Arm Cycling to Improve Fitness in Polio Survivors
Condition: Postpoliomyelitis Syndrome
MeSH terms: Postpoliomyelitis Syndrome
Study type: Interventional

Summary: 
      The aim of this study is to investigate the effect of upper limb cardiovascular training on
      fitness, energy cost of walking, fatigue and pain in polio survivors. Polio survivors often
      have difficulty accessing aerobic forms of exercise due to limitations in mobility, pain
      associated with walking and fatigue. This can result in becoming physically unfit and places
      polio survivors at risk of secondary heath problems due to inactivity. A large percentage of
      polio survivors have lower limb involvement but have strong arms. The participants in this
      study will exercise at home using simple arm cycles for 8 weeks. They will attend for
      assessment on two occasions. All exercise will be prescribed by a Physiotherapist and
      includes measures to ensure safety while exercising at home.
    

Detailed description: 
      The American College of Sports Medicine (ACSM) recommendations state that stable muscle
      groups should be utilised for exercise in polio survivors and that patients with severe
      atrophic polio or with recent weakness should not exercise, while March of Dimes (2001)
      recommend not exercising muscle groups where new weakness is being experienced. Floor or
      treadmill walking or lower limb cycling may also aggravate pain in those with lower limb
      weakness and altered lower limb biomechanics.

      Training with an upper limb ergometer is likely to be an appropriate form of exercise in
      patients with good, stable upper limb strength. One small, but well designed, trial of upper
      limb ergometry over 16 weeks resulted in a 19% increase in maximal oxygen uptake (VO2max) in
      10 postpolio subjects exercising 3 times per week (Kriz et al 1992). ACSM recommend using a
      Schwinn Air-DyneTM four limb exerciser; however this is an expensive and bulky piece of
      equipment and is unlikely to be feasible for ongoing use by community dwelling polio
      survivors.

      A small upper limb ergometer may be a cost effective, accessible option for exercise for
      community dwelling polio survivors. A closely monitored and carefully prescribed
      cardiovascular fitness programme may enable polio survivors, who have gained control of
      symptoms of fatigue and pain through changes in lifestyle and activity, to increase fitness
      and perhaps subsequently reduce energy cost of walking.
    

Intervention name(s): Upper Limb Ergometry
Intervention type(s): Other
Intervention description(s): Cardiovascular training will be performed using upper limb ergometers at home for 8 weeks. Each subject will receive an individually prescribed programme and will begin exercising for at least ten minutes per day three days per week. If an individual has difficulty exercising for 10 minutes continuously, the 10 minute session may be broken into 2-3 minute bursts of exercise, with one minute rests. Subjects will aim to increase exercise durations to 20 minutes per day five days per week and will exercise at moderate to high intensities.
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Late Effects of Polio; Cardiovascular Fitness; Fatigue; Energy cost of Walking; Pain