EFFECTS OF A TWELVE-WEEK ARM ERGOMETRY TRAINING ON SELECTED HEALTH INDICES OF LOWER LIMB PARALYTIC POLIOMYELITIS SURVIVORS

Abstract

Reduced mobility consequent to motor paralysis is associated with Secondary Health Conditions (SHC) among Lower Limb Paralytic Poliomyelitis Survivors (LLPPS). Arm ergometry, an effective aerobic exercise, can be used to improve the overall health of LLPPS with SHC, but no clinical trial has comprehensively and concurrently assessed its potential benefit in this population using a Randomised Clinical Trial (RCT) design. The study investigated the effects of a twelve-week arm ergometry training on selected health indices or LLPPS with SHC. The RCT involved 60 LLPPS from eleven local government centres in Ibadan, Oyo State. They were randomly selected from the 252 who had SHC as determined using Tate SHC Questionnaire in a Cross-Sectional Survey. Participants were randomly assigned into Exercise Group (EG) and Control Group (CG). The EG received thrice-weekly arm ergometry training for twelve consecutive weeks in addition to flexibility exercises which was received by the CG. Participants' Resting Heart Rate (RHR), Resting Systolic Blood Pressure (RSBP), Resting Diastolic Blood Pressure (RDBP), Percent Body Fat (PBF), and Body Mass Index (BMI) were assessed using standard methods, while Cardio -Respiratory Fitness was assessed using Six-Minute Walk Test (6-MWT). The General Health Status (GHS), Quality of Life ( QoL) and Depressive Symptoms (DS) were assessed using Dartmouth COOP Health Chart (higher scores indicate reduced activity), Ferrans and Powers QoL measure and Beck Depression Inventory respectively. Assessments were carried out at baseline and end of 4TH 8th and 12th weeks. Data were analysed using ANOVA independent t- test and Mann Whitney-U at p = 0.05. Twenty eight participants in EG (15 males, 13 females) and 26 in CG(11 males, 15 females) completed the study. Twenty six participants had bilateral, while 28 had unilateral lower limb affectation. Twelve were independently ambulant while 42 used assistive devices. Most participants were unmarried and had only secondary school education. They were predominantly traders and artisans with average monthly income of 4,556 naira. The mean ages of EG (38.43±6.97) and CG (38.08 ±5.75 years) were not significantly different. The common SHC observed were hypertension, depression, obesity, back pain and spinal deformities. At baseline, the health indices of EG and CG were not significantly different. At twelfth week, CG had significantly higher R SBP (126.69 ±7.18 vs 121.50 ± 6.29) and PBF (30.52±6.01 vs 23.43±11.24) than the EG respectively. The CG had significantly higher scores than EG in daily activities (at 4th/8th, 0/8th, 4th/12th and 0/12th weeks) and social activities (at week 8th/ 12TH) domains of GHS, Groups were not significantly different in QoL, and DS. Within-group comparison showed significant decreases in EG's RHR (F=I6.33), RSBP (F= 8.99), RDBP (F=14.37), PBF (F=20.78). DS (Xr2= 19.61) and increases in 6-MWT (F=33.45) and QoL (xr²=23.53). CG had significant increase in PBF (F= 20.78) and decrease in pain (xr²13.67) and Feelings (xr²=8.01) domains of GHS. No gender variation was observed in all the variables. Twelve-week arm ergometry training improved the health indices of lower limb paralytic poliomyelitis survivors with secondary health conditions. Arm ergometry should be incorporated into the rehabilitation programme of these individuals.