Post-Polio Syndrome (PPS)

what typically affects those under age 5?

Attack on motor neurons in brainstem/anterior horn: Paralysis, weakness, atrophy, Fatigue, Neck stiffness, Pain

Poliomyelitis

what is the typical recovery from Poliomyelitis?

Some neurons destroyed & some survive

Regain strength through intact neurons sprouting to affected neurons & creating larger motor units (but fewer)

Intact motor fibers can hypertrophy

Can utilize compensatory techniques

What is a new weakening of muscles previously affected by polio OR weakness in muscles not originally thought to be affected by polio?

Degeneration of nerve terminals in motor unit (overworked)

Post-Polio Syndrome (PPS)

What is the prevalence of Post-Polio Syndrome (PPS)?

25-50% of survivors of polio

what is the clinical course of PPS?

At least 15 yrs of stable neuromuscular fnx post-polio onset

Slow, step-wise & unpredictable

what are the clinical features of PPS?

Slowly progressive muscle weakness

Asymmetrical or “patchy” presentation

Abnormal fatigue: Generalized & muscular

Muscle atrophy

Joint/muscle pain/tenderness

what is the medical mgmt for PPS?

No known effective treatments

Pain/fatigue mgmt via medications

Patient education

Psychosocial mgmt

Referral to PT

what are general PT goals/mgmt for PPS?

Lifestyle modification to optimize function: Energy conservation, Use of AD/orthoses

pt educaiton: Avoid overuse & excessive fatigue, Consider exercise on alternating days to allow rest

maintain/improve strength: NONFATIGUING exercise program. Sub-max, short reps w/ rest b/t→ CAREFUL MONITORING. Avoid overuse of weakened muscles

Improve cardiac conditioning