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PT Rehab II > Post-Polio Syndrome > Flashcards

Post-Polio Syndrome Flashcards

1
Q

What causes Poliomyelitis

A

Poliovirus

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2
Q

True or False; Poliomyelitis can only cause permanent paralysis.

A

False; it can cause temporary or permanent paralysis

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3
Q

Exposure to polio was through the:

A

GI Tract

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4
Q

True or False; you can get post-polio syndrome after inapparent infection

A

True

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5
Q

The period of recovery lasts for how long?

A

Weeks to years

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6
Q

Recovery can be complicated by:

A

Developmental growth and reconstructive surgery

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7
Q

How long does neurological stability last?

A

> 15 years

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8
Q

How many patients with post-polio syndrome experience fatigue, new muscle weakness, and loss of functional abilities?

A

25-40%

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9
Q

What is the universal criteria for post-polio syndrome?

A

History of Polio

Period of partial or complete functional recovery followed by relative stability lasting at least 15 years

Development of new neurologic weakness and abnormal fatigue, with or without other symptoms

Symptoms persist for at least 1 year

Exclusion of other neurologic, medical, or orthopedic problems as reasons for the symptoms

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10
Q

What types of cells does the Poliovirus destroy?

A

Anterior horn cells

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11
Q

Not destroyed anterior horn cells __________ some of the orphaned fibers

A

Reinnervate

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12
Q

What is the order of the proposed etiology of poliovirus?

A

Orphaned cells are reinnervated by anterior horn cells that were not affected. The branching and cutting back of neural processes is the basis of recovery. Stress and overuse of the enlarged motor units lead to distal degeneration of axons and new weakness. Body response is compounded by age-related changes that typically occur in the nervous system.

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13
Q

What are the clinical features of post-polio syndrome?

A

Fatigue

New Weakness

Pain

Cold Intolerance

Decreased Function

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14
Q

What are some hallmark signs of fatigue?

A

Tiredness, exhaustion

Ability to concentrate is affected

Mental fatigue may impact psychosocial function and lead to decreased quality of life

“Hitting a wall”

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15
Q

What is the cause of fatigue for patients with PPS?

A

Defects in neuromuscular transmission caused by the degeneration of the distal motor unit

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16
Q

Where does new weakness occur?

A

In muscles already involved and muscles that did not clinically show any effects of the original polio infection

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17
Q

True or false; the new weakness is symmetric, usually distal and rapidly progressive in nature.

A

False; the weakness is asymmetric, usually distal and slowly progressive in nature

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18
Q

True or false; overuse has been associated with the new muscle weakness

A

True

19
Q

What type of assistive device should be considered?

A

Wheelchair

20
Q

What can increased muscle weakness may lead to?

A

Impaired balance which can lead to greater risk for falls

21
Q

Is pain from the polio disease itself?

A

No, but it most likely manifests from the impairments, microtrauma, poor posture, etc.

22
Q

How does pain manifest itself?

A

Due to overuse of muscles and increased ligamentous stress secondary to weakness

23
Q

Patients with muscle pain will exhibit:

A

Higher levels of fatigue, lower QOL, poor physical function and greater depression

24
Q

What are clinical features of post-polio syndrome?

A

Joints can be come unstable when muscles are weak or when excessive daily physical activity overstresses these muscles and their surrounding soft tissues

Mobility is often reduced in the presence of joint or muscle pain, which then leads to muscular atrophy

25
Q

What system is involved with cold intolerance?

A

Sympathetic involvement

26
Q

True or False; If the person has difficulty with edema, heat is a modality of choice.

A

False, heat is not a modality of choice

27
Q

Decreased function is caused by

A

Fatigue, pain, and weakness

28
Q

What is a common complaint of decreased function?

A

Shortness of breath

29
Q

True or False; People with post polio syndrome have a greater chance for having OA than the general population.

A

True

30
Q

What is wrong with medications for fatigue (high doses of prednisone and amantadine)?

A

They have not been proven effective

31
Q

What are the goals for physical therapy management for post-polio syndrome?

A

Ambulate safely

Achieve optimal functional independence

Avoid fatigue

Avoid muscular overuse

Educate the patient and family

32
Q

“The extreme exercises and therapies that helped polio survivors to appear normal set the stage for PPS and are the opposite of what [they] need to do today to manage PPS”

A

“The extreme exercises and therapies that helped polio survivors to appear normal set the stage for PPS and are the opposite of what [they] need to do today to manage PPS”

33
Q

Why is important to keep exercise programs individualized for those with post-polio syndrome?

A

Everyone has different muscles that are affected.

34
Q

What three outcome measures should be monitored with physical activity/exercise?

A

HR, BP, and RPE

35
Q

What is the intensity, frequency and duration of non-fatiguing aerobic interval training?

A

Target HR: 60-70% of Max HR; 3x/ week, 15-30 minutes

36
Q

Muscle testing at a 3+ to 4 can be exercised…

A

Cautiously

37
Q

Muscle testing at a 4+ to 5 can be exercised…

A

Moderately to vigorously

38
Q

What are some considerations regarding exercise classes?

A

Many will try too hard to keep up with others

Many will do too much at the encouragement of the instructors

39
Q

Why would stretching not be a great idea for someone with PPS?

A

Shortening of muscles and ligaments could be substituted for weak or absent musculature.

Example: mild shortening of the plantar flexion may increase knee stability when there is quadriceps weakness

40
Q

Why would an assistive device be necessary for pain management for patients with PPS?

A

Address fall risk

41
Q

What intervention(s) can be prescribed to provide better biomechanical alignment of the feet and lower extremities?

A

Shoe lifts, AFOs, KAFOs

42
Q

True or False; Orthoses are prescribed to accomplish a complete correction, not just supporting better joint alignment.

A

False; Orthoses are only there for support, it will not fix the entire problem

43
Q

If the patient is able to ambulate 10 days later… would you want to prescribe an electric scooter?

A

No

PT Rehab II (5 decks)

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