Fatigue in Post-Polio Syndrome

Monalisa Pereira Motta , Abrahão Augusto Juveniano Quadros , Letícia Simões Ferreira and Acary Souza Bulle Oliveira

Abstract
Post-Polio Syndrome (PPS) is characterized by the appearance of new muscular symptoms or worsening of previous residual symptoms, several years after the acute polio. The most common symptoms include a trial of fatigue, deterioration in muscle strength and pain. Fatigue is one of the most frequent complaints of PPS and the majority of patients identify fatigue as their most troubling symptom. The aetiology of the symptom arouses great interest, mainly due to its multifactorial character, and can be divided into two components: peripheral (muscular) fatigue and central (general) or simultaneously-occurring fatigue. Considering the importance of the symptom and the limitations that can cause in PPS patients, it is important to consider a series of variables, so that it can be better understood, thus providing a more effective and specific treatment.

Keywords
Post-Poliomyelitis Syndrome; Neuromuscular disorders; Fatigue; Central fatigue; Muscular fatigue.

DOI
10.21472/bjbs.061203

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References
Ablashi, D. V. Viral studies of chronic fatigue syndrome. Clinical Infectious Diseases, v. 18, Suppl. 1, p. S130-S133, 1994.

Agre, J. C.; Rodriquez, A. A.; Sperling, K. B. Symptoms and clinical impressions of patients seen in a post-polio clinic. Archives of Physical Medicine and Rehabilitation, v. 70, No. 5, p. 367-370, 1989.

Ascensão, A.; Magalhaes, J.; Oliveira, J.; Duarte, J.; Soares, J. Fisiologia da fadiga muscular. Delimitação conceptual, modelos de estudo e mecanismos de fadiga de origem central e periférica. Revista Portuguesa de Ciências do Desporto, v. 3, No. 1, p. 108-143, 2003.

Berlly, M. C.; Strauser, W. W.; Hall, K. M. Fatigue in Postpolio Syndrome. Archives of Physical Medicine and Rehabilitation, v. 72, p. 115-118, 1991.

Bertuzzi, R. C. M.; Franchini, E.; Kiss, M. A. P. D. Fadiga muscular aguda: uma breve revisão dos sistemas fisiológicos e suas possíveis relações. Motriz, v. 10, No. 1, p. 45-54, 2004.

Bodian, D. Histopathologic basis of clinical findings in poliomyelitis. The American Journal of Medice, v. 6, no. 5, p. 563-578, 1949. https://doi.org/10.1016/0002-9343(49)90130-8

Borg, K.; Henriksson, J. Prior poliomyelitis-reduced capillary supply and metabolic enzyme content in hypertrophic slow-twitch (type I) muscle fibres. Journal of Neurology, Neurosurgery & Psychiatry, v. 54, No. 3, p. 236-240, 1991.

Bruno, R. L.; Cohen, J. M.; Galski, T.; Frick, N. M. The neuroanatomy of post-polio fatigue. Archives of Physical Medicine and Rehabilitation, v. 75, p. 498-503, 1994.

Bruno, R. L.; Sapolsky, R.; Zimmerman, J. R.; Frick, N. M. Pathophysiology of a central cause of post-polio fatigue. Annals of New York Academy of Science, v. 753, p. 257-275, 1995. https://doi.org/10.1111/j.1749-6632.1995.tb27552.x

Chalder, T.; Berelowitz, G.; Pawlikowska, T.; Watts, L.; Wessely, S.; Wright, D.; Wallace, E. P. Development of a fatigue scale. Journal of Phychomatic Research, v. 37, no. 2, p. 147-153, 1993. https://doi.org/10.1016/0022-3999(93)90081-P

Conde, M. T. R. P.; Oliveira, A. S. B.; Quadros, A. A. J.; Moreira, G. A.; Silva, H. C. A.; Pereira, R. D. B.; Silva, T. M.; Tufik, S.; Waldman, E. A. Post-Polio Syndrome: Epidemiologic and prognostic aspects in Brazil. Acta Neurologica Scandinavica, v. 120, p. 191-197, 2009. https://doi.org/10.1111/j.1600-0404.2008.01142.x

Edwards, R. Human muscle function and fatigue: Physiological mechanisms. In: Porter, R.; Whelan, J. Human muscle fatigue: Physiological mechanisms. London: Pitman Medical, 1981. (Ciba Foundation Symposium, 82). p. 1-18.

Grimby, G.; Einarsson, G. Muscle morphology with special reference to muscle strength in post-polio subjects. Birth Defects Original Article Series, v. 23, No. 4, p. 265-274, 1987.

Grimby, G.; Einarsson, G.; Hedberg, M.; Aniansson, A. Muscle adaptive changes in post-polio subjects. Scandinavian Journal of Rehabilitation Medicine, v. 21, No. 1, p. 19-26, 1989.

Halstead, L. S.; Rossi, C. D. New problems in old polio patients: Results of a survey of 539 polio survivors. Orthopedics, v. 8, p. 845-850, 1985.

Halstead, L. S.; Rossi, C. D. Post-polio syndrome: Clinical experience with 132 consecutive outpatients. Defects Original Article Series, v. 23, p. 13-26, 1987.

Mota, D. D. C. F.; Cruz, D. A. L. M.; Pimenta, C. A. M. Fadiga: uma análise do conceito. Acta Paulista de Enfermagem, v. 18, No. 3, p. 285-293, 2005. https://doi.org/10.1590/S0103-21002005000300009

Motta, M. P. Efeito terapêutico do uso da L-carnitina+piracetam na fadiga e na força muscular de pacientes com Síndrome Pós-Poliomielite (SPP): estudo clínico randomizado, duplo-cego, controlado com placebo. São Paulo: Universidade Federal de São Paulo, Escola Paulista de Medicina, 2017. (Master thesis).

Motta, M. P.; Quadros, A. A. J.; Brito, M. C.; Oliveira, A. S. B. Post-Polio Syndrome. Brazilian Journal of Biological Sciences, v. 5, no. 11, p. 631-639, 2018. https://doi.org/10.21472/bjbs.051102

Oliveira, A. S. B.; Quadros, A. A. J. Síndrome Pós-Poliomielite: orientações para profissionais de saúde. São Paulo: SES/SP, 2008. (Versão para Internet). Available from: <http://www.saude.sp.gov.br/resources/ses/perfil/profissional-da-saude/homepage//sindrome_pos_poliomielite_.pdf>. Accessed on: Apr. 23, 2018.

Östlund, G.; Wahlin, A.; Sunnerhagen, K. S.; Borg, K. Post-Polio Syndrome: Fatigued patients a specific subgroup? Journal of Rehabilitation Medicine, v. 43, No. 1, p. 39 45, 2011. https://doi.org/10.2340/16501977-0634

Östlund, G.; Borg, K.; Wahlin, A. Cognitive functioning in post-polio patients with and without general fatigue. Journal of Rehabilitation Medicine, v. 37, No. 3, p. 147-151, 2005. https://doi.org/10.1080/16501970410024172

Östlund, G.; Wahlin, A.; Sunnerhagen, K. S.; Borg, K. Vitality among Swedish patients with post-polio: a physiological phenomenon. Journal of Rehabilitation Medicine, v. 40, No. 9, p. 709-714, 2008. https://doi.org/10.2340/16501977-0253

Quadros, A. A. J.; Conde, M. T. R. P.; Marin, L. F.; Silva, H. C. A.; Mesquita e Silva, T.; Paula, M. B. E.; Pereira, R. D. B.; Ramos, P. E.; Abe, G.; Oliveira, A. S. B. Frequency and clinical manifestations of Post-Poliomyelitis Syndrome in a Brazilian tertiary care center. Arquivos de Neuro-Psiquiatria, v. 70, no. 8, p. 571-573, 2012. https://doi.org/10.1590/S0004-282X2012000800002

Rowland, L. P.; Bach, J. R.; Borg, K.; Cashman, N. R.; Dalakas, M. C.; Dean, E.; Halstead, L. S.; Headley, J. L.; John, T. J.; Johnston, R. B.; Olkin, R.; Perlman, S. L.; Trojan, D. A.; Vickrey, B. G.; Wendling, W. W. March of Dimes International Conference on Post-Polio Syndrome: Identifying best practices in diagnosis & care. White Plains, NY: March of Dime, 2000. Available from: <https://www.polioplace.org/sites/default/files/files/MOD-Identifying.pdf>. Accessed on: Apr. 23, 2018.

Santos, M. G.; Dezan, V. H.; Sarraf, T. A. Bases metab´licas da fadiga muscular aguda. Revista Brasileira de Ciência e Movimento, v. 11, No. 1, p. 7-12, 2003.

Schanke, A.-K.; Stanghelle, J. K. Fatigue in polio survivors. Spinal Cord, v. 39, p, 243-251, 2001. https://doi.org/10.1038/sj.sc.3101147

Silva, S. T.; Sunnerhagen, K. S.; Willén, C.; Hammar, O. The extent of using mobility assistive devices can partly explain fatigue among persons with late effects of polio: A retrospective registry study in Sweden. BMC Neurology, 16:230, 2016. https://doi.org/10.1186/s12883-016-0753-6

Sugino, T.; Aoyagi, S.; Shirai, T; Kajimoto, Y.; Kajimoto, O. Effects of citric scid and l-Carnitine on physical fatigue. Journal of Clinical Biochemestry and Nutrition, v. 41, No. 3, p. 224-230, 2007. https://doi.org/10.3164/jcbn.2007032

Sunnerhagen, K. S.; Grimby, G. Muscular effects in late polio. Acta Physiologica, v. 171, p. 335-340, 2001. https://doi.org/10.1046/j.1365-201x.2001.00836.x

Thomas, C. K.; Zijdewind, I. Fatigue of muscles weakened by death of motoneurons. Muscle & Nerve, v. 33, no. 1, p. 21-41, 2006. https://doi.org/10.1002/mus.20400

Thorsteinsson, G. Management of Postpolio Syndrome. Mayo Clinic Proceedings, v. 72, No. 7, p. 627-638, 1997. https://doi.org/10.1016/S0025-6196(11)63568-4

Trojan, D. A.; Arnold, D. L.; Shapiro, S.; Bar-Or, A.; Robinson, A.; Le Cruguel, J. P.; Narayanan, S.; Tartaglia, M. C.; Caramanos, Z.; Costa, D. Fatigue in Post-Poliomyelitis Syndrome: Association with disease-related, behavioral, and psychosocial factors. PM&R, v. 1, No. 5, p. 442-449, 2009. https://doi.org/10.1016/j.pmrj.2009.03.003

Trojan, D. A.; Cashman, N. R. Post-Poliomyelitis Syndrome. Muscle & Nerve, v. 31, No. 1, p. 6-19, 2005. https://doi.org/10.1002/mus.20259

Trojan, D. A.; Cashman, N. R.; Shapiro, S.; Tansey, C. M.; Esdaile, J. M. Predictive factors for Post-Poliomyelitis Syndrome. Archives of Physical Medicine and Rehabilitation, v. 75, No. 7, p. 770-777, 1994.

Viana, C. F.; Pradella-Hallinan, M.; Quadros, A. A. J.; Marin, L. F.; Oliveira, A. S. B. Circadian variation of fatigue in both patients with paralytic poliomyelitis and post-polio syndrome. Arquivos de Neuro-Psiquiatria, v. 71, No. 7, p. 442-445, 2013. https://doi.org/10.1590/0004-282X20130059

Wiechers, D. O. New concepts of the reinnervated motor unit revealed by vaccine-associated poliomyelitis. Muscle & Nerve, v. 11, No. 4, p. 356-364, 1988.