Post Polio Flashcards
What % of polio is asymptomatic
95%
Polio affects what cells of the spinal cord?
Anterior horn cells
What countries still have wild polio
Afghanistan and Pakistan
Post polio can only happen after a patient has had neurological stability for atleast….
15 years
The onset of typical post polio syndrome happens 30-50 years after polio and is characterized by
New weakness
What is the pattern of weakness in polio
No pattern
For a diagnosis of post polio, a person must have had a history of polio confirmed by:
Spinal tap acutely
Giant motor units with EMG
No pattern to weakness
Motor deficits only
AND
A period of neurological recovery followed by a period of stability lasting at least 15 years
What is the typical compensation used by post polio patients
Use of weak muscles at very high levels of capacity (they will fatigue easy)
Use of ligaments for stability (results in hyper mobility)
For a person to receive a 4/5 on an MMT, it means that how many muscle cells remain
40%-10%.
T or F: the unaffected side in patients with post polio is still weaker than age and gender norms
T
Golden rule of post polio
If anything causes fatigue, pain, or weakness
Don’t do it or do much less of it
Goal for patients with PPS
self management
Increasing pain or numbness at night for PPS patients can indicate
Their mattress is too firm
When would we not want to stretch patients with PPS
If those shortened muscles provide stability
Main treatment for patients with PPS
energy conservation techniques
How should patients with PPS lose weight
Diet, it will be hard for them to do enough exercise to lose weight
When working with patients with PPS. Should we put them on warmup machines?
No, only do exercise for the targeted muscles and nothing else
General rule of MMT/exercise for PPS patients
If muscle is 3/5 and below don’t exercise it
3+ - 4 can be exercised cautiously
4+ can be exercises moderate to vigorously as long as there’s no signs of overuse
What exertion scale is valid to use in PPS patients
Borg
Safe exercises for post polio
Water exercise
Seated
UE bike
Isolated muscles without weights
Self stretching
Modified yoga and tai chi
Potentially unsafe exercises for PPS
riding stationary bike
Walking or jogging, or any stair steppers or ellipticals
Circuit training
Free weights
Aerobic or kickboxing
How should you typically start the exercise dosing for a patient with PPS
50% intensity of non PPS patient with twice as much rest time and go from there
Do essential exercises only
what % of polio pts develop post-polio
20-50%
post polio typically occurs _______ years after polio
30-50 years
What did we historically think is the cause of post-polio?
Increasing metabolic demand from giant motor units
should we assume that a Post-polio pt probably ambulates with an AD if all of their MMTs are 3/5 or under?
No
T or F: we want to use a HHD to strength test post-polio
F, not preferred
power production is very different than endurance and functional use
Pt’s with a 5/5 MMT who have polio likely have what amount of remaining muscle cells?
over 40%
MMT vs muscle cells:
5:
4:
3:
2:
1:
5: over 40%
4: 40-10%
3: 10-8%
2: 3-5%
1: 2-3%
0: 0-2%
Different reasons that pt’s with post-polio can have fatigue:
Muscle overuse
brain fatigue
general fatigue
sleep disturbances
cardiac issues
respiratory issues
medications
______________ is more disturbed for pt’s with post polio than actual strength
continuous repetitive muscle activity
patients with PPS fatigue earlier
What did the Magnet study find about using magnets to reduce pain in PPS patients?
more effective than placebo
Pt with PPS complains to you after therapy of: muscle cramping, muscle twitching
Signs of overuse: do less exercise!
also signs: progressive muscle weakness and atrophy
aquatic exercise considerations for PPS:
Make sure they have energy to exit the pool
Good recommendation for PPS patients for their exercises:
KEEP DAILY LOG of activities and symptoms
For PPS patients, if a muscle is ______ or below in MMT grade, we don’t exercise it!
3/5
