Musculoskeletal pain in polio survivors and strength-matched controls

Objectives: To determine whether a significant difference exists between musculoskeletal symptoms of polio survivors and those of older adults with no history of polio, and to determine if activity level and strength predict pain in either group. Design: Matched research design. Setting: A research laboratory in a rehabilitation setting. Participants: Fifty-four polio survivors and 54 adults with no history of polio were matched for gender, race, and bilateral knee extensor strength and selected from a cohort of 316 subjects who participated in a study on the relation between activity level and health status. Interventions: Not applicable. Main Outcome Measures: Location and severity of musculoskeletal pain, activity frequency and intensity level, maximum voluntary isometric strength, and physical performance measures. Results: Polio survivors reported significantly more symptoms than the matched controls (P<.05). Symptom status among the polio survivors was strongly associated with performance strain, perceived exertion, and activity intensity. Although the polio survivors had activity frequencies and habitual walking speeds that were similar to those from the matched controls, there was evidence that they performed activities at higher intensity levels. Conclusions: Activity level is a factor in the development of musculoskeletal symptoms in polio survivors. Polio survivors who perform at higher intensity levels are more likely to have moderate to severe pain and more mobility difficulties. (C) 2004 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.