Decades after their acute infection, many polio survivors are suffering renewed muscle weakness, increasing respiratory difficulties, musculoskeletal pain, fatigue and cold intolerance which lead to a 'second disability'. Some symptoms are due to chronic mechanical strain caused by using joints rendered unstable after the acute infection. The cause of others, such as postpoliomyelitis muscular atrophy, is . unknown although overuse, ageing, disuse atrophy and metabolic fatigue of axon sprouts in the abnormally large motor units may play a role. The aim of rehabilitation is to halt the progress of the condition and reduce its physical and psychological impact. Reduction in strenuous activity is important. The use of orthoses or a wheelchair may help to reduce pain and the energy cost of mobility. Respiratory aids such as the cuirasse can improve health. Counselling and peer group support can help the patient to accept his physical limitations.
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References
1.
Lee M.The residue of poliomyelitis. The Office of Health Economics,Survey1, January 1965
2.
Frick NM, Bruno RLPostpolio sequelae: physiological and psychological overview. Rehab Lit1986; 47: 106-11.
3.
Raymond CAWorldwide assault on poliomyelitis gathering support, garnering result. Medical News andPerspectives1986; 255: 1541-46.
4.
Report from the PHLS Communicable Disease Surveillance Centre . Br Med J1986; 293: 195-96.
5.
Raymond CADecades after polio epidemics, survivors report new symptoms. Medical News and Perspectives1986; 255: 1397-99.
6.
Halstead LS, Ross CDNew problems in old polio patients: Results of a survey of 539 polio survivors . Orthopedics1985; 8: 845-50.
Perry J., Fleming C.Polio: long-term problems. Orthopedics1985 ; 8: 877-81.
9.
Raymond M., Charcot JMParalysie essentiele de l'enfancé: atrophie musculaire consécutive . Gaz MedParis1875 ; 225.
10.
Kayser-Gatchalian MCLate muscular atrophy after poliomyelitis. EuropNeurol1973; 10: 371-80.
11.
Anderson A. , Levine SA, Gellert H.Loss of ambulatory ability in patients with old anterior poliomyelitis. Lancet1972; 2: 1061-63.
12.
Salmon LA, Riley HAThe relationship between chronic anterior poliomyelitis or progressive spinal muscular atrophy and an antecedent attack of acute anterior poliomyelitis . Bull Neurol Inst NY1935; 4: 35-63.
13.
Mulder DW, Rosenbaum RA, Layton DDLate progression of poliomyelitis or forme fruste amyotrophic lateral sclerosis?Mayo Clinic Proc1972; 47: 756-61.
14.
Alter M., Kurland LT, Molgaard CALate progressive muscular atrophy and antecedent poliomyelitis. Adv Neurol1982; 36: 303-309.
15.
Campbell Amg , Williams ER, Pearce J.Late motor neurone degeneration following poliomyelitis. Neurology1969; 19: 1101-1106.
16.
Dalakas MC, Elder G., Hallett M. et al. A longterm follow up study of patients with postpoliomyelitis neuromuscular symptoms. N Eng J Med1986; 314: 959-63.
17.
Feldman RMThe use of strengthening exercises in postpolio sequelae. Orthopedics1985; 8: 889-90.
18.
Fischer DAPoliomyelitis: late respiratory complications and management. Orthopedics1985; 8: 891-94.
19.
Lane DJ, Hazleman B., Nichols Pjr.Late onset respiratory failure in patients with previous poliomyelitis. QuarterlyJ Med1974; 43: 551-68.
20.
Alcock Ajw, Hildes JA, Kaufert PA et al. Respiratory poliomyelitis. A follow-up study. Can Med Assoc J1984; 130: 1305-10.
21.
Frick NMPostpolio sequelae and the psychology of second disability. Orthopedics1985; 8: 851-53.
22.
Weichers DOAcute and latent effects of poliomyelitis in the motor unit as revealed by electromyography. Orthopedics1985; 8: 870-72.
23.
Hayward M., Seaton D.Late sequelae of paralytic poliomyelitis: a clinical and electromyographic study. J Neurol Neurosurg Psychiatry1979; 42: 117-22.
Curgian LM, Sparapani M.The chest cuirasse and related nursing management. Rehab Nursing1986; 11: 17-19.
30.
Brown L., Kinnear W., Sergeant K-A., Shneerson J.Artificial ventilation by external negative pressure - a method for manufacturing cuirasse shells. Physiotherapy1985; 71: 181-83.
31.
Spalding Jmk, Crampton-Smith A.Clinical practice and physiology of artificial respiration. Oxford: Blackwell Scientific Publications , 1963.
