Exercise and PPS – A New Study 

Dr. Bruno’s Original Post:  We have often talked about the failure of exercise to increase muscle strength or provide cardiac conditioning in polio survivors. Here is a brand new study that once again documents the failure of exercise to increase muscle strength or provide cardiac conditioning.

Keep in mind that anyone who was physically able to participate in this study had mild PPS leg muscle weakness since they were able to ride a bicycle. As to the recommendations for further study:  If the large muscles of the legs cannot condition the heart, no other large muscle groups remain.

Aerobic Exercise Training in Post-Polio Syndrome:Process Evaluation of a Randomized Controlled Trial

Voorn EL, et al PLOS ONE 13(1): e0192338.

Published: January 30, 2018.     

Objective

To explore reasons for the lack of efficacy of a high intensity aerobic exercise program in post-polio syndrome (PPS) on cardiorespiratory fitness by evaluating adherence to the training program and effects on muscle function.

Patients

Forty-four severely fatigued individuals with PPS were randomized to:

  • exercise therapy (n = 22) or

  • usual care (n = 22).

Methods

Participants in the exercise group were instructed to exercise 3 times weekly for 4 months on a bicycle ergometer (60–70% heart rate reserve).

Results

The attendance rate was high (median 89%). None of the participants trained within the target heart rate range during >75% of the designated time. Instead, participants exercised at lower intensities, though still around the anaerobic threshold (AT) most of the time. Muscle function did not improve in the exercise group.

Conclusion

Our results suggest that severely fatigued individuals with PPS cannot adhere to a high intensity aerobic exercise program on a bicycle ergometer. Despite exercise intensities around the AT, lower extremity muscle function nor cardiorespiratory fitness improved. Improving the aerobic capacity in PPS is difficult through exercise primarily focusing on the lower extremities, and may require a more individualized approach, including the use of other large muscle groups instead. 

Dr. Bruno’s Additional Response

Bottom Line:

Do not do anything that feels wrong (or) causes either pain or discomfort that lasts for any length of time.

Your body will tell you what you can and can’t do, so listen to it and do less to start! 

Source:  Full Article

Richard L. Bruno, HD, PhD

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Post-Polio Syndrome vs Post-Polio Sequelae

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Fatigue.  Is it Always PPS?