16 dic. 2011

The basic management principles for individuals with postpolio syndrome


Rehabilitation Program

Physical Therapy

The basic management principles for individuals with postpolio syndrome include energy conservation and pacing one's activities. Although basic, these activity modifications may be difficult for some patients to accept. Psychological interventions, such as cognitive behavior therapy, may also be initiated to help reduce fatigue.[7]
Reports on exercises are conflicting, but the key factor seems to be exercise intensity. Strengthening exercises should be nonfatiguing. A specific suggestion is to exercise every other day, and the perceived rate of exertion should be less than "very hard." Loads should be held for only 4-5 seconds, and there should be a 10-second rest between bouts and a 5-minute rest between sets. The patient should perform about 3 sets of 5-10 repetitions.[8]
In addition to specifying exercises for those body areas experiencing the deleterious effects of disuse, the exercise prescription also should consider how to protect (1) muscles and joints that are experiencing the adverse effects of overuse and (2) body areas with very significant chronic weakness (generally, areas where the muscles have less than antigravity strength on manual muscle testing).
Results of these exercises vary. Strengthening programs performed as described show a 60% increase on isokinetic strength, improved cardiorespiratory status, no decline in strength in 6-12 months, and 5% increase in isometric strength.
Electrical stimulation has been used to strengthen weakened muscles or to reeducate muscles weakened through disuse, as well as to decrease pain.
For myofascial pain, consider heat, electrical stimulation, trigger point injections, stretching exercises, biofeedback, muscle relaxation exercises, or static magnetic fields for trigger points.
For gait disturbances, assistive devices can be used, but sometimes patients refuse because of the philosophy of "not giving in." Treatment also can involve limitation of ambulation to shorter distances and the use of orthotics for joint protection.

Occupational Therapy

Patients with postpolio syndrome usually benefit from different adaptive techniques and equipment to perform any activities of daily living, as well as education and energy conservation techniques.

Speech Therapy

Speech evaluation in persons with postpolio syndrome usually is recommended with any suggestion of swallowing problems. The therapist teaches the patient about different techniques to improve his/her swallowing function.

Consultations

  • Pulmonologists
    • When the patient with postpolio syndrome reports respiratory problems, a full pulmonary evaluation may be required.
    • Sometimes, the patient may even need mechanical respiratory support.
    • A sleep evaluation may be necessary for suspected sleep apnea.
  • Orthopedists - The patient may present with various joint deformities that may require orthoses and sometimes even surgery.

Medication Summary

Medications, most of which address fatigue, have been used with only partial success in patients with postpolio syndrome. Contradictory information is reported on the use of antivirals. Some authors have found no significant improvement with antivirals as compared with placebo. Amantadine may act to release dopamine from dopaminergic terminals and other central sites. Corticosteroids have been studied, but with no good results.

Polio Film

http://www.pbs.org/wgbh/americanexperience/films/polio/

video

Salk Institute

Polio Video

Polio Lungs

https://youtu.be/qytuMHXDlds

Twitter

Enlaces

México Post Polio Una Vida Un Camino Una Experiencia
http://postpoliosinmex.blogspot.com/

Post Polio LITAFF A.C.

www.postpoliolitaff.org/
Postpoliolitaff.- Asociación Post Polio Litaff A.C Primera Organización oficial sobre Síndrome de Post Poliomielitis En México.


Polio y Efectos Secundarios SPP
http://polioyspp.blogspot.com/
- See more at: http://polioamigossinfronteras.blogspot.mx/#sthash.6PkHAkfM.dpuf

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