related sarcopenia was negatively associated (r2=0.422, p<0.001) with nutritional state. _CONCLUSION: _Our study demonstrated that while there were differences between polio survivors and otherwise healthy controls in terms of screening via the SARC-F, it is helpful to discern between primary and secondary (i.e. disease-related) sarcopenia in older adults. For polio-related sarcopenia (i.e. significant muscular asymmetry), we assert that the SARC-F as a screening tool is not suitable. An alternative tool that combines objective data sensitive to differences across limbs, may be more appropriate in confirming sarcopenia in the polio-survivor population.
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