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Master Thesis

Traitement du syndrome post-poliomyélitique par immunoglobulines intraveineuses : une étude rétrospective d’efficacité sur des critères cliniques et isocinétiques

Abstract : INTRODUCTION: post-poliomyelitis syndrome (PPS) refers to the loss of strength associated with clinical and functional deterioration experienced felt by many poliomyelitis survivors several decades after primary infection. The pathophysiology of PPS isn’t fully understood, leading to a lack of universal treatment. However, a dysimmunitary 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 subjects with PPS. METHODS: we carried out a descriptive study, performed retrospectively on patients with PPS treated with IVIG, at the Montpellier University Hospital 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. RESULTS: a total of 26 IVIG cures prescribed as part of an PPS, 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 an average of + 31 (67) meters [p = 0.072], the walking speed remained unchanged around 0.84 (0.25) m/s, the pain VAS decreased by an average of -1.16 (1.78) points [p = 0.09] and a gain in muscle strength was observed on 11 out of 12 isokinetic measurements compared to quadriceps and hamstrings. The subgroup analysis showed an increased effect in patients with initial quadriceps muscle testing > 3/5 according to the MRC scale. CONCLUSION: 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 especially significant in patients with a minor muscle deficiency.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02964335
Contributor : Scd Université de Montpellier <>
Submitted on : Wednesday, February 3, 2021 - 10:44:01 AM
Last modification on : Saturday, July 3, 2021 - 3:16:35 AM

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Vincent Moiziard. Traitement du syndrome post-poliomyélitique par immunoglobulines intraveineuses : une étude rétrospective d’efficacité sur des critères cliniques et isocinétiques. Médecine humaine et pathologie. 2019. ⟨dumas-02964335⟩

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