Acute poliomyelitis is a viral disease that may cause paralysis due to an attack on the motor nerve cells in the spinal cord. Three immunologically distinct types of poliovirus have been identified, and infection by one type will not confer immunity against potential future infections by the other two types. Successful inoculation with either the oral poliovirus vaccine (Sabin) or …

Physical therapy (PT) can provide a comprehensive evaluation against which future problems might be measured; help with managing pain or decline in physical function; evaluate for new bracing and assistive devices or use of existing devices; or educate in lifestyle modification. A comprehensive evaluation that may take up to a few hours should be performed. It includes an interview to …

Personal assistance is defined as one person assisting another with tasks an individual would ordinarily do if he or she did not have a disability. Defined more as a human service than a medical service, tasks include dressing, bathing, feeding, trach care, and catheter care; getting in and out of bed or a wheelchair; household responsibilities, including shopping, cooking, and …

Pathology is the study of abnormal biological structure (anatomy) and abnormal function (physiology) that results from disease. Post-polio syndrome is theorized to result from pathologic changes in motor nerves and muscles from the acute paralytic poliomyelitis infection (see Poliomyelitis, Acute). After the poliovirus invades the central nervous system, it can damage or destroy anterior horn cells. During the recovery phase …

Pain can be due to any number of factors ranging from very benign to quite serious. Polio survivors who are experiencing pain should undergo a comprehensive medical evaluation to diagnose its cause. Pain is most often due to overuse of muscles, tendons, ligaments, and/or joints, and primary interventions are directed at alleviating or eliminating the overuse factors.  Pain syndromes associated …

Pacing, the very simple act of interspersing intervals of activity with intervals of rest to avoid excessive fatigue, can be very beneficial to post-polio individuals. Pacing not only minimizes the sense of muscle fatigue, but also, by objective measures, reduces local muscle fatigue and improves recovery of muscle strength (Agre et al., 1998). To date, appropriate rest and pacing of …

Oxygen therapy should never be administered alone in the presence of elevated carbon dioxide (PaCO2) levels in the arterial blood, known as hypercapnia. Oxygen, even with as little as 2 L (liters) per minute, may cause a sudden and rapid rise in PaCO2. This may blunt respiratory drive and produce profound apnea with severe sleepiness, especially when oxygen is administered …

In polio survivors there are two types of osteoporosis to be aware of—localized osteoporosis (in the bones of the area that was affected by polio) and generalized osteoporosis potentially affecting many bones of the body. The majority of bone mineralization happens before 30 years of age. Bone formation is stimulated by growth, muscle pull on the bone, and weight-bearing/resistance exercise. …

Orthotics is the use of braces (called calipers in parts of the world with British influence) and splints (orthoses) to biomechanically assist in supporting and stabilizing parts of the body affected by paralyzed and/or weak muscles (Bunch, 1985). Orthotics, grouped by a description of the area in which they provide support, are usually divided into three categories: lower extremity, upper …

The goals of surgery following acute poliomyelitis were to correct deformities, stabilize joints, and improve function. Surgery was recommended only when other treatments, such as muscle re-education, stretching of contractures, splinting, and bracing failed (Nursing, 1948). The same is essentially true today, with the exception that surgery for the lower extremity rarely eliminates bracing, although it may increase bracing options …