By Richard L. Bruno
The weather outside if frightful, and your toes are too frostbiteful. But, since you’ve no place to go…
Wait. Who says you’ve no place to go? It may warm your cold polio feet on this blustery March day to know about a Norwegian study of 88 subjects diagnosed with “post polio syndrome” (PPS). Twenty-nine were said to be “control” subjects, even though most were getting “one or two physiotherapy and/or swimming sessions” a week.
Fifty-nine subjects received therapy for PPS for four weeks, although the details of the treatment were not described. Therapy was said to be “adapted” for polio survivors from the “ordinary” rehab programs provided to non-polio survivors: “Most subjects attended daily treatment in the swimming pool and physiotherapy,” classes in “relaxation techniques, self-training and gymnastics.” Details of what was done in the pool, in PT and the definitions of “self-training and gymnastics” (polio gymnastics?) were not provided.
And maybe it doesn’t matter that we have little idea of what therapy was provided. Maybe all that matters is where the therapy was given. Thirty of the subjects were treated in Tenerife, that dry and sunny Spanish isle off the coast of Africa, where the average daytime temperature was 77 degrees. Twenty-nine unlucky polio survivors were treated in their native Norway, where the daytime temperature hovers below freezing.
But what a difference 45 degrees (latitude) made! All subjects reported moderate pain and depression and moderate to severe fatigue before the study. The Tenerife subjects said that their muscles and joints “felt softer” and that they were more mobile and active. Pain decreased by 59% and fatigue dropped 16% in the subjects on Tenerife; pain decreased by only 28% and fatigue actually increased by 2% in those freezing in Norway. Depression was reduced by 65% on Tenerife but only by 40% in those left behind in Norway.
The authors concluded that it was “a rather positive surprise” that polio survivors treated on Tenerife felt better, and that it is important in winter “to take into account the positive psychosocial effects of some days off in warmer surroundings, using summer clothes, spending time together with fellow men and participating in the social life.” Methinks it wasn’t the “adapted” rehab program or summer clothes that made polio survivors feel better, but the warm, sun-soaked island, time together with fellow men (and women) and a few piña coladas that did the trick.
More interesting than the author’s surprise at the salutary effects on polio survivors of a month in a tropical paradise is what happened three months after the Tenerife subjects returned home to frigid Norway. Returnees’ pain and fatigue were still decreased, but only by 28% and 13%, respectively, and depression was still reduced by the full 65%. But, pain and fatigue three months after treatment in those who remained in Norway actually increased by 2% and 5%, respectively, while depression edged upward to only a 30% reduction. Three months after the therapy groups completed treatment, the “control” subjects (who, you’ll remember, did have some unspecified “therapy” in Norway but were not in the “adapted” rehab program) had an 18% decrease in pain but a 40% reduction in depression, that is they actually felt better than polio survivors who were actively treated in Norway.
All right, so this is a crummy study that shouldn’t have been published. We have no idea what therapy was given to the post-polio patients and the so-called “control” subjects were actually receiving treatment. What is clear is that spending a month in a warm climate during the dead of a Scandinavian winter significantly reduced pain, fatigue and depression in polio survivors, and I imagine would do the same for anyone with any disability.
What does this have to do with American polio survivors? Your accountant may be able to use this study to justify taking a trip to warmer clines in winter as a medical deduction as a treatment for PPS. You may even be able to write off a move to a warmer state as part of PPS treatment. But, until April 15th comes around, make a piña colada, soak in a warm tub, close your eyes and think “palm trees, palm trees.”
Dr. Richard L. Bruno is Chairperson of the International Post- Polio Task Force and Director of The Post-Polio Institute and International Centre for Post-Polio Education and Research at Englewood (NJ) Hospital and Medical Center. His new e-Book, How to STOP Being Vampire Bait: Your Personal Stress Annihilation Program, is now available through PostPolioInfo@aol.com.
I’m moving!