RESEARCH ARTICLE


The Prevalence and Severity of Joint Problems and Disability in Patients with Poliomyelitis in Urban India



S Baliga*, 1, T Mcmillan 1, A Sutherland 1, D Sharan 2
1 University of Aberdeen, Aberdeen, Scotland
2 Mobility India, Bangalore, India


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© Baliga et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Trauma and Orthopeadics Aberdeen Royal Infirmary, Foresterhill Road, Aberdeen. AB25 2ZN, Scotland; Tel: +447815676059; E-mail: santoshbaliga@doctors.org.uk


Abstract

Poliomyelitis is caused by an enterovirus infection of the anterior horn cells in the spinal cord. Up to 40% of survivors recover full muscle strength, however 60–90% are left with varying degrees of residual paralysis, where the patient suffers from cramping myalgia and lower motor neuron pattern weakness. This study aimed to identify and quantify, in terms of prevalence and severity of the types of joint deformities encountered in polio sufferers. It also aimed to assess the disability caused by such problems. Finally we documented the provision and use of mobility aids, orthotics and surgery in the patient group.

Impairment was confined to one lower limb, and this is consistent, as the majority of patients were infected in infancy. The study found that pes cavus, scoliosis, flexion deformity of the knee and true lower-limb shortening accounted for over half of the deformities found. The mean Barthel Disability score was 19 and over 80% of patients used at least one aid, usually in the form of a Knee-Ankle-Foot Orthosis (KAFO). Surgery also plays a large in role in the management of polio patients, however necessity needs to be assessed on an individual basis taking into account many aspects of the patient’s life.

Keywords: Disability, joint deformity, polio rehabilitation, poliomyelitis.