Six- and 12-month functional outcomes among patients with confirmed acute flaccid myelitis (AFM) with onset in 2018, United States.
Adriana S Lopez, Sarah Kidd, Eileen Yee and 2 others
PMID 37182848WHAT IT FOUND
Most children with acute flaccid myelitis still need help with daily tasks at 6 and 12 months.
While some show slight improvement or adaptation, severe limb weakness and dependence on assistance remain common. Early rehabilitation is critical, but outcomes vary by acute illness severity.
Key findings
01At 6 months, 65% of patients required at least some adult assistance to fulfill age-appropriate roles, while 32% were independent.
02Patients requiring mechanical ventilation or ICU admission during acute illness were more likely to require long-term support at 12 months compared to those who did not.
03Improvement between 6 and 12 months was often small and may reflect adaptation to weakness rather than true recovery of muscle strength.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
Only about one-third of the total confirmed cases participated, raising the possibility that respondents with more severe outcomes were overrepresented, although baseline characteristics did not differ significantly between participants and non-participants. The study relied on self-report surveys via phone interviews, which cannot distinguish between true muscle strength recovery and functional adaptation to weakness. Data on specific therapies or treatments received during hospitalization or follow-up were not collected, so the study cannot link outcomes to specific rehabilitation interventions. The same patients did not always participate in both the 6- and 12-month assessments, limiting the ability to track individual longitudinal changes.
Declared interests
The authors declared no conflicts of interest. The data was collected as part of standardized public health surveillance by the CDC and determined not to be research involving human subjects.
The easy way to misread this
Do not assume that slight improvements in functional scores between 6 and 12 months represent recovery of muscle strength. The study notes that children may adapt to weakness, and the self-report method cannot distinguish between true physiological improvement and compensatory strategies.