Self-assessed secondary difficulties among paralytic poliomyelitis and spinal cord injury survivors in Japan

OBJECTIVE: To determine the time course of secondary worsening of difficulties (SWD) experienced by postpolio and spinal cord injury (SCI) subjects in the general population. DESIGN: Self-report survey. SETTING: Multicenter study in general community in Japan. PARTICIPANTS: A total of 662 postpolio and 736 SCI subjects who had had contact with some rehabilitation facility. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Respondents completed a questionnaire about demographic factors, physical complaints, activities of daily living (ADLs), social participation, and a visual analog scale of time course for difficulties (VAST-D) devised for the present study in which the subjects drew a single curve to indicate the lifetime course of disability as they perceived it. RESULTS: Signs of SWD in all extremities of the polio patients and in the upper extremities of the SCI subjects were visually shown by the VAST-D. Additionally, the prevalence of postpolio syndrome and SWD in the SCI group was estimated to be 55.3% and 45.1%, respectively. CONCLUSIONS: SWD was visually shown by the VAST-D in polio and SCI subjects.