Key result
Over 4 years, men with late effects of polio had a significantly greater decline in lower limb muscle strength than women, with men experiencing up to a 4.2% annual decline in knee extension strength.
Observational (n=52)
No
In persons with late effects of polio, men experience a greater progressive decline in lower limb muscle strength over 4 years compared to women.
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Suggests sex-stratified monitoring of strength in late polio; hypothesis-generating for mechanisms and interventions.
BACKGROUND: In persons with prior paralytic poliomyelitis, progressive muscle weakness can occur after a stable period of at least 15 years. Knowledge is limited about which factors influence changes in lower limb muscle strength in these persons. OBJECTIVE: To assess changes in lower limb muscle strength annually over 4 years in persons with late effects of polio and to identify prognostic factors for changes in muscle strength. DESIGN: A prospective, longitudinal study. SETTING: University hospital outpatient program. PARTICIPANTS: Fifty-two ambulant persons (mean age ± standard deviation: 64 ± 6 years) with verified late effects of polio. METHODS: Mixed linear models were used to analyze changes in muscle strength and to identify determinants among the following covariates: gender, age, age at acute polio infection, time with late effects of polio, body mass index, and estimated baseline muscle weakness. MAIN OUTCOME MEASUREMENTS: Knee extensor and flexor and ankle dorsiflexor muscle strength were measured annually with a Biodex dynamometer. RESULTS: The men (n = 28) had significant linear change over time for all knee muscle strength measurements, from -1.4% (P < .05) per year for isokinetic knee flexion in the less-affected lower limb to -4.2% (P < .001) for isokinetic knee extension in the more-affected lower limb, and for 2 ankle dorsiflexor muscle strength measurements (-3.3%-1.4% per year [P < .05]). The women (n = 24) had a significant linear change over time only for ankle dorsiflexor measurements (4.0%-5.5% per year [P < .01]). Gender was the strongest factor that predicted a change in muscle strength over time. CONCLUSIONS: Over 4 years, men had a greater decline in muscle strength than did women, but the rate of decline did not accelerate. This finding indicates that gender could be a contributing factor to the progressive decline in muscle strength in persons with late effects of polio.
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Flansbjer et al. (2015) conducted an observational in Late effects of polio (n=52). Male gender vs. Female gender was evaluated on Annual change in lower limb muscle strength over 4 years (p=<0.001). Over 4 years, men with late effects of polio had a significantly greater decline in lower limb muscle strength than women, with men experiencing up to a 4.2% annual decline in knee extension strength.
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