Muscle stretching and joint range-of-motion exercises are important whenever there is muscle weakness. Muscle/ligament/tendon tightness should be carefully evaluated because sometimes tightness can provide support for joints that otherwise would be unstable. In other circumstances, preventing tightness, where muscles are weak, can be important to maximize function. Preventing or stretching out tightness is particularly important in the chest wall and abdominal musculature if there is a limitation of breathing capacity. Preventing tightness in the hip and knee is important to maintain/maximize walking ability when there is significant weakness of the hip and thigh musculature.
General conditioning exercises or aerobic exercises, specifically to maintain or improve cardiovascular endurance, are good for many polio survivors and have been shown to be effective (Owen & Jones, 1985; Kriz et al., 1992). The best endurance exercise is swimming (see Aquatic Therapy), because it minimizes mechanical stress on tendons and joints, but beneficially stresses the cardiovascular system.
Conditioning exercises or any repetitive activity, including walking, which causes pain or a sense of excessive muscle fatigue and increased weakness should be limited or discontinued. The primary focus of any exercise program should be on building endurance, not strength (Agre et al., 1997; Ernstoff et al., 1996).
In general, muscles that are significantly weakened by previous polio respond poorly to vigorous strengthening exercise programs. Very gradual strengthening exercises which are guided in intensity and duration by the individual’s level of fatigue and/or pain can lead to modest but significant improvements in strength (Agre et al., 1996). Exercise should be focused on functionally important muscles.
An appropriate exercise program will help to maintain the strength of previously involved muscles, and also avoid overloading those muscles which previously were not recognized as having been affected. An adequate exercise program will help to minimize loss in strength and endurance associated with the aging process. Weight-bearing exercise, when possible, can be helpful to prevent or slow the progression of osteoporosis. Balance exercises, if they don’t overuse weakened muscles, can decrease falls and prevent fractures and other injuries. Professional advice may be needed to design a feasible and effective personalized exercise program.
References
Agre, J., Rodriquez, A., Franke, T., Swiggum, E., Harmon, R., & Curt, J. (1996). Low-intensity, alternate-day exercise improves muscle performance without apparent adverse effect in postpolio patients. American Journal of Physical Medicine & Rehabilitation, 75(1), 50-58.
Agre, J., Rodriquez, A., & Franke, T. (1997). Strength, endurance, and work capacity after muscle strengthening exercise in postpolio subjects. Archives of Physical Medicine & Rehabilitation, 78, 681-685.
Ernstoff, B., Wetterqvist, H., Kvist, H., & Grimby, G. (1996). Endurance training effect on individuals with postpoliomyelitis. Archives of Physical Medicine & Rehabilitation, 77, 843-848.
Kriz, J.L., Jones, D.R., Speier, J.L., Canine, J.K., Owen, R.R., & Serfass, R.C. (1992). Cardiorespiratory responses to upper extremity aerobic training by post-polio subjects. Archives of Physical Medicine & Rehabilitation, 73, 49-54.
Owen, R.R., & Jones, D. (1985). Polio residuals clinic: Conditioning exercise program. Orthopedics, 8(7), 882-883.