{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T19:05:11Z","timestamp":1792004711259,"version":"4.4.0"},"reference-count":80,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2006,6,12]],"date-time":"2006-06-12T00:00:00Z","timestamp":1150070400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2006,8]]},"abstract":"<jats:p>Post\u2010polio syndrome (PPS) is characterized by new or increased muscular weakness, atrophy, muscle pain and fatigue several years after acute polio. The aim of the article is to prepare diagnostic criteria for PPS, and to evaluate the existing evidence for therapeutic interventions. The Medline, EMBASE and ISI databases were searched. Consensus in the group was reached after discussion by e\u2010mail. We recommend Halstead's definition of PPS from 1991 as diagnostic criteria. Supervised, aerobic muscular training, both isokinetic and isometric, is a safe and effective way to prevent further decline for patients with moderate weakness (Level B). Muscular training can also improve muscular fatigue, muscle weakness and pain. Training in a warm climate and non\u2010swimming water exercises are particularly useful (Level B). Respiratory muscle training can improve pulmonary function. Recognition of respiratory impairment and early introduction of non\u2010invasive ventilatory aids prevent or delay further respiratory decline and the need for invasive respiratory aid (Level C). Group training, regular follow\u2010up and patient education are useful for the patients\u2019 mental status and well\u2010being. Weight loss, adjustment and introduction of properly fitted assistive devices should be considered (good practice points). A small number of controlled studies of potential\u2010specific treatments for PPS have been completed, but no definitive therapeutic effect has been reported for the agents evaluated (pyridostigmine, corticosteroids, amantadine). Future randomized trials should particularly address the treatment of pain, which is commonly reported by PPS patients. There is also a need for studies evaluating the long\u2010term effects of muscular training.<\/jats:p>","DOI":"10.1111\/j.1468-1331.2006.01385.x","type":"journal-article","created":{"date-parts":[[2006,6,12]],"date-time":"2006-06-12T11:13:17Z","timestamp":1150110797000},"page":"795-801","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":136,"title":["EFNS guideline on diagnosis and management of post\u2010polio syndrome. Report of an EFNS task force"],"prefix":"10.1111","volume":"13","author":[{"given":"E.","family":"Farbu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N. E.","family":"Gilhus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. P.","family":"Barnes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Borg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"De Visser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Driessen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Howard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Nollet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Opara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Stalberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2006,7,20]]},"reference":[{"key":"e_1_2_9_2_2","first-page":"158","article-title":"Paralysie essentielle de l'enfance, atrophie musculaire cons\u00e9cutive","volume":"27","author":"Raymond M","year":"1875","journal-title":"Comptes Rendus de la Societ\u00e9 de la Biologie et de ses Filiales"},{"key":"e_1_2_9_3_2","doi-asserted-by":"crossref","first-page":"845","DOI":"10.3928\/0147-7447-19850701-06","article-title":"New problems in old polio patients: results of a survey of 539 polio survivors","volume":"8","author":"Halstead LS","year":"1985","journal-title":"Orthopedics"},{"key":"e_1_2_9_4_2","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.3928\/0147-7447-19911101-09","article-title":"Assessment and differential diagnosis for post\u2010polio syndrome","volume":"14","author":"Halstead LS","year":"1991","journal-title":"Orthopedics"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.1995.tb27532.x"},{"key":"e_1_2_9_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/0960-8966(95)00013-5"},{"key":"e_1_2_9_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-9993(99)90173-9"},{"key":"e_1_2_9_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.284.4.412"},{"key":"e_1_2_9_9_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.sc.3101202"},{"key":"e_1_2_9_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s004150200030"},{"key":"e_1_2_9_11_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1468-1331.2002.00390.x"},{"key":"e_1_2_9_12_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1468-1331.2003.00613.x"},{"key":"e_1_2_9_13_2","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0404.2003.00186.x"},{"key":"e_1_2_9_14_2","doi-asserted-by":"publisher","DOI":"10.1080\/16501970310017423"},{"key":"e_1_2_9_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.EDE.0000058920.38635.D3"},{"key":"e_1_2_9_16_2","doi-asserted-by":"publisher","DOI":"10.1080\/096382800296674"},{"key":"e_1_2_9_17_2","first-page":"13","article-title":"Post\u2010polio syndrome: clinical experience with 132 consecutive outpatients","volume":"23","author":"Halstead LS","year":"1987","journal-title":"Birth Defects Original Article Series"},{"key":"e_1_2_9_18_2","doi-asserted-by":"publisher","DOI":"10.1038\/scientificamerican0498-42"},{"key":"e_1_2_9_19_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/136.7.769"},{"key":"e_1_2_9_20_2","first-page":"7","article-title":"Late onset polio sequelae in Denmark \u2013 presentation and results of a nation\u2010wide survey of 3 607 polio survivors","volume":"28","author":"Lonnberg F","year":"1993","journal-title":"Scandinavian Journal of Rehabilitation Medicine Supplementum"},{"key":"e_1_2_9_21_2","first-page":"267","volume":"58","author":"Pentland B","year":"2000","journal-title":"Health Bulletin"},{"key":"e_1_2_9_22_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-4598(199804)21:4<540::AID-MUS16>3.0.CO;2-0"},{"key":"e_1_2_9_23_2","unstructured":"LygrenH JonesKO GrenstadT DreyerV FarbuE RekandT.Disability Fatigue Pain and Muscle Strength in Poliosurvivors. Submitted."},{"key":"e_1_2_9_24_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198707023170102"},{"key":"e_1_2_9_25_2","doi-asserted-by":"publisher","DOI":"10.1002\/mus.880180705"},{"key":"e_1_2_9_26_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-4598(199811)21:11<1428::AID-MUS10>3.0.CO;2-X"},{"key":"e_1_2_9_27_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.2004.00867.x"},{"key":"e_1_2_9_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/0022-510X(93)90294-9"},{"key":"e_1_2_9_29_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0317167100039883"},{"key":"e_1_2_9_30_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.53.6.1225"},{"key":"e_1_2_9_31_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.74.12.1655"},{"key":"e_1_2_9_32_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.1995.tb27556.x"},{"key":"e_1_2_9_33_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.1995.tb27555.x"},{"key":"e_1_2_9_34_2","first-page":"22","article-title":"Overwork weakness in partially denervated skeletal muscle","volume":"15","author":"Bennett RL","year":"1958","journal-title":"Clinical Orthopedics"},{"key":"e_1_2_9_35_2","doi-asserted-by":"publisher","DOI":"10.3109\/09638289609165888"},{"key":"e_1_2_9_36_2","volume-title":"March of Dimes International Conference on Post Polio Syndrome. Identifying Best Practices in Diagnosis and Care","author":"March of Dimes","year":"2000"},{"key":"e_1_2_9_37_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.54.3.236"},{"key":"e_1_2_9_38_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-4598(199606)19:6<728::AID-MUS7>3.0.CO;2-C"},{"key":"e_1_2_9_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2003.08.101"},{"key":"e_1_2_9_40_2","first-page":"361","article-title":"Cardiorespiratory and metabolic adjustments during submaximal and maximal exercise in polio athletes","volume":"51","author":"Veicsteinas A","year":"1998","journal-title":"Medicina Dello Sport"},{"key":"e_1_2_9_41_2","doi-asserted-by":"publisher","DOI":"10.1002\/mus.10327"},{"key":"e_1_2_9_42_2","first-page":"11","article-title":"Muscle conditioning in late poliomyelitis","volume":"72","author":"Einarsson G","year":"1991","journal-title":"Archives of Physical Medicine & Rehabilitation"},{"key":"e_1_2_9_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-9993(96)90268-3"},{"key":"e_1_2_9_44_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-4598(199610)19:10<1282::AID-MUS5>3.0.CO;2-A"},{"key":"e_1_2_9_45_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-9993(97)90073-3"},{"key":"e_1_2_9_46_2","doi-asserted-by":"crossref","first-page":"3255","DOI":"10.1001\/jama.1989.03420220069029","article-title":"Cardiorespiratory responses to aerobic training by patients with postpoliomyelitis sequelae","volume":"261","author":"Jones DR","year":"1989","journal-title":"JAMA"},{"key":"e_1_2_9_47_2","first-page":"49","article-title":"Cardiorespiratory responses to upper extremity aerobic training by postpolio subjects","volume":"73","author":"Kriz JL","year":"1992","journal-title":"Archives of Physical Medicine and Rehabilitation"},{"key":"e_1_2_9_48_2","doi-asserted-by":"crossref","first-page":"1243","DOI":"10.3928\/0147-7447-19911101-13","article-title":"Effect of modified aerobic training on movement energetics in polio survivors","volume":"14","author":"Dean E","year":"1991","journal-title":"Orthopedics"},{"key":"e_1_2_9_49_2","doi-asserted-by":"publisher","DOI":"10.1053\/apmr.2002.32451"},{"key":"e_1_2_9_50_2","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1080\/dre.25.2.77.84","article-title":"Treatment of patients with postpolio syndrome in a warm climate","volume":"25","author":"Strumse YAS","year":"2003","journal-title":"Disability & Rehabilitation"},{"key":"e_1_2_9_51_2","doi-asserted-by":"publisher","DOI":"10.1053\/apmr.2001.9626"},{"key":"e_1_2_9_52_2","doi-asserted-by":"publisher","DOI":"10.1080\/16501970213232"},{"key":"e_1_2_9_53_2","first-page":"219","article-title":"The late sequelae of poliomyelitis","volume":"66","author":"Howard RS","year":"1988","journal-title":"The Quarterly Journal of Medicine"},{"key":"e_1_2_9_54_2","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/90.3.189"},{"key":"e_1_2_9_55_2","first-page":"2474","article-title":"Post\u2010polio respiratory failure. New manifestations of a forgotten disease","volume":"108","author":"Bergholtz B","year":"1988","journal-title":"Tidsskrift for den Norske Laegeforening"},{"key":"e_1_2_9_56_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1474-7766.2003.06128.x"},{"key":"e_1_2_9_57_2","doi-asserted-by":"crossref","first-page":"125","DOI":"10.2340\/165019771993125129","article-title":"Pulmonary function and symptom\u2010limited exercise stress testing in subjects with late sequelae of poliomyelitis","volume":"25","author":"Stanghelle JK","year":"1993","journal-title":"Scandinavian Journal of Rehabilitation Medicine"},{"key":"e_1_2_9_58_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.100.1.118"},{"key":"e_1_2_9_59_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.1995.tb27535.x"},{"key":"e_1_2_9_60_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.101.1.254"},{"key":"e_1_2_9_61_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.122.5.1695"},{"key":"e_1_2_9_62_2","doi-asserted-by":"publisher","DOI":"10.1053\/apmr.2000.7164"},{"key":"e_1_2_9_63_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199104253241703"},{"key":"e_1_2_9_64_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00714594"},{"key":"e_1_2_9_65_2","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-199501000-00010"},{"key":"e_1_2_9_66_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0892-1997(01)00030-3"},{"key":"e_1_2_9_67_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.1995.tb27560.x"},{"key":"e_1_2_9_68_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-6196(11)63568-4"},{"key":"e_1_2_9_69_2","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1016\/0003-9993(94)90134-1","article-title":"Predictive factors for post\u2010poliomyelitis syndrome","volume":"75","author":"Trojan DA","year":"1994","journal-title":"Archives of Physical Medicine and Rehabilitation"},{"key":"e_1_2_9_70_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.98.1.133"},{"key":"e_1_2_9_71_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-9993(96)90304-4"},{"key":"e_1_2_9_72_2","doi-asserted-by":"publisher","DOI":"10.4065\/73.3.216"},{"key":"e_1_2_9_73_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-8529(03)00069-0"},{"key":"e_1_2_9_74_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.123.1.67"},{"key":"e_1_2_9_75_2","doi-asserted-by":"publisher","DOI":"10.1177\/026921559701100406"},{"key":"e_1_2_9_76_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1053-8135(96)00216-8"},{"key":"e_1_2_9_77_2","doi-asserted-by":"crossref","first-page":"1223","DOI":"10.3928\/0147-7447-19911101-11","article-title":"Activity and post\u2010polio fatigue","volume":"14","author":"Packer TL","year":"1991","journal-title":"Orthopedics"},{"key":"e_1_2_9_78_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-9993(99)90110-7"},{"key":"e_1_2_9_79_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.sc.3100425"},{"key":"e_1_2_9_80_2","doi-asserted-by":"publisher","DOI":"10.1080\/09638280010006151"},{"key":"e_1_2_9_81_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jneuroim.2004.01.010"}],"container-title":["European Journal of Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1468-1331.2006.01385.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1468-1331.2006.01385.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T09:55:08Z","timestamp":1736416508000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1468-1331.2006.01385.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,7,20]]},"references-count":80,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2006,8]]}},"alternative-id":["10.1111\/j.1468-1331.2006.01385.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1468-1331.2006.01385.x","archive":["Portico"],"relation":{},"ISSN":["1351-5101","1468-1331"],"issn-type":[{"value":"1351-5101","type":"print"},{"value":"1468-1331","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,7,20]]},"assertion":[{"value":"2006-07-20","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}