Polio Flashcards

1
Q

Polio is a viral infection that attacks what? What does this lead to?

A

anterior horn cells of the brainstem and spinal cord that leads to muscular paralysis

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2
Q

25% of people with polio will have _____________ symptoms. How long do these symptoms last?

A

flu-like symptoms
- sore throat
- fever
- tiredness
- nausea
- headache
- stomach pain

Symptoms usually last 2-5 days then go away on their own

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3
Q

Hallmark symptoms of polio

A

LMN symptoms
- muscle spasms persisted days to weeks that limits ROM due to pain and contributes to mobility issues
- imbalance issues
- contractures

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4
Q

S&S of polio

A
  • meningitis and encephalitis
  • ASYMMETRICAL paralysis/weakness in extremities (fasciculations, atrophy, decreased, DTRs)
  • bulbar and respiratory involvement
  • sensory system spared
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5
Q

What is spared with Polio? What does this allow to happen?

A
  • sensory system spared
  • allows for functional control of bowel/bladder and sexual function
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6
Q

characteristics of post-polio syndrome

A

acute onset of weakness, atrophy, and other signs and symptoms

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7
Q

etiology of post-polio syndrome

A
  • 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
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8
Q

risk factors for post-polio syndrome

A
    • 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
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9
Q

How is post-polio syndrome diagnosed?

A

diagnosis of exclusion
- based primarily on symptoms and exclusion of any other neuromuscular diagnosis

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10
Q

diagnostic criteria for post-polio syndrome?

A

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

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11
Q

What is a stepwise progression?

A

periods of relative stability with interspersed periods of decline

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12
Q

characteristics of post-polio syndrome

A
  • gradual new weakening in muscles that were previously affected by the polio infection
  • slow progression, either steady or stepwise
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13
Q

S&S of post-polio symptoms

A
  • progressive weakness, atrophy
  • fatigue
  • pain
  • cold intolerance
  • sleep disorders
  • dysphonia or dysphagia
  • respiratory deficiency
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14
Q

characteristics of fatigue with post-polio

A
  • typically occurs at same time each day
  • can be accompanied by signs of autonomic distress (sweating or headaches)
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15
Q

characteristics of pain with post-polio

A
  • myalgia
  • cramping
  • joint pain with repetitive injury
  • hypersensitivities
  • joint deformities (scoliosis)
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16
Q

What causes cold intolerance with post-polio syndrome?

A

result of sympathetic nervous system involvement (bulbar)

17
Q

common secondary complications of post-polio

A
  • falls
  • malnutrition and dehydration
  • pneumonia
  • chronic respiratory failure
  • osteoporosis
18
Q

What medications are effective for post-polio?

A

No medications shown to treat symptoms

19
Q

prognosis of post-polio

A
  • 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
20
Q

strengthening considerations with post-polio

A
  • carefully prescribed conditions to avoid overworking or fatiguing muscles
  • patients must be WELL-EDUCATED to avoid pain and fatigue
21
Q

How to tell if a patient has overdone it with strengthening?

A

if it takes several days to regain strength

22
Q

What intensity should be done with post-polio strengthening?

A

sub-max intensity w/ short duration exercise every other day is helpful to increase QoL

23
Q

exercise guidelines for clinically stable post-polio

A

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

24
Q

What type of exercises are good for clinically stable post-polio?

A
  • aquatic therapy
  • bike
  • walking
  • seated UE aerobics
25
Q

exercise guidelines for clinically unstable post-polio

A
  • prevent further weakness or improve the status of limb function by energy conservation strategies
  • exercises generally contraindicated until rest and see stabilization or improvement
  • non-fatiguing exercise program may be carefully performed
26
Q

stretching considerations for post-polio

A
  • stretching overworked muscles not indicated as it may increase joint instability
  • any increase ROM must be supported by adequate muscle strength (may not be possible with this population)
  • gently stretching to combat pain or screaming from occasional overuse
27
Q

How to address cramping pain?

A

gentle stretching after application of heat

28
Q

How to address MSK pain?

A
  • due to overuse - tendonitis, bursitis, muscle strains, myofascial pain
  • anti-inflammatory medications
29
Q

How to address biomechanical pain?

A
  • degenerative joint pain, low back pain, nerve compression
  • posture education
  • AD and orthotics