Brogårdh Christina, Flansbjer Ulla-Britt, Lexell Jan
Department of Health Sciences, Lund University, Lund, 221 00, Sweden; and Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden(∗).
Department of Health Sciences, Lund University, Lund, Sweden(†).
PM R. 2016 Sep;8(9):825-32. doi: 10.1016/j.pmrj.2016.02.003. Epub 2016 Feb 16.
Muscle weakness in one or both upper limbs is common in persons with previous polio, but there is very limited knowledge how it influences daily life.
To assess muscle weakness and self-perceived disability of the upper limbs in persons with late effects of polio and evaluate their association.
Cross-sectional study.
University hospital outpatient clinic.
Twenty-eight persons (mean age 67, SD 16 years) with late effects of polio in their upper limbs.
A fixed dynamometer (Biodex System 3 PRO dynamometer (Biodex Medical Systems Inc, Shirley, NY) was used to measure isometric shoulder abduction and elbow flexion, as well as isokinetic concentric elbow flexion and extension. A hand-held dynamometer (Grippit, Hägersten, Sweden) was used to measure isometric grip strength. The Disabilities of Arm, Shoulder and Hand (DASH) questionnaire was used to assess self-perceived disability of the upper limbs. The relationships between the measures were analyzed with the Spearman rank correlation coefficients (rho).
The participants were 20%-31% weaker in their more-affected upper limb compared with their less-affected limb. The DASH score was on average 33.5 (SD 18.6), indicating a mild-to-moderate disability of their upper limbs. Changing a lightbulb overhead, carrying a heavy object, and performing recreational activities that required muscle force with the arms were perceived as most difficult. The correlations (rho) between the muscle strength measurements and DASH scores ranged from -0.46 (95% confidence interval [95% CI] -0.10 to -0.71) to -0.61 (95% CI -0.31 to -0.80) for the more affected upper limb, and from -0.54 (95% CI -0.21 to -0.76) to -0.68 (95% CI -0.41 to -0.84) for the less affected upper limb (P < .05-.01).
Persons with previous polio and muscle weakness in their upper limbs perceive difficulties to use their arms in daily life, especially when performing activities above their head and strenuous household or leisure activities. The fair-to-moderate correlations of muscle strength with self-perceived disability imply that the weakness can only partially explain the perceived disabilities of arm, shoulder and hand. Other factors are therefore important to consider in the rehabilitation of persons with late effects of polio and upper limb disability.
既往患过小儿麻痹症的患者中，单上肢或双上肢肌无力很常见，但对于其如何影响日常生活的了解非常有限。
评估小儿麻痹症后遗症患者上肢的肌无力情况及自我感知的残疾状况，并评估二者之间的关联。
横断面研究。
大学医院门诊。
28例（平均年龄67岁，标准差16岁）有上肢小儿麻痹症后遗症的患者。
使用固定测力计（Biodex System 3 PRO测力计，Biodex Medical Systems Inc，雪莉，纽约）测量等长肩部外展和肘部屈曲，以及等速向心肘部屈曲和伸展。使用手持式测力计（Grippit，瑞典哈格斯滕）测量等长握力。采用上肢功能障碍和伤残问卷（DASH）评估上肢自我感知的残疾情况。用Spearman等级相关系数（rho）分析各测量指标之间的关系。
与受累较轻的上肢相比，受累较重的上肢力量弱20%-31%。DASH评分平均为33.5（标准差18.6），表明上肢存在轻度至中度残疾。更换头顶的灯泡、搬运重物以及进行需要手臂用力的娱乐活动被认为是最困难的。受累较重上肢的肌肉力量测量值与DASH评分之间的相关性（rho）范围为-0.46（95%置信区间[95%CI]-0.10至-0.71）至-0.61（95%CI-...
