Effects of Daoyin Qìgōng in postpolio syndrome patients with cold intolerance

Efeitos do Doyin Qìgōng em pacientes com síndrome pós-pólio com queixa de intolerância ao frio.

Paulo Eduardo Ramos1, Gislaine Cristina Abe1, Márcia Pradella-Hallinan1,2, Abrahão Augusto Juviniano Quadros1, Beny Schmidt1, Acary Souza Bulle Oliveira1

ABSTRACT

Postpolio syndrome (PPS) is characterized by progressive muscle weakness due to former infection with poliomyelitis and can be associated with other symptoms such as cold intolerance (CI). Doyin Qìgōng (DQ) is a technique in Traditional Chinese Medicine that impacts the circulation of energy and blood. Objective: It was to verify the effects of DQ in PPS patients complaining of cold intolerance. Methods: Ten PPS patients were assessed using the visual analogue scale (VAS) adapted for CI before and after intervention with DQ; patients practiced it in a sitting position for 40 minutes, 3 times per week over 3 consecutive months. Patients were reassessed three months after ceasing DQ. Results: There was a statistically significant difference in local and systemic VAS-Cold both at the end of DQ training and three months past the end of this. Conclusion: The DQ technique ameliorated CI complaints in patients with PPS.

Key words: Postpoliomyelitis syndrome, Qìgōng, breathing exercises, public health.

RESUMO

A síndrome pós-poliomielite (SPP) é caracterizada por instalação de nova fraqueza muscular às manifestações residuais da poliomielite, associada a outros sintomas, como intolerância ao frio (IF). O Doyin Qìgōng (DQ) é uma técnica da medicina tradicional chinesa que interfere na circulação da energia e do sangue. Objetivo: Foi verificar os efeitos do DQ em pacientes com SPP com queixa de intolerância ao frio. Método: Dez pacientes com SPP foram avaliados com a escala visual analógica (EVA) adaptada para IF antes e após intervenção com DQ, adaptados para a posição sentada, com duração de 40 minutos, 3 vezes por semana, durante 3 meses. Resultados: Verificou-se diferença estatisticamente significante, na EVA-frio local e sistêmica, após o término do treinamento. Conclusão: O DQ é uma técnica que interferiu positivamente na queixa de IF em pacientes com SPP.

Palavras-Chave: síndrome pós-poliomielite, Qìgōng, exercícios respiratórios, saúde pública.

Post-polio syndrome (PPS) is characterized by progressive muscle weakness due to former infection with poliomyelitis and is often associated with other symptoms such as muscle fatigue, muscle and or joint pain, cold intolerance (CI) and sleep disorders1-3. A Brazilian study of 167 patients who had previously been diagnosed with paralytic poliomyelitis and subsequently with PPS highlighted a CI frequency of 69.8%4,5. The affected extremities are often unseasonably cold due to involvement of the sympathetic nerve cells, leading to vasoconstriction5. Until now, CI in patients with PPS had no defined etiology or specific rehabilitative or pharmacological treatment; muscle-strengthening exercises and static magnetic fields seem to be beneficial, but these therapies warrant further research6. Guidelines for the treatment of symptoms include adequate clothing, distal/proximal mas-age and local heat for a short period of time5,7.From a clinical and histological perspective, the path physiology of PPS is associated with lower motor neuron dysfunction. One of the main mechanisms which may lead to this syndrome is overtraining. This activity favors the dys-function of motor neurons which survive axon terminals which are completely destroyed. Compensatory mechanisms are triggered to reinerve muscle tissue, thereby increasing the drive motor through stimulation of intact motor axons.

Department of Neurology and Neurosurgery, Department of Clinical Neurology, Division of Neuromuscular Disease Research, Clinic of Traditional Chinese Medicine, Universidade Ferderal de São Paulo (UNIFESP), São Paulo SP, Brazil;

2Department of Psychobiology, Sleep Institute, UNIFESP, São Paulo SP, Brazil.

Correspondence: Gislaine Cristina Abe; Universidade Federal de São Paulo; Rua Estado de Israel 899; 04022-002 São Paulo SP - Brasil; E-mail: gislaineabe@hotmail.com Conflict of interest: There is no conflict of interest to declare.

Received 28 March 2012; Received in final form 18 April 2012; Accepted 25 April 2012