polio

Question 1

what is poiio

Answer 1

Polio is a viral infection which attacks the anterior horn cells of the brainstem and SC  muscular paralysis
Recovery ranged from quick return to baseline, temporary or permanent paralysis, or even death

Question 2

most ppl infected with polio will

Answer 2

not have any visible s/s

Question 3

polio s/s

Answer 3

A smaller proportion of peoplewith poliovirus infectionwill develop other, more serious symptomsthat affect the brain and spinal cord:

Meningitisand encephalitis

Paralysis or weakness in the arms, legs, or both (ASYMMETRICAL)
Fasciculations, atrophy, decreased DTRs

Bulbar and respiratory involvement

SENSORY SPARED

Question 4

polio vax developed

Answer 4

1955

Question 5

PPS is a condition that

Answer 5

affects survivors of polio years after recovery from an initial acute attack of the poliomyelitis virus.
Characterized by acute onset of weakness, atrophy, and a myriad of other signs & symptoms

Question 6

PPS etiology

Answer 6

PPS is thought to be caused by ↑ metabolic demand made by the body by giant motor units
Giant motor units were formed during the original viral infection (axonal sprouting)

yrs of high use -> motr units lose ability to meet work demands

Question 7

risk factors for PPS

Answer 7

+ paralytic poliomyelitis
Older age at onset (initial illness)
Degree of initial recovery
Greater physical activity in intervening years

Question 8

PPS dx

Answer 8

No definitive diagnostic test = DIAGNOSIS OF EXCLUSION

Question 9

PPS dx criteria

Answer 9

prior paralytic poliomyelitis w/ motor neuron loss
A period of partial or complete functional recovery
Slowly progressive and persistent new muscle weakness or decreased endurance
s/s persist for at least a yr

Question 10

PPS characteristics

Answer 10

Most often, polio survivors start to experience gradual new weakening in muscles that were previously affected by the polio infection
Slow progression, either steady or stepwise
Stepwise: marked by periods of relative stability, interspersed with periods of decline.

Question 11

hallmark sign of PPS

Answer 11

weakness atrophy of mm previously affected

yrs of inc metabolic efford = break down in giant motor cells

Question 12

PPS s/s

Answer 12

weakness atrophy

Fatigue
Beyond typical fatigue, and typically occurs at same time each day
Can be accompanied by signs of autonomic distress: sweating or headaches
Described as “Hitting the polio wall”

pain

Cold intolerance
Result of sympathetic nervous system involvement (bulbar)

Sleep disorders; dysphonia or dysphagia; respiratory deficiency

Question 13

PPS common secondary complications

Answer 13

falls
malnutrition
pneumonia
chronic respiratory failure
OA

Question 14

meds found to be effective in PPS pt

Answer 14

steriods and IVIG

Question 15

PPS prognosis

Answer 15

Post-polio syndrome is rarely life-threatening, but the symptoms can significantly interfere with an individual’s ability to function independently.

Question 16

PPS symptoms can secondarily affect what

Answer 16

Respiratory muscle weakness, can result in trouble with proper breathing, affecting daytime functions and sleep.
Weakness in swallowing muscles can result in aspiration of food and liquids into the lungs and lead to pneumonia.

Question 17

PPS and strengthening

Answer 17

Have to be careful – VERY easy to fatigue
avoid overworking or fatiguing muscle groups and localized motor units
Patients must be WELL EDUCATED in not overdoing workouts & to avoid pain and fatigue
If it takes several days to regain strength – they have overdone it!

Question 18

PPS and stengthening intensity

Answer 18

Sub-maximal intensity with short-duration exercise every other day helpful to ↑ QOL
Short intervals of exercise with rest in between to recover

more exercise not better
less is best

Question 19

energy conservation techniques PPS

Answer 19

A large focus of PPS rehabilitation
Consider how to modifying a person’s lifestyle in order to prevent fatigue
Pacing techniques
Lifestyle modifications

Question 20

stretching considerations

Answer 20

Stretching overworked muscles may not be indicated due to potential for increasing joint instability

Any inc ROM must be supported by adequate muscle strength which may not be possible for this population

Gentle stretching may be indicated as a strategy to combat pain or cramping from occasional overuse

Question 21

3 maj causes of pain in pps

Answer 21

Cramping (18% of patients):
- Gentle stretching after application of heat
Musculoskeletal (47% of patients):
- over use
- itis
- meds
biomechanical
- degen
- posture