Original research
Performance and Self-reported Functioning of People With Chronic Idiopathic Axonal Polyneuropathy: A 4-Year Follow-up Study

https://doi.org/10.1016/j.apmr.2020.06.017Get rights and content

Abstract

Objective

To describe the course of performance of activities (observed and self-reported) of people with chronic idiopathic axonal polyneuropathy (CIAP) over 4 years and to assess the associations with muscle strength, sensory function, and psychological personal factors (intention, perceived behavior control [PBC], and feelings of depression or anxiety).

Design

Prospective observational study with measurement at baseline, 6 months, 1 year, and 4 years.

Setting

Outpatient neurology clinic.

Participants

People with CIAP (N=92).

Main Outcome Measures

Walking was measured using the shuttle-walk test (SWT), a pedometer (mean step count/d), and the “physical functioning” subscale of the Short Form-36 questionnaire. Muscle strength and sensory function were measured using a MicroFET handheld dynamometer and the Sensory Modality Sum score. Personal factors were assessed with the Hospital Anxiety and Depression Scale, and intention and PBC were assessed with a protocolized questionnaire.

Results

Multilevel model analysis showed a significant decrease over time in mean scores in performance of activities (SWT, step count), which was associated with older age and loss of muscle strength (SWT: β=73.392, step count: β=676.279, P<.001). Limitations in self-reported functioning (physical functioning) significantly increased and were associated with older age (β=−0.916, P=.001), increased comorbidity (β=−6.978, P=.024), loss of muscle strength (β=7.074, P<.001), low PBC (β=0.744, P<.001), and increased feelings of depression (β=1.481, P<.001).

Conclusions

Performance of activities of people with CIAP decreased over time (SWT, step count, physical functioning). Older age, loss of muscle strength, comorbidity, feelings of depression, and low perceived behavior control were associated with this decrease. However, there were considerable individual differences.

Section snippets

Participants

A total of 92 persons formally diagnosed as having CIAP who visited the outpatient clinic were invited to participate in this prospective longitudinal observational study. Recruitment started in 2006 and data collection ended in 2013.

Procedure

Participants were examined at the outpatient clinic at 4 time points: baseline (T0), a half year after T0 (T1), 1 year after T0 (T3), and 4 years after T0 (T4). One week before the visit, questionnaires were sent to the participant to be completed by them at home

Participant characteristics

At T0 (baseline) we included 92 participants with CIAP; 85 participated at T1 (6mo after T0), 78 participated at T2 (1y after T0), and 65 completed all measurements at T3 (4y after T0) (table 1). A total of 27 participants (29.3%) dropped out of the study. Dropouts were because of increased comorbidity (n=7), a testimony of not willing to continue participation (n=10) and unknown reason (n=9), and 1 person died. A comparison between those who completed the study and those who dropped out showed

Discussion

This group of 92 people with CIAP revealed a gradual decline of muscle and sensory function and of performance of activities over 4 years, with a large initial interindividual variation that remained during the entire follow-up period. Previous research in people with CIAP already demonstrated a rather corresponding slow deterioration in sensory and motor function over time.6,7,11 In patients with CIAP the deterioration in performance of activities on both performance measures (SWT and step

Conclusions

Overall, we found a decrease in performance of activities over time, more than what could be related to aging only, and interindividual differences in our group of participants with CIAP.

Suppliers

  • a.

    MicroFET handheld dynamometer; Hoggan Health Industries Inc.

  • b.

    Jamar dynamometer; Therapeutic Equipment Co.

  • c.

    DigiWalker Step Counter; Lifestyles Inc.

  • d.

    SPSS version 20; IBM.

  • e.

    MLwiN version 2.021; Centre for Multilevel Modelling of the Institute of Education in London.

Acknowledgments

We thank Claire Huisman, BSc for her help editing the manuscript, her translations, and proofreading.

References (47)

  • E. Tak et al.

    Prevention of onset and progression of basic ADL disability by physical activity in community dwelling older adults: a meta-analysis

    Ageing Res Rev

    (2013)
  • F.R. van Genderen et al.

    Determinants of participation in patients with severe haemophilia

    Haemophilia

    (2012)
  • N.A. Visser et al.

    Incidence of polyneuropathy in Utrecht, the Netherlands

    Neurology

    (2015)
  • N.C. Notermans et al.

    Chronic idiopathic polyneuropathy presenting in middle or old age: a clinical and electrophysiological study of 75 patients

    J Neurol Neurosurg Psychiatry

    (1993)
  • G. Wolfe et al.

    Chronic cryptogenic sensory polyneuropathy: clinical and laboratory characteristics

    Arch Neurol

    (1999)
  • N.A. Visser et al.

    Chronic idiopathic axonal polyneuropathy and vitamin B6: a controlled population-based study

    J Peripher Nerv Syst

    (2014)
  • L.L. Teunissen et al.

    Quality of life in patients with axonal polyneuropathy

    J Neurol

    (2000)
  • P. Zis et al.

    Chronic idiopathic axonal polyneuropathy: a systematic review

    J Neurol

    (2016)
  • N. Notermans et al.

    Chronic idiopathic axonal polyneuropathy: a five year follow up

    J Neurol Neurosurg Psychiatry

    (1994)
  • S. Sachedina et al.

    Progression in idiopathic, diabetic, paraproteinemic, alcoholic, and B12 deficiency neuropathy

    J Peripher Nerv Syst

    (2013)
  • M. Johnston et al.

    Developing an integrated biomedical and behavioural theory of functioning and disability: adding models of behaviour to the ICF framework

    Health Psychol Rev

    (2014)
  • The international classification of functioning, disability and health: ICF

    (2001)
  • P.G. Erdmann et al.

    Functioning of patients with chronic idiopathic axonal polyneuropathy (CIAP)

    J Neurol

    (2007)
  • Cited by (2)

    van Meeteren and Schröder contributed equally to this work.

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