Submit Manuscript | http://medcraveonline.com Introduction Post-Polio Syndrome (PPS) is a disorder of the nervous system that can break out in individuals who have suffered from polio. 1–4 Symptoms include reacquired muscle weakness, fatigue, and muscle and joint pain, which may result in impaired functionality. 5 Pain is one of the most frequent occurrences in PPS, being reported by up to 86% of patients. 6 Its origin is predominantly related to impaired body mechanics, caused by either musculoskeletal overuse or disuse. 6 To help diagnosis, PPS was divided into three categories: type I pain is post-polio pain, which occurs only in the muscles affected by it; type II pain includes injuries to tissues, muscles, tendons, bursae and ligaments; type III pain, or biomechanical pain, occurs due to joint degeneration. 7 Energy preservation is of paramount importance in the treatment of PPS and Guidelines for Rehabilitation of People with PPS syndrome and co-morbidities advocate managing pain through physical rehabilitation, lifestyle changes and drug treatment. 8 Physical rehabilitation helps in the improvement of body mechanics, in gait adjustments, and in muscle and joint overload relief. 7,8 Lifestyle changes include daily routine changes, home and workplace adaptations, weight control and compliance with pain- relief domestic guidelines, such as limbering, heat applications, self- massage and rest. 7–8 Drug treatment is essential for pain control in PPS and, to date, benzodiazepine-class muscle relaxants are the most effcient drugs. 7,11 Several drugs have been evaluated in the treatment of PPS pain, including prednisone, amantadine, and intravenous immunoglobulin, but none of them have shown entirely satisfactory results. 12–14 Piracetam is a nootropic agent, distinguished by increasing neuron effciency, restoring the functioning of cortical cells and activating cognitive functions 15 and L-Carnitine is a quaternary ammonium compound, which facilitates the intramitochondrial transportation of fat in type 1 muscle fber, generating energy for the functioning of muscles. 16,17 Considering that pain in PPS is associated with musculoskeletal activity (overuse or disuse), it is assumed that supplementation with a fxed-dose combination of L-Carnitine + Piracetam improves energy performance of muscles and, hence, reduces pain. Objectives To analyze the therapeutic effect of a fxed-dose combination of L-Carnitine + Piracetam in the pain of patients with PPS. Method This was a randomized, double-blind, placebo-controlled clinical trial that compared the use of a fxed-dose combination of L-Carnitine + Piracetam to placebo, as an adjuvant therapy in the treatment of pain in patients with PPS. It was approved by the Comitê de Ética e Pesquisa – CET (Ethics and Research Committee) of the Universidade Federal de São Paulo-UNIFESP/EPM (Federal University of São Int Phys Med Rehab J. 2020;5(6):233‒236. 233 ©2020 Campos et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and build upon your work non-commercially. Assessment of a fxed-dose combination of l-carnitine + piracetam in the treatment of pain in post-poliomyelitis syndrome Volume 5 Issue 6 - 2020 Katia Maria de Campos, 1 Abrahão Augusto Juviniano Quadros, 1 Marcio Falci, 2 Acary Souza Bulle Oliveira 1 1 Department of Neurology and Neurosurgery, Research Section of Neuromuscular Diseases, Federal University of São Paulo, Paulista Medical School (UNIFESP/EPM), Brasil 2 Advisor to the Scientifc Chair of Biolab Sanus Farmaceutica Ltda, Brasil Correspondence: Katia Maria de Campos, Department of Neurology and Neurosurgery, Research Section of Neuromuscular Diseases, Federal University of São Paulo, Paulista Medical School (UNIFESP/EPM), Rua Josefna Arnoni, 115 apto. 161 bl.3 São Paulo/SP, Brazil, CEP -02374-050, Tel 5511 999319115, Email Received: October 14, 2020 | Published: November 09, 2020 Abstract Introduction: Pain is one of the most frequent symptoms of Post Poliomyelitis Syndrome (PPS) and its treatment also includes medication. The no otropic agent Piracetam enhances neuronal effectiveness and the compound L-Carnitine generates muscle energy. Considering that pain in PPS is related to muscle overuse or disuse, it is assumed that supplementation with a fxed-dose combination of L-Carnitine + Piracetam improves muscle performance, reducing pain. Objective: To analyze the effect of a fxed-dose combination of L-Carnitine + Piracetam on pain in PPS patients. Method: A randomized, double-blind clinical trial, has compared the use of a fxed-dose combination of L-Carnitine + Piracetam to placebo, in the treatment of pain in 94 patients at the PPSambulatory care center of UNIFESP. Results: Both groups reported a reduction inpain, however, only the active group improved functional performance after using the medication. Conclusion: the use of a fxed-dose combination of L-Carnitine + Piracetam is effcient in the treatment of pain in PPS patients. Keywords: drug treatment, L-carnitine, pain, piracetam, post poliomyelitis syndrome, rehabilitation International Physical Medicine & Rehabilitation Journal Research Article Open Access