SPECIFIC RECOMMENDATIONS FOR POST-POLIOS,

DOS & DON'TS, GENERAL THERAPIES

AND THINGS TO AVOID

What follows is a general, practical guide for post-polios to use and that summarizes in outline form the current thinking about post-polio. It is not a substitute for individual medical evaluation or therapy. It will be most valuable if it stimulates you to seek further and more specific information.

-Take time to rest: nap if possible during the day, work fewer hours,

take longer vacations.
-If you are experiencing increasing muscle weakness, exercise only

under the supervision of a knowledgeable physician. -Make sure you get adequate nutrition.
-Be alert to (not obsessed with) changes in your body, and heed your

body's signals.
-Take note of any new symptoms plus clear or gradual changes. -Get enough exercise to prevent disuse atrophy, but not enough to

produce overuse damage.
-Learn how to pace yourself.
-Prevent the secondary complications of weakness, particularly falls;

this might entail the use of crutches or a cane, or a wheelchair for extended travel, or braces or other adaptive equipment. -Avoid weight gain; too much weight only aggravates stress on joints and

muscles.
-Consider possible adaptations to your life style; even minor

adjustments--changes in hobbies or modes of transportation--can help. -Do not assume that every physician fully understands post-polio

problems; educate yourself, and never hesitate to ask questions. -Minimize alcohol use, particularly at bedtime; alcohol inhibits

swallowing, interferes with nutrition, and causes falls and other accidents.
-Try to maintain a positive attitude toward your health; accept change,

adapt, and never equate your self-worth with physical disabilities. -Post-polios with respiratory insufficiency should take common colds

very seriously.
-Get enough bulk-producing fiber in your diet. Avoid stimulant

laxatives.
-Medical evaluation of post-polios should include a complete history,

physical exam, and appropriate lab studies. -Muscle strength evaluation should be done by a registered physical

therapist or someone familiar with neuromuscular diseases. Repeat muscle testing is now advised every year, even if there is no obvious change in strength.
-The current recommendation is that all post-polios have a complete

medical evaluation covering the three major areas affected by polio: neuromuscular, circulatory, and respiratory. -Problems with extremities or joint function may require special

consultation--from physiatrists, orthopedists and/or neurologists--familiar with skeletal deformities and muscle weakness. -Experienced physical or occupational therapists can help determine

functional losses and how best to adapt. -Muscle stretching and joint range-of-motion exercises are important

where there is muscle weakness.
-Swimming is the best cardiovascular endurance and general conditioning

exercise. Water temperature should be warm (at least 90 degrees). -discontinue an exercise that causes pain, weakness, or muscle fatigue,

including walking.
-Muscles weakened by polio respond poorly to vigorous strengthening

programs. Such programs--weight lifting, for example--often aggravate the condition.
-Post-polios should know their own strength limits or endurance and

avoid going repeatedly to that limit. -Post-polios should avoid narcotics for any reason; aspirin is

preferred as an analgesic for muscle or joint pain. -Occupational therapists can help assess upper extremity function, daily

activities, and need for assistive devices--all to help achieve the highest level of independence possible. -Rest is the best known treatment for aching muscles. Moist heat,

anti-inflammatory medication, and avoiding exertion are also helpful. -Physical therapy--heat, massage, joint mobilization, and stretching

exercises--can help chronic lower back pain. -Change of gait pattern, such as using crutches, may be needed to

prevent recurrence of lower back pain. -Post-polios MUST learn to conserve energy. -Post-polios, even though once rehabilitated, must be re-evaluated and

learn new techniques to replace those that no longer work. -Body positioning during sleep is important for post-polios with severe

weakness, postural or joint deformities. -Post-polios with marginal respiratory reserve at sea level should be

prepared to use respiratory aid when traveling to elevations above 3,000 feet.
-Post-polios with respiratory insufficiency are advised to receive the

influenza vaccination according to U.S. Public Health Service guidelines and recommendations.


Compiled by the Post-Polio League for Information and Outreach (P-POLIO)

Sources:

Handbook on the Late Effects of Poliomyltis, 1984, ed. by Gini Laurie,

Federick M. Maynard, M.D., D. Armin Fischer, M.D., Judy Raymond; published by the Gazette International Networking Institute, St. Louis, MO.

1st Annual Research Symposium on the Late Effects of Poliomyelitis, Warm

Springs, GA

1981 Rehabilitation Gazette, reporting on the 1st International

Symposium on the Late Effects of Poliomyelitis.

Conference at Sister Kenny Institute, Minneapolis, MN, on September 26,

1984

Conference at Helen Hayes Hospital, West Haverstraw, NY, on October 12,

1984