Should My Physical Therapy After Surgery be Specialized to My Condition or is Normal Therapy Okay?

Question: In 1988, I was your patient at the University of Michigan when you diagnosed my post-polio syndrome. I am preparing for a complete knee replacement on my right leg, which is the one affected by polio. My question is: Should my physical therapy after surgery be specialized to my condition or will normal therapy be OK? My surgeon has not had any dealings with polio patients. Any information you can supply will be greatly appreciated.

Answer: The important thing about knee replacement in a polio leg is the strength of the quadriceps and hamstring muscles. If they are 4-/5 or less, the artificial knee joint should be protected with bracing in the post-operative period, and sometimes even long term for walking long distances in order to prevent loosening of the artificial knee joint. PT is best done by a therapist who has evaluated you pre-operatively and can then help you post-operatively with both re-mobilization and with exercises. Exercises need to be planned out on an individualized basis based on your pre-operative muscle strength in that leg. Strengthening may need to proceed slowly to avoid overuse damage, but that is usually not an issue in the early period. It is more important later when strengthening is a major goal and is relevant if and when a protective brace can be safely discontinued. You may want to share these thoughts with your surgeon.

Post-Polio Health (Vol. 30, No. 3, Summer 2014)