Assessment of energy expenditure in individuals with post-poliomyelitis syndrome

Abstract

The post-poliomyelitis syndrome (PPS) is a late effect of poliomyelitis, classified as motor neuronopathy, since the clinical and histological aspects are closely related to dysfunction of the lower motor neurons 1 . The frequency of PPS varies from 22% to 80% in different international studies. A Brazilian study showed a frequency of 77,2% in patients classified as having PPS, of which 62.8% were women and 37.2% were men 2 . The PPS usually occurs 30-50 years after the acute polio infection. It is characterized by new symptoms or worsening of previous residual symptoms such as: new weakness, muscle fatigue, new atrophy, muscle pain, joint pain and cold intolerance 3,4,5,6 . Currently, it is recognized as a disease entity defined by the World Health Organization, and is represented in the International Code of Disorders (ICD10/G14) 7 . Different hypotheses have been proposed for the pathophysiology of PPS 8,9,10,11 , but the most accepted is the theory of "overuse" (overload or overtraining), proposed by Charcot 12 and defended by others 13,14,15,16 . The most important characteristic of PPS is the development of a new muscle weakness. This new weakness may occur in muscles that already have some degree of muscle weakness or muscles that were previously committed, and subsequently reinnervated. This new weakness inevitably leads to increased energy expenditure for the performance of routine physical activity ABSTRACTThe objective of this study was to identify energy expenditure, retrospectively, in individuals with post-poliomyelitis syndrome (PPS) in the Brazilian population. Methods: The Baecke questionnaire for the evaluation of habitual physical activity (HPA), assessment of quality of life (WHOQOL-Bref), and the Fatigue Severity Scale were administered to patients with PPS, poliomyelitis sequelae (PS) and to a control group (CG). Participated in the study 116 individuals (PPS=52,PS= 28,CG=36). Results: Patients with PPS tended to increase their HPA from 10 to 20 years of age, compared with those in the PS group and the CG. In the period from 21 to 30 years of age, there was significant increase in the PPS group's occupational physical activity compared to the PS group, and the occupational physical activity (21-30 years of age) correlated with the onset of symptoms of PPS. Conclusion: Patients with PPS had a higher energy expenditure during life, especially in occupational physical activity at ages 21-30 years, suggesting this decade is critical for the development of PPS. Palavras-chave: síndrome pós-poliomielite; poliomielite; metabolismo energético.

Conhecimentos Dos Enfermeiros De Unidades Básicas De Saúde Sobre a Síndrome Pós-Poliomielite

“…A Síndrome pós-poliomielite é uma condição que afeta sobreviventes da poliomielite aguda (PAA), decorridos anos da recuperação de um ataque agudo inicial do vírus. Constase que quando há um desgaste nos neurônios motores acometidos pelo vírus, que é reativado em média 20 anos, após o indivíduo haver tido o contato direto oral-fecal, por alimentos e produtos contaminados, ocorre a manifestação 3,4 .…”