Post-Polio

Question 1

What is the etiology of post-polio syndrome?

Answer 1

new muscular symptoms that occur decades after the primary polio infection

Question 2

Who is more likely to develop PPS? (women or men)

Answer 2

women

Question 3

who is at more risk of developing PPS?

Answer 3

those who had a more serious disease course of polio

Question 4

What is the typical age of patients with PPS?

Answer 4

70s+

Question 5

What is the pathophysiology of PPS?

Answer 5

-after a polio infection, axons go through collateral sprouting to regain functional abilities
-instead of innervating 3000 muscle fibers now a single axon will innervate 5000 muscle fibers
-eventually the axon cannot handle the increased stress/load and denervation occurs

Question 6

What are the symptoms of PPS?

Answer 6

-muscle weakness
-muscle atrophy
-fatigue
-muscle/joint pain
-weakness can also affect axial muscles and therefore impair breathing
*weakness is worse with cold and increased physical activity
*weakness progresses slowly over time

Question 7

How do you diagnose PPS?

Answer 7

-EMG
-Muscle biopsy
-rule out other neurologic disorders

Question 8

What is the medical management of PPS?

Answer 8

-fatigue management
-non-pharmacological pain management
-tendon transfer surgeries for impaired foot posture

Question 9

What is the PT exam/eval for PPS?

Answer 9

-LMU signs
-strength
-functional ability
-rule out UMN signs
-fatigue/endurance levels
-pain scales
-gait
-balance

Question 10

What is the PT treatment for PPS?

Answer 10

-cautious with exercise and conventional strengthening
-lifestyle modifications
-compensation
-energy conservation
-never exercise to fatigue
-only do non-exhaustive exercise
-may have joint deformities from uneven strain of musculature on the joint