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Excerpt from the
Handbook on the Late Effects of Poliomyelitis for Physicians and Survivors©


Traumatic injuries, such as fractures, joint dislocations and severe sprains, strains and bruises, commonly require significant periods of immobilization and rest in order to heal. Deconditioning from bedrest or immobilization is a common phenomenon in neurologically intact individuals. Disuse atrophy of polio-affected muscles immobilized by casts and splints occurs rapidly, with rates of 5-10% loss of strength per day, or 10-20% per week. Weakening of other muscles often occurs because of reduced exercise/activity necessitated by the pain and immobilization of the injured body part. For example, people who must use crutches to walk while keeping weight off fractured leg bones, rarely walk their usual daily distances, are not able to perform their typical routines, and thus become deconditioned.

After a period of post-injury weakening and deconditioning, a polio survivor may take much longer to recover strength and conditioning to pre-injury levels. It has been estimated from clinical observations that the recuperation period after surgery, severe illness, or injury is at least three to four times longer. Survivors are vulnerable to additional strain injuries during post-injury periods due to altered activity and/or the post-injury rehabilitation efforts. They also are vulnerable to an increase in fatigue due to deconditioning as a result of weeks of reduced activity. Traumatic injury may make obvious previously asymptomatic respiratory muscle weakness and result in new breathing difficulties.

Therefore, it is not surprising that about one-third of polio survivors report the onset of "profound fatigue" and/or "post-polio decline" during a period after illness, surgery or trauma (Agre et al., 1989; Yarnell, 1998). Minimizing the period of immobilization and anticipating a longer and more carefully prescribed period of rehabilitation and/or recuperation after traumatic injury can be very helpful for, and is often crucial for, a post-polio survivor to make a full recovery to the pre-injury level of function.



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