# TWO-YEAR COURSE OF WALKING ADAPTABILITY IN PERSONS LIVING WITH LATE EFFECTS OF POLIO

## TL;DR

This study found that walking adaptability in people with late effects of polio did not change over two years, except for those with high balance scores who improved in obstacle avoidance.

## Contribution

The study provides new insights into the long-term stability of walking adaptability in individuals with late effects of polio.

## Key findings

- Walking adaptability did not change over two years for most participants.
- Reactive obstacle avoidance improved for those with high baseline balance scores.
- No significant differences were found between subgroups for most outcomes.

## Abstract

To evaluate the 2-year course of walking adaptability in persons with late effects of polio.

Prospective cohort study.

A total of 48 persons with late effects of polio (69% female, mean age 63.1 years) with a fall history and/or fear of falling.

Walking adaptability (i.e. variable target-stepping and reactive obstacle-avoidance) was assessed on an interactive treadmill at baseline, 1 year and 2 years. Further, leg-muscle strength and balance were assessed at baseline. The course of walking adaptability was analysed with linear mixed models. Based on median values, subgroups were defined for low vs high baseline walking-adaptability and for clinical characteristics. Tme by subgroup interactions were analysed.

Variable target-stepping and reactive obstacle-avoidance did not change (p > 0.285). Reactive obstacle-avoidance improved for persons with a high balance score at baseline (p = 0.037), but not for those with lower scores (p = 0.531). No other time by subgroup interactions were found (p > 0.126).

Walking adaptability did not change in persons with late effects of polio over 2 years, and walking adaptability course did not differ between subgroups stratified for walking adaptability determinants, except for balance. Since falls are a major problem among persons with late effects of polio, future studies should investigate whether walking adaptability declines over a longer time and which persons are most at risk.

LAY ABSTRACT

Falls are related to a reduced walking adaptability in persons with late effects of polio, which may deteriorate over time due to late onset polio sequelae. This study investigated whether walking adaptability in persons with late effects of polio deteriorates over time. To this end, 48 participants performed walking adaptability tests on an interactive treadmill at baseline, 1 year and 2 years. Walking adaptability outcomes were assessed and baseline outcomes were compared with outcomes at year 2. Reactive obstacle avoidance improved for persons with a high balance score. Furthermore, walking adaptability did not change in 2 years, possibly due to the absence of a decline in clinical characteristics known to be associated with walking adaptability (e.g. leg-muscle strength). Given the slow decline in leg-muscle strength as one of the best predictors for walking adaptability, future studies should investigate whether walking adaptability declines over a longer time period.