Polio Flashcards
Polio is a viral infection that attacks what? What does this lead to?
anterior horn cells of the brainstem and spinal cord that leads to muscular paralysis
25% of people with polio will have _____________ symptoms. How long do these symptoms last?
flu-like symptoms
- sore throat
- fever
- tiredness
- nausea
- headache
- stomach pain
Symptoms usually last 2-5 days then go away on their own
Hallmark symptoms of polio
LMN symptoms
- muscle spasms persisted days to weeks that limits ROM due to pain and contributes to mobility issues
- imbalance issues
- contractures
S&S of polio
- meningitis and encephalitis
- ASYMMETRICAL paralysis/weakness in extremities (fasciculations, atrophy, decreased, DTRs)
- bulbar and respiratory involvement
- sensory system spared
What is spared with Polio? What does this allow to happen?
- sensory system spared
- allows for functional control of bowel/bladder and sexual function
characteristics of post-polio syndrome
acute onset of weakness, atrophy, and other signs and symptoms
etiology of post-polio syndrome
- PPS causes giant motor neurons to form (axonal sprouting) to compensate for lost neurons
- there is an increased metabolic demand on these giant motor neurons
- then over time these motor neurons are overworked and lose their ability
risk factors for post-polio syndrome
- paralytic poliomyelitis
- older age of onset
- degree of initial recovery (the greater the recovery the more likely to develop PPS)
- greater physical activity in intervening years
How is post-polio syndrome diagnosed?
diagnosis of exclusion
- based primarily on symptoms and exclusion of any other neuromuscular diagnosis
diagnostic criteria for post-polio syndrome?
1) prior paralytic poliomyelitis w/ motor neuron loss
2) period of partial or complete functional recovery after acute polio
3) slowly progressive and persistent new muscle or decreased endurance
4) symptoms that persist for at least a year
What is a stepwise progression?
periods of relative stability with interspersed periods of decline
characteristics of post-polio syndrome
- gradual new weakening in muscles that were previously affected by the polio infection
- slow progression, either steady or stepwise
S&S of post-polio symptoms
- progressive weakness, atrophy
- fatigue
- pain
- cold intolerance
- sleep disorders
- dysphonia or dysphagia
- respiratory deficiency
characteristics of fatigue with post-polio
- typically occurs at same time each day
- can be accompanied by signs of autonomic distress (sweating or headaches)
characteristics of pain with post-polio
- myalgia
- cramping
- joint pain with repetitive injury
- hypersensitivities
- joint deformities (scoliosis)
What causes cold intolerance with post-polio syndrome?
result of sympathetic nervous system involvement (bulbar)
common secondary complications of post-polio
- falls
- malnutrition and dehydration
- pneumonia
- chronic respiratory failure
- osteoporosis
What medications are effective for post-polio?
No medications shown to treat symptoms
prognosis of post-polio
- rare life-threatening but symptoms can significantly interfere with independent function
- weakness can affect swallowing and respiratory which can lead to aspiration/pneumonia and sleep/breathing dysfunction
strengthening considerations with post-polio
- carefully prescribed conditions to avoid overworking or fatiguing muscles
- patients must be WELL-EDUCATED to avoid pain and fatigue
How to tell if a patient has overdone it with strengthening?
if it takes several days to regain strength
What intensity should be done with post-polio strengthening?
sub-max intensity w/ short duration exercise every other day is helpful to increase QoL
exercise guidelines for clinically stable post-polio
With muscles at least 4/5 strength
- 60-70% HRmax
- 3 days/week
- 20-30 min - with pacing and while avoiding fatigue
With muscles 3/5, exercise from normal use of limbs may be sufficient
- implement pacing and avoid fatigue
What type of exercises are good for clinically stable post-polio?
- aquatic therapy
- bike
- walking
- seated UE aerobics
