Lincolnshire Post-Polio Library - A Service of The Lincolnshire Post-Polio Network
The late effects of Polio Information for Health Care Providers
Charlotte Leboeuf

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14 MANAGING THE LATE EFFECTS OF POLIO

Early detection, education and energy management are three key concepts in the management of the late effects of polio (LEOP).

EARLY DETECTION of symptoms associated with LEOP may prevent further deterioration due to overuse. The concept of "overuse" is relative. Strength and endurance have often become considerably lowered unbeknown to the person. You will need to:

-   enquire into the possibility of a history of polio in patients with symptoms suggestive of LEOP.
-   evaluate known cases of previous polio for features of LEOP.

EDUCATION is necessary to dispel fear and to ensure compliance. It is helpful to explain the following:

-   Post-polio muscles work harder and they have weaker nerve supply than normal muscles.
-   "Good" muscles may, in fact, be substantially weakened.
-   Overuse may cause further weakness of post-polio muscles and nerves.
-   Overuse occurs quicker in post-polio muscles than in normal muscles.
-   It appears that inflammation sometimes occurs within the muscles.

ENERGY MANAGEMENT is about striking a balance between rest and activity. It may entail any or all of the following:

-   reducing the workload (activity level and time spent);
-   resting and pacing;
-   making life-style modifications;
-   making use of assistive devices (e.g. braces, corset, electric wheel chair or scooter, respiratory assistance, shower chair or bath board, higher chair or electrically operated chair, kitchen trolley and electric tooth-brush).

Health professionals, as well as people with residual polio, are often unaware of the improved range of orthopaedic aids, technical assistance and other equipment, which has been developed over the last decades.

It is probably common for people with long-term paralytic sequelae never to have been re-evaluated for new and/or altered needs in terms of rehabilitation, orthotic equipment and other aids.

People who need to make life style changes may resent doing so, since it may involve giving up activities and independent practices. Having to make use of a wheelchair or respiratory assistance (again!) is understandably often seen as a retrograde step, even though the final outcome may be an overall improvement of the quality of life.

Useful reading:

  1. Eulberg MK, Halstead LS, Perry J. Postpolio syndrome: How you can help. Patient Care 1988;June 15:131-69. (Copy available from the Neurological Resource Centre of S.A.)
  2. Kaufert JM, Locker D. Rehabilitation ideology and respiratory support technology. Soc Sci Med 1990;30:867-77. [PubMed Abstract]

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Copyright The Lincolnshire Post-Polio Network 1997 - 2010.

This document comprises an index, foreword, introduction and seventeen other sections or subdocuments. Permission for printing copies is granted only on the basis that ALL sections are printed in their entirety and kept together as a single document.

Document preparation: Chris Salter, Original Think-tank, Cornwall, United Kingdom.
Created: 7th July 1997
Last modification: 20th January 2010.
Last information content change: 6th June 2000

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