Akhilesh Kumar Ramachandran, Stephen P. J. Goodman, Michael J. Jackson, Timothy J.H. Lathlean
Polio Australia Incorporated, University of New England, The University of Adelaide, Australia.
DOI: 10.2340/16501977-2832

Objective: To evaluate and assess the effectiveness of muscle strengthening and cardiovascular interventions in improving outcomes in poliomyelitis (polio) survivors.
Data sources: A systematic literature search was conducted in Medline, PubMed, CINAHL, PsychINFO, Web of Science, and Google Scholar for experimental and observational studies.
Study selection and extraction: Screening, data-extraction, risk of bias and quality assessment were carried out independently by the authors. The quality appraisal and risk of bias were assessed using the Downs and Black Checklist. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was followed to increase clarity of reporting.
Data synthesis: A total of 21 studies that met all the inclusion criteria were subjected to statistical analyses according to intervention (muscle strengthening or cardiovascular fitness). A random-effects meta-analysis showed a statistically significant effect for the exercise interventions favouring improvement in outcomes according to the International Classification of Functioning, Disability and Health (ICF).
Conclusion: This review provides further insight into the effects associated with muscle strengthening and cardiovascular interventions among polio survivors, and helps to further identify the current state of research in this area. Future research is needed, focusing on individualized approaches to exercise with polio survivors and specific exercise prescription recommendations, based on established frameworks, such as the ICF.

Polio survivors are an ageing population and prone to functional decline. Multiple age-related diseases affect this population, in addition to Late Effects of Polio (LEoP). Exercise plays an important role in improving strength and overall cardiovascular fitness in these individuals, and clinicians face challenges when advising polio survivors on the optimal level of exercise to avoid producing pain and/or fatigue. Improvements in strength and cardiovascular fitness have the potential to translate into activities of daily living within this cohort. To our knowledge, this is the first systematic review and meta-analysis using a broad approach (i.e. including both experimental and observational studies) to capture and summarize the research to date regarding the role of muscle strengthening and aerobic conditioning exercise in polio survivors. This review provides valuable information for clinicians, which will help enable the development of specific exercise prescription appropriate to this population.

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