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Purpose: Post-polio Syndrome (PPS) affects polio survivors many years after the initial attack, and causes new musculoskeletal symptoms and decline in physical function. This study aims to compare the effect of exercise and lifestyle modification versus lifestyle modification alone, on fatigue and functional capacity in persons with PPS.

Method: An experimental study was conducted at the physiotherapy department of VS Hospital in Ahmedabad. As per the criteria of Halstead (1985), 21 PPS subjects who were between 18 and 65 years of age, and able to walk indoors and outdoors, with or without assistive aids, were included. They were randomly allocated into 3 groups using the envelope method. Those with physician- diagnosed respiratory or cardiac insufficiency, disabling co-morbidity which interfered with the intervention programme or influenced the outcome, and those unable to cooperate due to cognitive impairment or use of any psychotropic drugs, were excluded. Fatigue and functional capacity were measured using Fatigue Severity Scale (FSS) and 2-minute walk distance, respectively. Physical and psychological functions were assessed using Patient Reported Outcome Measurement Information System (PROMIS) questionnaire and Patient Health Questionnaire (PHQ-9) respectively. Intervention was given for 5 days a week, over 4 weeks. Group A received exercise and lifestyle modification, group B received lifestyle modification alone and group C continued their usual routine for 1 month.

Results: There was a significant difference in fatigue and functional capacity within groups A and B, with group A showing better reduction in fatigue than groups B or C. Physical function improved only within group A, and a significant difference was seen compared to groups B and C. Psychological function showed no difference within or between the groups.

Conclusion: There was improvement in fatigue, functional capacity and physical function in PPS subjects after 4 weeks of exercise and lifestyle modification. Lifestyle modifications alone for 4 weeks improved fatigue and functional capacity in PPS subjects. There is significant reduction in fatigue and improvement in functional capacity when lifestyle modification advice is given along with exercise.

Purpose: It is a common and well‐recognised phenomenon that functional deterioration occurs many years after people are affected by poliomyelitis infection. This study aims to determine the presentation of pain in subjects with post-polio syndrome (PPS) and also the correlation between severity of pain and interference in activities of daily living (ADL).

Method: A cross-sectional survey was conducted among 72 persons with PPS in Gujarat state in India. Each one was given a self-administered questionnaire which included an 11‐point Numeric pain rating scale (NRS) for intensity of pain, questions about site, duration and diurnal variation of pain, and an 11‐point Numeric pain rating scale for pain interference.

Results: The study showed that 17 persons (24%) had only joint pain, 28 (39%) had only muscular pain and 27 (37%) had both joint as well as muscular pain. The highest number of subjects or 34 persons (47%) had knee pain, followed by 24 (33%) with shoulder pain, 21% with hip and 19% with low back pain. Muscle pain was maximum in arm musculature, as reported by 33 persons (45%), followed by pain in leg and foot muscles among 25 (36%) and 17 (23%) persons, respectively. Maximum number of subjects or 31% had pain while working which was relieved by rest, while 28 % had pain which continued all day. 43% experienced more pain in winter while 57% had no seasonal variation in pain. 30 persons (42%) had severe pain, 26 had moderate pain and only 16 had mild pain. Mean pain intensity was 5.88 ±1.52. Interference in ADL on NRS was 4.72 ±2.70. Interference in ADL and pain intensity were found to be positively correlated with Pearson’s co-efficient r=0.6295(p<0.0001).

Conclusion: The majority of those who had recovered from polio experienced increased or new symptoms and problems in ADL, muscle pain, joint pain, and difficulties in walking.

This is the annual report of the Global Polio Eradication Initiative (GPEI) measuring progress made in 2007 against the objectives of the GPEI Strategic Plan 2004-2008 and against milestones set for the Intensified Eradication Effort in February 2007. Set up in 1988, the GPEI is spearheaded by WHO, Rotary International, CDC and UNICEF

This report argues that real progress in health depends on strengthening health systems, centred on the principles of primary health care. This requires effective use of existing knowledge and technologies and innovation to create new health tools, along with appropriate structures and strategies to apply them. Success will need new forms of cooperation between international health agencies, national health leaders, health workers and communities, and other relevant sectors. Chapter 1 of the report looks at the current state of global health, highlighting the gap between the poor and better-off everywhere. Chapter 2 reflects on the slow progress towards achieving the Millenium Development Goals. Chapter 3 looks at the HIV/AIDS pandemic, and demonstrates why HIV/AIDS control needs to drive the agenda for the global health community. Chapter 4 looks at the steps needed to achieve polio eradication within the next few years, and chapter 5 concentrates on the lessons learned from the SARS outbreak. The theme of chapter 6 is the the overlap between communicable and non-communicable diseases and injuries occurring throughout the developing world, leading to a crisis of priorities for health systems. The concluding chapter returns to the statement that stronger health systems are necessary, and that strengthening health systems should be based on the principles and practices of primary health care