Post Polio

Question 1

What % of polio is asymptomatic

Answer 1

95%

Question 2

Polio affects what cells of the spinal cord?

Answer 2

Anterior horn cells

Question 3

What countries still have wild polio

Answer 3

Afghanistan and Pakistan

Question 4

Post polio can only happen after a patient has had neurological stability for atleast….

Answer 4

15 years

Question 5

The onset of typical post polio syndrome happens 30-50 years after polio and is characterized by

Answer 5

New weakness

Question 6

What is the pattern of weakness in polio

Answer 6

No pattern

Question 7

For a diagnosis of post polio, a person must have had a history of polio confirmed by:

Answer 7

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

Question 8

What is the typical compensation used by post polio patients

Answer 8

Use of weak muscles at very high levels of capacity (they will fatigue easy)

Use of ligaments for stability (results in hyper mobility)

Question 9

For a person to receive a 4/5 on an MMT, it means that how many muscle cells remain

Answer 9

40%-10%.

Question 10

T or F: the unaffected side in patients with post polio is still weaker than age and gender norms

Answer 10

T

Question 11

Golden rule of post polio

Answer 11

If anything causes fatigue, pain, or weakness

Don’t do it or do much less of it

Question 12

Goal for patients with PPS

Answer 12

self management

Question 13

Increasing pain or numbness at night for PPS patients can indicate

Answer 13

Their mattress is too firm

Question 14

When would we not want to stretch patients with PPS

Answer 14

If those shortened muscles provide stability

Question 15

Main treatment for patients with PPS

Answer 15

energy conservation techniques

Question 16

How should patients with PPS lose weight

Answer 16

Diet, it will be hard for them to do enough exercise to lose weight

Question 17

When working with patients with PPS. Should we put them on warmup machines?

Answer 17

No, only do exercise for the targeted muscles and nothing else

Question 18

General rule of MMT/exercise for PPS patients

Answer 18

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

Question 19

What exertion scale is valid to use in PPS patients

Answer 19

Borg RPE

Question 20

Safe exercises for post polio

Answer 20

Water exercise

Seated

UE bike

Isolated muscles without weights

Self stretching

Modified yoga and tai chi

Question 21

Potentially unsafe exercises for PPS

Answer 21

riding stationary bike

Walking or jogging, or any stair steppers or ellipticals

Circuit training

Free weights

Aerobic or kickboxing

Question 22

How should you typically start the exercise dosing for a patient with PPS

Answer 22

50% intensity of non PPS patient with twice as much rest time and go from there

Do essential exercises only

Question 23

what % of polio pts develop post-polio

Answer 23

20-50%

Question 24

post polio typically occurs _______ years after polio

Answer 24

30-50 years

Question 25

What did we historically think is the cause of post-polio?

Answer 25

Increasing metabolic demand from giant motor units

Question 26

should we assume that a Post-polio pt probably ambulates with an AD if all of their MMTs are 3/5 or under?

Answer 26

No

Question 27

T or F: we want to use a HHD to strength test post-polio

Answer 27

F, not preferred power production is very different than endurance and functional use

Question 28

Pt's with a 5/5 MMT who have polio likely have what amount of remaining muscle cells?

Answer 28

over 40%

Question 29

MMT vs muscle cells: 5: 4: 3: 2: 1:

Answer 29

5: over 40% 4: 40-10% 3: 10-8% 2: 3-5% 1: 2-3% 0: 0-2%

Question 30

Different reasons that pt's with post-polio can have fatigue:

Answer 30

Muscle overuse brain fatigue general fatigue sleep disturbances cardiac issues respiratory issues medications

Question 31

______________ is more disturbed for pt's with post polio than actual strength

Answer 31

continuous repetitive muscle activity patients with PPS fatigue earlier

Question 32

What did the Magnet study find about using magnets to reduce pain in PPS patients?

Answer 32

more effective than placebo

Question 33

Pt with PPS complains to you after therapy of: muscle cramping, muscle twitching

Answer 33

Signs of overuse: do less exercise! also signs: progressive muscle weakness and atrophy

Question 34

aquatic exercise considerations for PPS:

Answer 34

Make sure they have energy to exit the pool

Question 35

Good recommendation for PPS patients for their exercises:

Answer 35

KEEP DAILY LOG of activities and symptoms

Question 36

For PPS patients, if a muscle is ______ or below in MMT grade, we don’t exercise it!

Answer 36

3/5