Two-year course of walking adaptability in persons living with late effects of polio.
Jana Tuijtelaars, Merel-Anne Brehm, Jos W R Twisk and 1 others
PMID 38497608WHAT IT FOUND
Walking adaptability did not change over two years in people with late effects of polio who had good balance.
This suggests the condition progresses slowly, so short-term assessments may miss decline. Clinicians should expect stability in these specific skills over brief intervals.
Key findings
01No significant changes were found in variable target-stepping or reactive obstacle-avoidance performance over the two-year study period.
02Isometric knee-extension strength in the least-affected leg and Berg Balance Scale scores declined significantly over the two years.
03An exploratory analysis showed that obstacle-avoidance success rates improved over two years only for participants with high baseline balance scores.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study used a C-Mill treadmill with 2D projections, which may not reflect the complexity of 3D obstacles in daily life. The outcome measures may have lacked the sensitivity to detect small changes over time, as suggested by the authors. Participants were selected for having good balance performance, with very few scoring below the fall-risk cut-off, limiting generalizability to those with severe balance impairments. Dropouts occurred due to the pandemic and test exhaustion, though baseline characteristics between completers and dropouts were largely similar.
Declared interests
The authors declared no conflicts of interest. The C-Mill treadmill was purchased with a grant from the Amsterdam Movement Sciences research institute.
The easy way to misread this
Do not interpret the null finding for walking adaptability as evidence that the condition is static. Leg-muscle strength and balance scores did decline, indicating progression that the specific adaptability tests failed to capture.