Objective: To evaluate changes over time in a clinically based cohort of individuals with post-polio syndrome. Design: A prospective longitudinal study. Subjects: A total of 106 individuals with poliomyelitis sequelae were included in the study. They were self-referred or had been referred to the post-polio clinic. After 4 years subjects were called for a follow-up and underwent the same measurements as at the initial assessment. Methods: The following measurements were conducted at both the

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... tial assessment, and the follow-up: questionnaires including Nottingham Health Profile, muscle strength and walking speed. Results: Minor changes in disability during a 4-year period were shown. A significant reduction in muscle strength was only seen for 60° flexion in the left leg and for right and left dorsal flexion. No change could be seen in the total Nottingham Health Profile score. Conclusion: The minor changes in disability found in this study are an indication that we still do not know which subjects are at risk for deterioration. It is difficult to say whether the small changes over time shown in this study are associated with support from the polio clinic or are an expression of the natural history of the syndrome. However, it is hoped that support from the polio clinic may result in self-selected lifestyle changes, which may positively influence the development of symptoms and functional capacity.