Associations between activity limitations and participation restrictions in people with late effects of polio.

The study sample consisted mainly of people with mild to moderate disability, so results may not apply to those with severe late effects of polio. The cross-sectional design cannot determine causality or how these relationships change over time. Multiple statistical tests were performed without correction for multiple comparisons, increasing the risk of false positives; the authors advise interpreting p-values as trends. Some participants had missing data, and the sample had a higher proportion of women than typically reported in this population. The exploratory subgroup analyses included small numbers of participants in certain categories (e.g., only 49 for leisure), limiting reliability.

The study was funded by the Norrbacka-Eugenia Foundation and the Promobilia Foundation. The authors declared no competing interests.

Do not interpret the weak statistical association as meaning these concepts are unrelated or that you can ignore one when treating the other. The weak link means they are distinct enough that addressing activity limitations alone is unlikely to resolve participation restrictions, requiring separate assessment and intervention targets.