paralytic poliomyelitis , an acute disease caused by poliovirus , has been part of 
 human history for thousands of years . in the mid - twentieth century , after the 
 introduction of an effective vaccination program , the number of new cases 
 dramatically dropped . wild - type poliovirus was eliminated from the western 
 hemisphere , and the number of new cases continues to drop in the rest of the 
 world . ( 


 ) 
  some of the patients with a history of poliomyelitis report late - onset neuromuscular 
 symptoms and a decline in functional capacity . these late symptoms are referred to 
 as post - poliomyelitis syndrome ( pps ) . the syndrome is characterized by new and 
 increased muscle weakness , fatigue , muscle pain , joint pain , muscle cramps , cold 
 intolerance , and lung problems . ( 


 , 


 ) although pps is a common neurological disorder affecting a large 
 proportion of those who have recovered from paralytic poliomyelitis , the causes of 
 pps remain unclear . the most widely accepted hypothesis , proposed by wiechers and 
 hubbell , ( 


 ) attributes the symptoms to a distal degeneration of axons from the 
 greatly enlarged motor units that develop during recovery from acute paralytic 
 poliomyelitis . patients with pps have reported respiratory symptoms that include exertional dyspnea 
 and reduced physical endurance . ( 


 - 


 ) respiratory problems can result from impairment of medullary centers , 
 impairment of cranial nerves , impairment of respiratory muscles , or any combination 
 of the three . ( 


 ) 
  the world health organization estimates that there are 20 million polio 
 survivors , ( 


 ) and new cases of poliomyelitis have been reported in certain african 
 and asian countries . therefore , knowledge of lung function in such patients is 
 important in clinical practice in order to provide adequate information regarding 
 their functional status . the primary objective of the present study was to determine whether individuals with 
 pps can present with lung function abnormalities . a secondary objective was to 
 compare lung function between patients with pps and those with sequelae of paralytic 
 poliomyelitis ( without any signs or symptoms of pps ) , as well as between patients 
 with pps and healthy controls . given that patients with pps commonly experience a 
 significant loss of muscle strength , we hypothesized that they would also show 
 drastic changes in lung function . twenty - nine male participants were 
 assigned to one of three groups : control ( n = 10 ; mean age , 49.8  2.3 years ; body 
 mass , 88.4  5.0 kg ; and height , 175.4  1.6 cm ) ; poliomyelitis , composed of 
 patients who had had paralytic poliomyelitis but had not developed pps ( n = 9 ; mean 
 age , 47.9  2.1 years ; body mass , 81.9  5.1 kg ; and height , 169.0  2.8 cm ) ; and 
 pps , composed of patients who had been diagnosed with pps ( n = 10 ; mean age , 50.2  
 2.3 years ; body mass , 71.1  4.5 kg ; and height , 162.9  2.3 cm ) . age , body mass , 
 and height were expressed as mean  se . in the poliomyelitis and pps groups , height 
 was measured with a flexible tape measure , with the patients in the supine position . there were no significant differences among the groups except for lower body mass 
 and height in the pps group when compared with the control group ( p < 0.05 ) . the 
 diagnosis of pps was based on the method developed by borg , ( 


 ) all patients having been diagnosed by the same neurologist , who has 
 extensive experience in treating patients with pps . the patients in the 
 poliomyelitis and pps groups were recruited from among those treated at the 
 post - polio clinic of the neuromuscular diseases section of the federal university of 
 so paulo , located in the city of so paulo , located in the city of so paulo , 
 brazil . the clinical profiles of the patients with poliomyelitis sequelae are 
 presented in table 1 . healthy controls were 
 recruited from among members of the university community by advertisements placed on 
 the website of the federal university of so paulo , located in the city of so 
 paulo , brazil , and in local newspapers . all individuals were disease - free except for 
 the residual effects of poliomyelitis , and none were receiving respiratory care . in 
 addition , none of the patients in the poliomyelitis group and only one of those in 
 the pps group had respiratory complaints . the participants were fully informed of 
 any risks and discomfort associated with the experiments before giving their written 
 consent to participate in the present study , which was approved by the research 
 ethics committee of the federal university of so paulo . all procedures were in 
 accordance with the principles of the declaration of helsinki . table 1 clinical profiles of patients with poliomyelitis sequelae.a 
  we assessed lung function by spirometry and by assessing respiratory muscle strength . a trained 
 laboratory technician demonstrated each respiratory maneuver to each subject before 
 initiating the test . spirometry was performed using a k4b spirometer ( cosmed , rome , italy ) 
 attached to a computer . our interpretation was based on the american thoracic 
 society / european respiratory society guidelines . ( 


 ) on the day of the test , the volunteers did not undergo any physical 
 exercise . they were instructed to perform 3 - 5 maximal forced expiratory maneuvers , a 
 3-min interval being allowed between trials . the outcomes of interest were fvc , 
 fev1 , the fev1/fvc ratio , pef , fef25 - 75% , and 
 maximal voluntary ventilation ( mvv ) , the highest value for each being used for data 
 analysis . in order to measure mvv , subjects were required to breathe as deeply and 
 rapidly as possible for 12 s. the respiratory volume values were then extrapolated 
 to 1 min . our spirometer was calibrated at least daily with a 3-l syringe ( hans rudolf , inc . , all volumes 
 were corrected for body temperature , ambient pressure , and saturation with water 
 vapor . ( 


 , 


 ) 
  respiratory muscle strength was assessed by measuring mip and mep with a manometer 
 ( gerar , so paulo , brazil ) , resolution being 1 cmh2o and capacity being 
 300 cmh2o . a small ( < 2 mm ) opening close to the mouthpiece was used 
 in order to decrease mouth pressure and prevent patients from using their cheeks to 
 generate pressure .   for the measurement of mip , participants emptied their lungs by blowing as hard as 
 possible and exhaling as much air as possible to rv , subsequently inhaling up to 
 tlc . , 
 participants were asked to fill their lungs with as much air as possible up to tlc 
 and then rapidly breathe out . the 
 obtained values were expressed in cmh2o and compared with reference 
 values for the brazilian population . ( 


 ) 
  regarding statistical analysis , normal distribution and homogeneity of variance were 
 determined by the kolmogorov - smirnov test and the levene test , respectively . the 
 values obtained in the lung function tests were converted to percentages of the 
 predicted values . to that end , the reference values for fvc , fev1 , the 
 fev1/fvc ratio , pef , and fef25 - 75% were based on those 
 used by pereira et al . for the brazilian population , ( 


 ) whereas those for mvv , mip , and mep were based on values used by neder 
 et al . ( 


 ) 
  the age at onset of acute poliomyelitis and the number of years of functional 
 stability were compared between the poliomyelitis and pps groups by the student 's 
 t - test for unpaired samples . another student 's t - test for unpaired samples was 
 performed in order to compare the obtained and predicted values for the following 
 respiratory variables : fvc , fev1 , the fev1/fvc ratio , pef , 
 fef25 - 75% , mvv , mip , and mep . subsequently , a one - way anova was 
 performed in order to detect differences in respiratory variables among the groups . when a significant effect was achieved , tukey 's post hoc test was performed in order 
 to detect differences among the means . no significant differences were observed between the poliomyelitis and pps groups 
 regarding the age at onset of acute poliomyelitis or the number of years of 
 functional stability ( table 1 ) . no significant differences were observed among the groups except for 
 an approximately 27% lower mean mvv in the pps group when compared with the control 
 group ( p = 0.0127 ) . nevertheless , the mvv values obtained in the pps group were 
 compared with those for the brazilian population and were found to be normal . regarding respiratory muscle strength , no significant differences were observed 
 among the groups ( table 3 ) . table 2 spirometric assessment in controls and patients with poliomyelitis 
 sequelae.a 
 
 table 3 respiratory muscle strength in controls and patients with 
 poliomyelitis sequelae.a after the implementation of an effective worldwide vaccination program , paralytic 
 poliomyelitis was virtually forgotten by the medical community . these survivors 
 have complained about new signs and symptoms , which are collectively known as pps . 
 because the major polio epidemics occurred in the 1950s in many western countries 
 and in the 1980s in latin american countries , and considering that late - onset 
 neurological changes typically do not appear until 30 - 50 years after infection , 
 millions of polio survivors had not experienced problems related to their 
 poliomyelitis sequelae until the late 1970s and early 1980s . people experiencing 
 these symptoms are now receiving attention from the medical community in several 
 parts of the world . in fact , as a result of an initiative led by professionals from 
 the federal university of so paulo , pps was included in the international 
 classification of diseases . additionally , new cases of polio have been reported in 
 certain african and asian countries . therefore , studies investigating the clinical 
 profile of pps are important to elucidate the pathological mechanisms and clinical 
 impact of this neuromuscular disease .   in the present study , we investigated the lung function of patients with sequelae of 
 paralytic poliomyelitis with and without pps . our results showed that there were no 
 significant differences among the groups ( control , poliomyelitis , and pps ) .   to our knowledge , this is the first study to investigate lung function in patients 
 with paralytic poliomyelitis divided into groups of patients with pps ( the pps 
 group ) and without pps ( the poliomyelitis group ) . previously , many studies 
 investigating lung function in patients with poliomyelitis sequelae ( 


 , 


 - 


 ) and other neuromuscular diseases ( 


 ) were controversial because of the differences among patients in terms 
 of their characteristics , which are usually dependent on the degree of impairment , 
 the origin of the patients ( outpatients having less disease progression ) , gender , 
 and the presence of respiratory complaints . our results showed no lung function impairment due to late sequelae of paralytic 
 poliomyelitis . they are in disagreement with those of previous studies evaluating 
 respiratory function in the same types of patients . ( 


 , 


 , 


 ) however , those studies evaluated patients with a history of 
 poliomyelitis and respiratory problems , in whom lung function was found to be 
 markedly lower . in our study , none of the patients in the poliomyelitis group had 
 any respiratory complaints and only one of those in the pps group complained of 
 dyspnea on exertion . it is known that mvv is partially dependent on respiratory muscle strength and 
 endurance . ( 


 ) in fact , knobil et al . ( 


 ) reported the case of a patient with decreased mvv associated with low 
 mip . in our study , mvv was significantly lower in the pps group than in the control 
 group . however , the mvv values found in the pps group were found to be normal after 
 having been compared with those for the brazilian population . we found no 
 significant differences in respiratory muscle strength ( as assessed by mip and mep ) 
 among the groups . this might explain why the mvv values in our study were not 
 significantly different from the reference values for the brazilian population .   in general , lung function was not affected in the patients with poliomyelitis 
 sequelae investigated in our study , a finding that is in disagreement with those of 
 a previous study . ( 


 ) in that study , lung function impairment in those patients was 
 associated with hospitalization , need for mechanical ventilation during the acute 
 stage of the disease , age at disease acquisition ( 10 years or older ) , presence of 
 quadriparesis , and time of exposure to the disease . in our study , only one of the 
 individuals in the pps group and two of those in the poliomyelitis group required 
 hospitalization and respiratory support . in addition , none of the affected 
 individuals had had poliomyelitis at an age older than 10 years ( the mean age at 
 disease acquisition being 1.6 in the poliomyelitis group and 1.5 years in pps 
 group ) , and only two of the individuals in the poliomyelitis group and three of 
 those in the pps group had quadriparesis . ( 


 ) in our study , none of the patients in the poliomyelitis group and one 
 of those in the pps group complained of dyspnea on exertion , having no other 
 respiratory complaints .   in conclusion , with the exception of lower mvv , there were no significant differences 
 in lung function between the group of patients with pps and that of those with 
 poliomyelitis or between the former and healthy controls . this is an important 
 clinical finding because it shows that patients with pps can have preserved lung 
 function . comparar a funo pulmonar de pacientes com sndrome ps - poliomielite  de 
 pacientes com sequelas de poliomielite paraltica ( sem quaisquer sinais ou 
 sintomas de sndrome ps - poliomielite ) e  de sujeitos saudveis . vinte e nove sujeitos do sexo masculino foram divididos em trs grupos : 
 controle , poliomielite ( pacientes que sofreram de poliomielite paraltica , 
 mas que no apresentaram sndrome ps - poliomielite ) e sndrome 
 ps - poliomielite . os voluntrios foram submetidos a avaliaes da funo 
 pulmonar ( espirometria e avaliao da fora muscular respiratria ) . os resultados da espirometria no revelaram diferenas significantes entre 
 os grupos ,  exceo da ventilao voluntria mxima , cuja mdia no grupo 
 sndrome ps - poliomielite foi aproximadamente 27% mais baixa que no grupo 
 controle ( p = 0,0127 ) . no entanto , os valores de ventilao voluntria 
 mxima observados no grupo ps - poliomielite foram comparados aos da 
 populao brasileira e se apresentaram dentro da faixa normal . no foram 
 observadas diferenas significantes entre os grupos no tocante  fora 
 muscular respiratria . exceo da ventilao voluntria mxima mais baixa , no houve 
 comprometimento significante da funo pulmonar em pacientes ambulatoriais 
 com diagnstico de sndrome ps - poliomielite quando comparados a pacientes 
 com sequelas de poliomielite , mas sem a sndrome ps - poliomielite e a 
 sujeitos saudveis . trata - se de um importante achado clnico , pois mostra 
 que pacientes com sndrome ps - poliomielite podem apresentar funo pulmonar 
 preservada . a poliomielite paraltica , uma doena aguda causada pelo poliovrus , faz parte da 
 histria humana h milhares de anos . em meados do sculo xx , aps a implantao 
 de um eficaz programa de vacinao , o nmero de novos casos diminuiu 
 consideravelmente . o poliovrus selvagem foi eliminado do hemisfrio ocidental , 
 e o nmero de novos casos continua a cair no resto do mundo . ( 


 ) 
  alguns dos pacientes com histria de poliomielite referem sintomas 
 neuromusculares de incio tardio e declnio da capacidade funcional . esses 
 sintomas tardios so chamados de sndrome ps - poliomielite ( spp ) . a sndrome  
 caracterizada por nova e maior fraqueza muscular , fadiga , dor muscular , dor nas 
 articulaes , cibras musculares , intolerncia ao frio e problemas 
 pulmonares . ( 


 , 


 ) embora a spp seja uma doena neurolgica comum que afeta grande 
 parte daqueles que se recuperaram da poliomielite paraltica , as causas da spp 
 ainda no esto claras . a hiptese mais amplamente aceita , proposta por wiechers 
 e hubbell , ( 


 ) atribui os sintomas a uma degenerao distal dos axnios 
 provenientes das unidades motoras muito aumentadas que se desenvolvem durante a 
 recuperao da poliomielite paraltica aguda . pacientes com spp relatam sintomas respiratrios que incluem dispneia aos 
 esforos e resistncia fsica reduzida . ( 


 - 


 ) problemas respiratrios podem resultar do comprometimento de 
 centros medulares , nervos cranianos ou msculos respiratrios , ou de uma 
 combinao desses problemas . ( 


 ) 
  a organizao mundial da sade estima que haja 20 milhes de sobreviventes da 
 plio , ( 


 ) e novos h relatos de novos casos de poliomielite em alguns pases 
 africanos e asiticos . portanto , o conhecimento da funo pulmonar nesses 
 pacientes  importante na prtica clnica , a fim de fornecer informaes 
 adequadas sobre seu estado funcional . o principal objetivo do presente estudo foi determinar se indivduos com spp 
 podem apresentar alteraes da funo pulmonar . o objetivo secundrio foi 
 comparar a funo pulmonar de pacientes com spp  de pacientes com sequelas de 
 poliomielite paraltica ( sem quaisquer sinais ou sintomas de spp ) e  de 
 controles saudveis . como os pacientes com spp comumente apresentam perda 
 significativa da fora muscular , levantamos a hiptese de que eles tambm 
 apresentariam alteraes drsticas da funo pulmonar . vinte e nove 
 participantes do sexo masculino foram divididos em trs grupos : controle ( n = 
 10 ; mdia de idade : 49,8  2,3 anos ; massa corporal , 88,4  5,0 kg ; estatura : 
 175,4  1,6 cm ) ; poliomielite , composto de pacientes que tiveram poliomielite 
 paraltica , mas no apresentaram spp ( n = 9 ; mdia de idade : 47,9  2,1 anos ; 
 massa corporal : 81,9  5,1 kg ; estatura : 169,0  2,8 cm ) e spp , composto de 
 pacientes com diagnstico de spp ( n = 10 ; mdia de idade : 50,2  2,3 anos ; massa 
 corporal : 71,1  4,5 kg ; estatura : 162,9  2,3 cm ) . a idade , massa corporal e 
 estatura foram expressas em forma de mdia  ep . nos grupos poliomielite e spp , 
 a estatura foi medida com uma fita mtrica flexvel , com os pacientes na posio 
 supina . no houve diferenas significativas entre os grupos ,  exceo de menor 
 massa corporal e estatura no grupo spp em comparao com o grupo controle ( p 
 < 0,05 ) . o diagnstico de spp baseou - se no mtodo de borg , ( 


 ) e todos os pacientes foram diagnosticados pelo mesmo neurologista , 
 com vasta experincia no tratamento de pacientes com spp . os pacientes dos 
 grupos poliomielite e spp foram recrutados dentre aqueles atendidos na clnica 
 de ps - plio do setor de doenas neuromusculares da universidade federal de so 
 paulo , em so paulo ( sp ) . o perfil clnico dos pacientes com sequelas de 
 poliomielite  apresentado na tabela 1 . 
 controles saudveis foram recrutados dentre os membros da comunidade universitria por meio de anncios colocados no site da universidade federal de 
 so paulo , em so paulo ( sp ) , e em jornais locais . todos os indivduos estavam 
 livres de doena , exceto pelos efeitos residuais da poliomielite , e nenhum deles 
 estava recebendo cuidados respiratrios . alm disso , nenhum dos pacientes do 
 grupo poliomielite e apenas um dos pacientes do grupo spp tinha queixas 
 respiratrias . os participantes foram devidamente informados dos riscos e 
 desconfortos associados aos experimentos antes de assinar o termo de 
 consentimento livre e esclarecido para participar do estudo , que foi aprovado 
 pelo comit de tica em pesquisa da universidade federal de so paulo . todos os 
 procedimentos estiveram em conformidade com os princpios da declarao de 
 helsinki . tabela 1 perfil clnico dos pacientes com sequelas de 
 poliomielite.a 
  a funo pulmonar foi avaliada por meio de espirometria e avaliao da fora 
 muscular respiratria . todos os testes de funo pulmonar foram realizados com 
 os indivduos sentados de forma ereta . um tcnico de laboratrio treinado 
 demonstrou cada manobra respiratria a cada indivduo antes do incio do teste .   a espirometria foi realizada com um espirmetro k4b ( cosmed , roma , 
 itlia ) conectado a um computador . nossa interpretao baseou - se nas diretrizes 
 da american thoracic society / european respiratory 
 society . ( 


 ) no dia do teste , os voluntrios no fizeram nenhum exerccio 
 fsico . eles foram instrudos a realizar 3 - 5 manobras expiratrias foradas 
 mximas e tinham permisso para fazer um intervalo de 3 min entre um teste e 
 outro . os desfechos de interesse foram cvf , vef1 , relao 
 vef1/cvf , pfe , fef25 - 75% e ventilao voluntria 
 mxima ( vvm ) , e o maior valor de cada um deles foi usado na anlise de dados . para medir a vvm , os indivduos deveriam respirar o mais profundamente e 
 rapidamente possvel durante 12 s. os valores do volume respiratrio foram ento 
 extrapolados para 1 min . todos os volumes foram corrigidos para temperatura 
 corporal , presso ambiente e saturao com vapor de gua . as variveis 
 espiromtricas foram comparadas a valores de referncia para a populao 
 brasileira . ( 


 , 


 ) 
  a fora muscular respiratria foi avaliada por meio da medio da pimx e pemx 
 com um manovacumetro ( gerar , so paulo , brasil ) , com resoluo de 1 
 cmh2o e capacidade de 300 cmh2o . uma pequena abertura 
 ( < 2 mm ) prxima do bocal foi usada a fim de diminuir a presso na boca e 
 evitar que os pacientes usassem suas bochechas para gerar presso .   para a medio da pimx , os participantes esvaziaram seus pulmes soprando o mais 
 forte possvel e expirando tanto ar quanto possvel at o vr e em seguida 
 inspiraram at a cpt . para a 
 medio da pemx , solicitamos aos participantes que enchessem seus pulmes de 
 ar , tanto quanto possvel , at a cpt e ento expirassem rapidamente . as medies 
 foram repetidas com intervalos de 1 min entre os testes . os valores obtidos foram expressos em 
 cmh2o e comparados a valores de referncia para a populao 
 brasileira . ( 


 ) 
  no tocante  anlise estatstica , a distribuio normal e a homogeneidade de 
 varincia foram determinadas por meio do teste de kolmogorov - smirnov e do teste 
 de levene , respectivamente . os valores obtidos nos testes de funo pulmonar 
 foram convertidos em percentagens dos valores previstos . para isso , os valores 
 de referncia para cvf , vef1 , relao vef1/cvf , pfe e 
 fef25 - 75% basearam - se naqueles usados por pereira et al . para a 
 populao brasileira , ( 


 ) ao passo que os valores de referncia para vvm , pimx e pemx 
 basearam - se em valores usados por neder et al . ( 


 ) 
  os grupos poliomielite e spp foram comparados quanto  idade de incio da 
 poliomielite aguda e ao nmero de anos de estabilidade funcional por meio do 
 teste t de student para amostras no pareadas . outro teste t de student para 
 amostras no pareadas foi realizado para comparar os valores obtidos e previstos 
 para as seguintes variveis respiratrias : cvf , vef1 , relao 
 vef1/cvf , pfe , fef25 - 75% , vvm , pimx e pemx . em 
 seguida , a anova com um fator foi realizada a fim de detectar diferenas entre 
 os grupos quanto a variveis respiratrias . quando se obteve um efeito 
 significativo , o teste post hoc de tukey foi realizado a fim de detectar 
 diferenas entre as mdias . os dados so apresentados em forma de mdia  ep . o 
 nvel de significncia foi fixado em 0,05 para todos os procedimentos 
 estatsticos . no foram observadas diferenas significativas entre os grupos poliomielite e spp 
 no tocante  idade de incio da poliomielite aguda ou ao nmero de anos de 
 estabilidade funcional ( tabela 1 ) . os 
 resultados da avaliao espiromtrica so apresentados na tabela 2 . no foram observadas diferenas significativas 
 entre os grupos ,  exceo da vvm , cuja mdia no grupo spp foi aproximadamente 
 27% mais baixa que no grupo controle ( p = 0,0127 ) . no entanto , os valores de vvm 
 obtidos no grupo spp foram comparados queles da populao brasileira e 
 revelaram - se normais . no tocante  fora muscular respiratria , no foram 
 observadas diferenas significativas entre os grupos ( tabela 3 ) . tabela 2 avaliao espiromtrica em controles e pacientes com sequelas de 
 poliomielite.a 
 
 tabela 3 fora muscular respiratria em controles e pacientes com 
 sequelas de poliomielite.a aps a implantao de um efetivo programa de vacinao em todo o mundo , a 
 poliomielite paraltica foi praticamente esquecida pela comunidade mdica . no 
 entanto , milhes de sobreviventes da plio ainda precisam de cuidados especiais 
 e assistncia clnica . os sobreviventes tm se queixado de novos sinais e 
 sintomas , que , juntos , so chamados de spp . como as grandes epidemias de 
 poliomielite ocorreram na dcada de 1950 em muitos pases ocidentais e na dcada 
 de 1980 em pases latino - americanos , e considerando que as alteraes 
 neurolgicas de incio tardio geralmente no aparecem at 30 - 50 anos aps a 
 infeco , milhes de sobreviventes da plio no haviam experimentado problemas 
 relacionados s sequelas da poliomielite at o final da dcada de 1970 e o 
 incio da dcada de 1980 . as pessoas que apresentam esses sintomas esto agora 
 recebendo a ateno da comunidade mdica em vrias partes do mundo . na verdade , 
 como resultado de uma iniciativa liderada por profissionais da universidade 
 federal de so paulo , a spp foi includa na classificao internacional de 
 doenas . alm disso , h relatos de novos casos de plio em alguns pases 
 africanos e asiticos . portanto , estudos que investigam o perfil clnico da spp 
 so importantes para elucidar os mecanismos patolgicos e o impacto clnico 
 dessa doena neuromuscular . no presente estudo , foi investigada a funo pulmonar de pacientes com sequelas 
 de poliomielite paraltica com e sem spp . nossos resultados mostraram que no 
 houve diferenas significativas entre os grupos ( controle , poliomielite e spp ) . at onde sabemos , este  o primeiro estudo a investigar a funo pulmonar de 
 pacientes com poliomielite paraltica , divididos em grupos de pacientes com spp 
 ( o grupo spp ) e sem spp ( o grupo poliomielite ) . anteriormente , muitos dos 
 estudos que investigaram a funo pulmonar de pacientes com sequelas de 
 poliomielite ( 


 , 


 - 


 ) e outras doenas neuromusculares ( 


 ) foram controversos por causa das diferenas entre os pacientes no 
 tocante a suas caractersticas , que geralmente dependem do grau de 
 comprometimento , da origem dos pacientes ( pacientes ambulatoriais apresentam 
 menor progresso da doena ) , do gnero e da presena de queixas respiratrias . nossos resultados no mostraram comprometimento da funo pulmonar causado por 
 sequelas tardias da poliomielite paraltica . eles vo de encontro aos de estudos 
 anteriores que avaliaram a funo respiratria nos mesmos tipos de 
 pacientes . ( 


 , 


 , 


 ) no entanto , esses estudos avaliaram pacientes com histria de 
 poliomielite e problemas respiratrios , nos quais a funo pulmonar revelou - se 
 significativamente pior . em nosso estudo , nenhum dos pacientes do grupo 
 poliomielite tinha quaisquer queixas respiratrias e apenas um dos pacientes do 
 grupo spp queixava - se de dispneia aos esforos . sabe - se que a vvm depende parcialmente da fora e resistncia muscular 
 respiratria . ( 


 ) relataram o caso de uma paciente com vvm reduzida associada a baixa 
 pimx . em nosso estudo , a vvm foi significativamente menor no grupo spp que no 
 grupo controle . no entanto , os valores de vvm encontrados no grupo spp 
 revelaram - se normais ao serem comparados queles da populao brasileira . no 
 foram encontradas diferenas significativas entre os grupos no tocante  fora 
 muscular respiratria ( avaliada por meio da pimx e pemx ) . isso pode explicar 
 por que os valores de vvm em nosso estudo no foram significativamente 
 diferentes dos valores de referncia para a populao brasileira . em geral , a funo pulmonar no foi afetada nos pacientes com sequelas de 
 poliomielite investigados em nosso estudo , um achado que vai de encontro aos de 
 um estudo anterior . ( 


 ) naquele estudo , o comprometimento da funo pulmonar foi associado 
 a hospitalizao , necessidade de ventilao mecnica durante a fase aguda da 
 doena , idade de aquisio da doena ( 10 anos ou mais ) , presena de 
 quadriparesia e tempo de exposio  doena . em nosso estudo , apenas um dos 
 indivduos do grupo spp e dois dos indivduos do grupo poliomielite necessitaram 
 de hospitalizao e suporte respiratrio . alm disso , nenhum dos indivduos 
 afetados tivera poliomielite com mais de 10 anos de idade ( a mdia de idade de 
 aquisio da doena foi 1,6 no grupo poliomielite e 1,5 anos no grupo spp ) , e 
 apenas dois dos indivduos do grupo poliomielite e trs dos do grupo spp 
 apresentavam quadriparesia .   relatou - se forte correlao entre comprometimento da funo pulmonar e 
 dispneia . ( 


 ) em nosso estudo , nenhum dos pacientes do grupo poliomielite e um 
 dos pacientes do grupo spp queixou - se de dispneia aos esforos , sem nenhuma 
 outra queixa respiratria . em concluso ,  exceo da vvm menor , no houve diferenas significativas entre 
 os pacientes com spp e aqueles com poliomielite ou entre os pacientes com spp e 
 controles saudveis no tocante  funo pulmonar . trata - se de um importante 
 achado clnico , pois mostra que pacientes com spp podem apresentar funo 
 pulmonar preservada .
objective : to compare lung function between patients with post - poliomyelitis syndrome 
 and those with sequelae of paralytic poliomyelitis ( without any signs or 
 symptoms of post - poliomyelitis syndrome ) , as well as between patients with 
 post - poliomyelitis syndrome and healthy controls . 
 methods : twenty - nine male participants were assigned to one of three groups : control ; 
 poliomyelitis ( comprising patients who had had paralytic poliomyelitis but 
 had not developed post - poliomyelitis syndrome ) ; and post - poliomyelitis 
 syndrome . 
 volunteers underwent lung function measurements ( spirometry and 
 respiratory muscle strength assessment ) . 
 results : the results of the spirometric assessment revealed no significant 
 differences among the groups except for an approximately 27% lower mean 
 maximal voluntary ventilation in the post - poliomyelitis syndrome group when 
 compared with the control group ( p = 0.0127 ) . nevertheless , the maximal 
 voluntary ventilation values for the post - poliomyelitis group were compared 
 with those for the brazilian population and were found to be normal . 
 no 
 significant differences were observed in respiratory muscle strength among 
 the groups . 
 conclusions : with the exception of lower maximal voluntary ventilation , there was no 
 significant lung function impairment in outpatients diagnosed with 
 post - poliomyelitis syndrome when compared with healthy subjects and with 
 patients with sequelae of poliomyelitis without post - poliomyelitis syndrome . 
 this is an important clinical finding because it shows that patients with 
 post - poliomyelitis syndrome can have preserved lung function .