'Aerobic muscle capacity in patients with Postpoliomyelitis Syndrome'

Patients who suffer from Postpoliomyelitis Syndrome (PPS) generally report
severe fatigue, and a decline in their functional abilities and health-related
quality of life, as their main problems (Nollet et al, 1999). It is very well
conceivable that these problems are, in part, caused by the reduced exercise
capacity most patients with PPS have (Nollet et al., 2001; Stanghelle et al.,
1993). This reduced exercise capacity is likely to be primarily caused by
deterioration of intrinsic/local muscle properties of the (mostly lower limb)
muscles and circulation (Kilmer, 2002; Miller, 2002; Willen et al., 1999).
However, despite the assumption that, apart from muscle fiber degeneration,
loss of aerobic muscle capacity and/or reduced peripheral circulation as a
result of physical deconditioning will lead to early muscle fatigue and thereby
limit exercise capacity in patients with PPS, no studies exist that have
demonstrated indisputable evidence. Therefore, an important objective is to
obtain more information on peripheral muscle properties that can account for
the reduced exercise capacity in patients with PPS.

Furthermore, clear guideline recommendations to determine the target intensity
for aerobic training in patients with PPS are lacking. To develop better
guideline recommendations, thereby preventing issues like under- or
overtraining, it is necessary to gain insight into the aerobic capacity of
these patients. However, since conventional ways to determine aerobic exercise
capacity in healthy subjects (by maximal exercise testing) can not be applied
to PPS patients due to the risk of overload, this project aims to develop an
alternative method for determining aerobic capacity in patients with PPS.

To obtain more information on peripheral muscle properties that can account for
the reduced exercise capacity in patients with PPS compared to healthy
subjects, and to develop an alternative method for determining aerobic exercise
capacity in patients with PPS.

A cross-sectional study will be conducted at the outpatient clinic of the
Department of Rehabilitation at the Academic Medical Center (AMC) in Amsterdam.
The study will be performed in collaboration with the Faculty of Human Movement
Sciences (VU University) in Amsterdam.

One visit to the Academic Medical Centre in Amsterdam and three visits to the
VU University in Amsterdam will be required for patients. Control subjects will
be asked to visit the VU University once more. The duration of the each
examination will be approximately 1 hour.
The risks related to the functional tests are considered minimal and a
physician will be present during the testing. Determination of the fatigue
resistance can cause temporary muscle soreness (the result of overexertion of
already weakened muscles), but are not known or expected to have any long term
negative effects. While there are no direct benefits to the participants, the
findings can be used in the clinical setting to more accurately set target
intensity for aerobic training in patients with PPS (and possibly other
neuromuscular disorders as well). This can guide choices of treatment for a PPS
patient and encourage further research into new evidence based treatment
options.