Objectives: Post-poliomyelitis syndrome (PPS) refers to the loss of strength associated with clinical and functional deterioration experienced by many poliomyelitis survivors several decades after primary infection. The pathophysiology of PPS isn’t fully understood, leading to the lack of universal treatment. However, a dysimmunitar origin is often mentioned. The objective of the study was to evaluate the effect of intravenous immunoglobulin (IVIG) treatment on clinical and isokinetic parameters in patients with PPS.
We carried out a descriptive retrospective study on patients who received IVIG for PPS between 2009 and 2018. The doses administered were 0.4 mg/kg/day for 5 days, most often repeated 3 times at one month intervals. The included patients received pre- and post-therapeutic evaluation based on clinical criteria (6-minute walk test, 10-meter walking speed and pain drawing with VAS-Visual Analog Scale) and isokinetic criteria by muscle strength measurement on quadriceps and hamstrings.
A total of 26 IVIG cures were performed on 8 men and 7 women, mean age 60 years, and an average duration of evolution of the PPS of 10 years. After treatment, the walking perimeter increased by a mean of 26.24 (SD : 44.19 ; p = 0.072) meters, the walking speed remained unchanged around 0.84 (SD : 0.25) m/s, the pain VAS decreased by an average of -1.16 (SD : 1.78 p=0,09) points and a gain in muscle strength was observed on 11 out of 12 patients who performed isokinetic tests. The subgroup analysis showed a better force improvement in patients with quadriceps muscle testing > 3/5 before treatment.
Our study tends to show a clinical benefit on walking, pain and muscle strength in patients with PPS treated with IGIV. The muscle strength improvement is better for patients with moderate muscular weakness.