title: Aerobic Exercise Training in Post-Polio Syndrome: Process Evaluation of a Randomized Controlled Trial.
abstract: OBJECTIVE
  To explore reasons for the lack of efficacy of a high intensity aerobic exercise program in post-polio syndrome (PPS) on cardiorespiratory fitness by evaluating adherence to the training program and effects on muscle function.
  
  
  METHODS
  A process evaluation using data from an RCT.
  
  
  METHODS
  Forty-four severely fatigued individuals with PPS were randomized to exercise therapy (n = 22) or usual care (n = 22).
  
  
  METHODS
  Participants in the exercise group were instructed to exercise 3 times weekly for 4 months on a bicycle ergometer (60-70% heart rate reserve).
  
  
  RESULTS
  The attendance rate was high (median 89%). None of the participants trained within the target heart rate range during >75% of the designated time. Instead, participants exercised at lower intensities, though still around the anaerobic threshold (AT) most of the time. Muscle function did not improve in the exercise group.
  
  
  CONCLUSIONS
  Our results suggest that severely fatigued individuals with PPS cannot adhere to a high intensity aerobic exercise program on a cycle ergometer. Despite exercise intensities around the AT, lower extremity muscle function nor cardiorespiratory fitness improved. Improving the aerobic capacity in PPS is difficult through exercise primarily focusing on the lower extremities, and may require a more individualized approach, including the use of other large muscle groups instead.
  
  
  BACKGROUND
  Netherlands National Trial Register NTR1371.
authors.affiliation: Department of Rehabilitation, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.|Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, MOVE Research Institute Amsterdam, Amsterdam, The Netherlands.
authors.forename: Eric L
authors.initials: EL
authors.lastname: Voorn
authors.affiliation: Department of Rehabilitation, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Fieke S
authors.initials: FS
authors.lastname: Koopman
authors.affiliation: Department of Rehabilitation, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Merel A
authors.initials: MA
authors.lastname: Brehm
authors.affiliation: Department of Rehabilitation, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Anita
authors.initials: A
authors.lastname: Beelen
authors.affiliation: Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, MOVE Research Institute Amsterdam, Amsterdam, The Netherlands.
authors.forename: Arnold
authors.initials: A
authors.lastname: de Haan
authors.affiliation: Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, MOVE Research Institute Amsterdam, Amsterdam, The Netherlands.
authors.forename: Karin H L
authors.initials: KH
authors.lastname: Gerrits
authors.affiliation: Department of Rehabilitation, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Frans
authors.initials: F
authors.lastname: Nollet
mesh_terms: D000368:Aged; D015308:Anaerobic Threshold; D000072599:Cardiorespiratory Fitness; D015444:Exercise; D005081:Exercise Therapy / Q000379:methods*; D005221:Fatigue / Q000150:complications* / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D016262:Postpoliomyelitis Syndrome / Q000150:complications* / Q000503:physiopathology / Q000628:therapy*