Post-polio syndrome

Abstract

Post-polio syndrome (PPS) is the term used for the new late manifestations that occur in patients 30 to 40 years after the occurrence of acute poliomyelitis. PPS has been recognized for over 100 years, but is more common at the present time because of the large epidemics of poliomyelitis in the 1940s and 1950s. PPS is manifested by neurologic, musculoskeletal, and general manifestations. Neurologic manifestations include new weakness, muscle atrophy, dysphagia, dysphonia, and respiratory failure. Musculoskeletal manifestations include muscle pain, joint pain, spinal spondylosis and scoliosis, and secondary root and peripheral nerve compression. General manifestations include generalized fatigue and cold intolerance. New muscle weakness of a mild-to-moderate degree responds well to a nonfatiguing exercise program and pacing of activity with rest periods to avoid muscle overuse. Generalized fatigue may be treated with energy conservation and weight loss programs and lower extremity orthoses. Pharmacologic agents also may be helpful, but have not been beneficial in controlled trials. Bulbar muscle weakness includes dysphagia, dysphonia, sleep disorders, and chronic respiratory failure. Dysphagia may be improved with instruction on compensatory swallowing techniques. Dysphonia is treated with voice exercise therapy and voice amplification devices. Sleep disorders are treated similarly to sleep disorders in non-PPS patients. Respiratory failure may be treated with continuous positive airway pressure, bilevel positive airway pressure, and nasal ventilation, or tracheotomy and permanent ventilation if necessary. Musculoskeletal (muscle and joint) pain is treated with weight loss, pacing of activities, use of assistive devices, and prescribing anti-inflammatory medications and physical therapy techniques. Cardiopulmonary conditioning can be improved without muscle overuse with cycle or arm ergometer exercise or dynamic aquatic exercise.

Gerenciamento da dor na Síndrome Pós-poliomielite: estudo de caso

“…Os possíveis fatores de risco para o desenvolvimento da SPP estão ligados à gravidade da PAA, sexo feminino, idade avançada na época do episódio, deficiências permanentes após a recuperação, ganho recente de peso e maior atividade física durante o período de estabilidade [21][22][23][24] . O indivíduo apresentado em nosso estudo realizou intensa atividade física durante a fase de estabilidade clínica, fator apontado como um dos principais agentes etiológi-cos envolvidos na gênese da SPP.…”

“…Estudos não controlados envolvendo exercícios isotônicos, isocinéticos e isométricos mostraram-se eficazes na redução da fadiga, da fraqueza muscular e da dor em pacientes portadores da SPP. Programas terapêuticos controlados, incluindo treino ergométrico em membros superiores e inferiores, condicionamento de marcha, exercícios aeróbicos e atividades aquáticas, também forneceram resultados significativos nessa mesma população 22,23 . Os indivíduos que padecem de síndrome pós-polio devem ser submetidos a atividades terapêuticas (cinesioterapia) em limites submáximos.…”

Flexion Osteotomy in Genu Recurvatum Following Post-Polio Syndrome: Use of an Old Technique in a New Condition

“…In addition, motor strength was assessed based on the scale developed by the medical research council (8). PPS was diagnosed, based on the criteria proposed by Jubelt and updated by the post-polio task force (1).…”

“…Post-polio syndrome (PPS) is the term used for the late manifestations of polio, occurring 30 to 40 years after the acute disease (1). Although PPS has been recognized for more than a century, it is more common today due to the epidemics of polio in previous decades (2).…”

“…Pain caused by joint instability is the main musculoskeletal problem in PPS (1). Weakness leads to the overstretching of the joints and pain (1), thereby increasing the risk of new deformities.…”