Prevalence of Post Polio Syndrome in Gujarat and the Correlation of Pain and Fatigue with Functioning in Subjects with Post Polio Syndrome

Background: Post-polio syndrome (PPS) refers to a clinical disorder affecting polio survivors with sequel years after the initial polio attack. They report new musculoskeletal symptoms like fatigue, pain and muscle weakness. The aim of this study was to determine prevalence of PPS in subjects with poliomyelitis in Gujarat state and to co-relate pain and fatigue with function in these subjects.

Method: 100 subjects with polio were recruited through tertiary care hospitals in this cross sectional survey. Those fulfilling the diagnostic criteria of PPS (Halstead 1985) were included who filled a self administered questionnaire. A convenience sample of 50 subjects having pain was analyzed for pain and fatigue intensity measure using Numerical Rating Scale. Physical and psychological functioning were examined using Patient Reported Outcomes Measurement Information System and Patient Health Questionnaire-9 questionnaires respectively.

Findings: Muscle weakness was reported by 66 and pain by 78 subjects. 70 subjects complained of joint pain and fatigue was present in 44 subjects. 68 polio survivors complained of difficulty in walking and 22 subjects had no complaints in activities of daily living. Pearson's test for co-relation was applied for 50 subjects with pain. A moderate co-relation between pain and physical functioning (r=0.794; p=0.01) and between pain and psychological function(r=0.564; p=0.01) was found. Fatigue had a weak co-relation with physical (r=-0.135, p=0.351) and psychological functioning (r= 0.072; p=0.620)

Conclusion: The prevalence of PPS among polio survivors can be estimated to be 86% in Gujarat, commonest symptoms being difficulty in walking, joint and muscle pain and muscle weakness and fatigue. Pain affects the physical and psychological function of subjects with PPS whereas fatigue did not.