Late Effects of Polio: A Model for Identification and Assessment of Preventable Secondary Disabilities

摘要

The major goal of the project was to develop methods for identifying and assessing preventable secondary disabilities among populations having primary disabilities caused by chronic motor impairments. Project investigators performed an in-depth study of a sample of 120 people with a history of polio. The sample, from the Michigan Post-Polio Registry, was chosen to include the complete range in (1) severity of chronic locomotor limitation and (2) degree of decline in functional abilities that can be experienced among the population. All of the subjects completed a 54-page Home Survey. Data analysis led to a detailed description of secondary conditions in the sample based on the Institute of Medicine's 1991 Model of Disability. Further analysis developed and explored the accuracy of simple screening models for identifying 30 targeted secondary conditions based on answers to the Home Survey questions and the presence of the conditions during interview/examination. A pilot screening instrument to identify eleven of these conditions in post-polio subjects is proposed for further reliability testing on other samples of post-polio subjects. Several focused investigations of specific secondary conditions give more detailed descriptive information and analyze various interrelationships between psychosocial and physiologic risk factors for the conditions that may be present. The major conclusions of the study is that a longitudinal data base is needed to evaluate preventive and therapeutic interventions for secondary disabilities and a reliable methodology based on self-report questions appears feasible for use in clinical and public health studies of secondary disability.