The Risk of Bone Fractures in Post-Poliomyelitis Patients Transitioning to Middle Adulthood

Sherf, Rutie Mamlok; Cantrell, Dror; Or, Karen; Marcus, Efrat; Shapira, Alex; Benbassat, Carlos; Ish‐Shalom, Sophia; Koren, Ronit

doi:10.4158/ep-2020-0102

Cited by 5 publications

(11 citation statements)

References 28 publications

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“…An increased risk of cancer is described among aging adults with chronic long-term physical disability 19 , not specifically for PPS patients. In opposite to other studies we found no association between PPS and CHD 18 , or osteoporotic fractures 20 .…”

Section: Discussioncontrasting

confidence: 99%

The risk of post-polio syndrome among immigrant groups in Sweden

Wändell

Borg

et al. 2023

Sci Rep

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To examine the risk of post-polio syndrome (PPS) in immigrant groups using native Swedish-born individuals as referents. This is a retrospective study. The study population included all individuals aged 18 years and older registered in Sweden. PPS was defined as having at least one registered diagnosis in the Swedish National Patient Register. The incidence of post-polio in different immigrant groups, using Swedish-born individuals as referents, was assessed by Cox regression, with hazard ratios (HRs) and 99% confidence intervals (CI). The models were stratified by sex and adjusted for age, geographical residence in Sweden, educational level, marital status, co-morbidities, and neighbourhood socioeconomic status. In total 5300 post-polio cases were registered, 2413 males and 2887 females. Fully adjusted HRs (99% CI) in immigrants versus Swedish-born were 1.77 in men (1.52–2.07) and 1.39 (1.19–1.62) in women. Statistically significant excess risks of post-polio were found in the following subgroups: men and women from Africa, HRs (with 99% CI) 7.40 (5.17–10.59) and 8.39 (5.44–12.95), respectively, and Asia, HRs 6.32 (5.11–7.81) and 4.36 (3.38–5.62) respectively, and in men from Latin America, HR 3.66 (2.17–6.18). It is of importance to be aware of risks of PPS in immigrants settled in Western countries, and that it is more common in immigrants from regions of the world where polio is still prevalent. Patients with PPS need treatment and proper follow-up until polio has been eradicated through global vaccination programs.

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Section: Discussioncontrasting

confidence: 99%

The risk of post-polio syndrome among immigrant groups in Sweden

Wändell

Borg

et al. 2023

Sci Rep

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“…It is shown that between 50% and 84% of persons with LEoP fall every year, 1–4 especially outdoors 2 and in activities related to walking 2,3 . Many get injured when they fall, 1,2,10,11 and the experiences of falls can lead to worry, distress, 12 and FoF 1,2,8,13,14 …”

Section: Introductionmentioning

confidence: 99%

“…7 It is shown that between 50% and 84% of persons with LEoP fall every year, [1][2][3][4] especially outdoors 2 and in activities related to walking. 2,3 Many get injured when they fall, 1,2,10,11 and the experiences of falls can lead to worry, distress, 12 and FoF. 1,2,8,13,14 FoF is defined as "an ongoing concern about falling that ultimately limits the performance of activities of daily living."…”

Section: Introductionmentioning

confidence: 99%

Measurement properties of the Falls Efficacy Scale‐International (FES‐I) in persons with late effects of polio: A cross‐sectional study

Brogårdh

Lexell

Westergren

2022

PM&R

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Background: Fear of falling (FoF) is very common in persons with late effects of polio (LEoP). An internationally recognized rating scale to assess FoF is the Falls Efficacy Scale-International (FES-I). Yet, there is limited knowledge about its measurement properties in persons with LEoP.Objective: To investigate the measurement properties of the FES-I (16-item version) and the short FES-I (7-item version) in persons with LEoP. Design: Explorative factor analysis and Rasch model analysis of crosssectional data. Setting: University hospital. Participants: A total of 321 persons with LEoP (mean age AE standard deviation [SD] 70 AE 10 years, 173 women). Main Outcome Measurement: The FES-I and the short FES-I, comprising four response options about concerns of falling ranging from 1 (not at all concerned) to 4 (very concerned). Methods: Data were collected by a postal survey. First, a factor analysis was performed to investigate the unidimensionality of the scale. Thereafter, a Rasch model analysis was used to further analyze the measurement properties of the FES-I and the short FES-I, such as local dependency, targeting, hierarchical order of items, Differential Item Functioning (DIF), response category functioning and reliability (Person Separation Index, PSI). Raw score transformation to interval measurements was also performed. Results: The factor analysis revealed that the FES-I was unidimensional, even though the Rasch analysis showed some misfit to the Rasch model and local dependency. Targeting for the FES-I and the short FES-I was somewhat suboptimal as the participants on average reported less FoF than expected. A negligible gender DIF was found for two items in the FES-I and for one item in the short FES-I. Reliability was high (PSI >0.86), and the response category thresholds worked as intended for both the FES-I and the short FES-I. Conclusion:The FES-I and the short FES-I have sufficient measurement properties in persons with LEoP. Both versions can be used to assess fear of falling (or FoF) in this population.

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“…Quadriceps weakness in itself is a risk factor for falls and hence fractures [4] . In addition, gait imbalance due to deformities, contractures, limb length discrepancies, and improper distribution of muscle forces predispose to falls [4,5] . It has been found by Bickerstaffe et al that the frequency of falls in polio patients is four times higher than the general population [4] .…”

Section: Introductionmentioning

confidence: 99%

Strategies in the management of femoral fractures in post-polio limb a retrospective analysis of 10 patients with 3-year follow-up

AN¹,

R²,

Muthu³

2022

Int. J. Orthop. Sci.

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Background: Out of 10-20 million people in the world with post-polio sequelae, around 6.5 million of them are in India. Due to its eradication, survivors have lived through their life and crossed 40-50 years of age. Falls and subsequent fractures are common in these patients, which are difficult to manage and cause considerable morbidity. We conducted this study to analyze the various strategies used in the management of fractures in a post-polio limb. Methods: This is a retrospective study analyzing a total of 10 adult patients with post-polio sequelae complicating the fractured limb which was managed with varied treatment options such as locking compression plate, dynamic hip screw, and hemiarthroplasty. The functional status of the patient was evaluated with Vignos grade of disability. Results: All the patients (mean age of 34 ±12 years ) were treated with extramedullary internal fixation devices such as locking compression plating in 6 patients, dynamic hip screw fixation in 1 patient, cancellous screw fixation in 2 patients, and total hip replacement in one patient. Of the 10 cases, 8 were fresh fractures, and 2 presented with a failed fixation for repeated fracture sustained later on. The mean follow-up period was 37.8 ±16.4 months. Bony union was attained at a mean duration of 3.5 ±1.4 months in all the patients undergoing fracture fixation. None of the included had secondary implant failure or other complications. Conclusion: Patients with limbs involving post-polio sequelae are more prone to fractures and are difficult to manage using the standard treatment protocols. Extramedullary internal fixation device provides effective stability for bony union and optimal functional results without major complications in these small, deformed, osteoporotic, and hypo-vascularized femurs.

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The Risk of Bone Fractures in Post-Poliomyelitis Patients Transitioning to Middle Adulthood

Cited by 5 publications

References 28 publications

The risk of post-polio syndrome among immigrant groups in Sweden

The risk of post-polio syndrome among immigrant groups in Sweden

Measurement properties of the Falls Efficacy Scale‐International (FES‐I) in persons with late effects of polio: A cross‐sectional study

Strategies in the management of femoral fractures in post-polio limb a retrospective analysis of 10 patients with 3-year follow-up

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