PAIN, PHYSICAL-ACTIVITY, AND DISABILITY IN INDIVIDUALS WITH LATE EFFECTS OF POLIO

Objective: The aim of this study was to provide a description of pain and its relationship to the effects of polio, physical activity and di sability. Design: Assessment instruments used were: a pain questionnai re, a pain drawing, a visual analogue scale (VAS), a 30-m walk indoors , isokinetic muscle strength, serum creatine kinase concentration, the Physical Activity Scale for the Elderly, and the Nottingham Health Pr ofile (NHP). Setting: A university hospital department. Subjects: Thir ty-two consecutive individuals with late effects of polio. Results: Mo re than 50% of the individuals had pain every day, mostly during physi cal activity. The mean VAS score for daily pain intensity was 55mm, ra nge 0 to 93mm. In the lower limbs cramping pain was the most common pa in characteristic in both polio-affected and non-polio-affected limbs. In the upper limbs and in the trunk, aching pain was the most common pain characteristic, especially in the polio-affected areas. The degre e of muscle weakness had no correlation to pain experience. The walkin g test demonstrated a relatively small difference between spontaneous and maximal walking speed. The NHP questionnaire demonstrated that all six dimensions (energy, pain, physical mobility, sleep, emotional rea ctions, and social isolation) were affected. The dimensions pain and p hysical mobility both strongly correlated with energy. Conclusions: Th ere is a relationship between physical activity in daily life and expe rience of pain. In many postpolio individuals who experience a high le vel of pain, spontaneous and maximal walking speed are approximately t he same. It is strongly recommended that individuals with late effects of polio, experiencing aching and especially cramping pain, modify th eir level of physical activity. (C) 1998 by the American Congress of R ehabilitation Medicine and the American Academy of Physical Medicine a nd Rehabilitation.