8/15/2014

What are the late effects of polio?

A Few Words about Definitions  (Source: Post-Polio Health International) 

Diagrams courtesy of
Post-Polio Health International
Technically, post-polio syndrome is NOT the same condition as post-polio sequelae / the late effects of polio. Post-polio syndrome is usually considered a specific NEW condition. A diagnosis of exclusion is used to determine if a patient has post-polio syndrome. This means if a survivor of polio is found to have osteoarthritis, for example, that is what the diagnosis will be – osteoarthritis, not post-polio syndrome. Because of this, the number will be lower for post-polio syndrome than when the number is referring to post-polio sequelae or the late effects of polio.
Twenty-five to forty percent of polio survivors experience post-polio syndrome (depending on the study).
As many as seventy percent of polio survivors are said to have post-polio sequelae or the late effects of polio.
The Late Effects of Polio – The Paralytic versus Non-Paralytic Polio Debate . . .
“It should be absolutely understood that patients who were told that they had ‘non-paralytic’ polio did, in reality, have polio, which affected their anterior horn cells. Now, 30 to 40 years later, these patients are potentially subject to all of the vagaries and insults to the body that affect other persons with postpolio syndrome.”
A Clarification of “Nonparalytic” Polio
Johnson, Ernest W MD
American Journal of Physical Medicine, Vol. 79(1), Jan/Feb 2000
“Asserting that a history of paralytic polio is required for a history of PPS effectively, and incorrectly, says that no neurologic damage was done during acute nonparalytic polio.”
Late Functional Loss in Nonparalytic Polio
Falconer, Marcia PhD; Bollenbach, Edward MA
American Journal of Physical Medicine, Vol. 79(1), Jan/Feb 2000
“PPS must be considered in the differential diagnosis of individuals with unexplained fatigue and weakness … regardless of whether they report a prior history of paralytic polio”
Late Functional Loss in Nonparalytic Polio
Halstead, Lauro S MD; Silver, Julie K
American Journal of Physical Medicine, Vol. 79(1), Jan/Feb 2000
Managing the late effects of polio
Polio-experienced health professionals recommend a management plan that is designed specifically for the individual polio survivor. The plan may include a variety of recommendations including:
  • bracing to support weak muscles and/or over-used and stretched joints
  • use of walking sticks and crutches to relieve weight on weak limbs and to prevent falls
  • customized shoes to address unequal leg lengths, which can be the cause of back pain and requires extra energy to walk
  • use of wheelchairs or motorized scooters for long-distance
  • recommendation of weight loss
  • recommendation of specific select exercises to avoid disuse weakness and overuse weakness
  • use of a breathing machine at night to treat underventilation
Polio survivors can also help them themselves by ‘listening’ to their bodies and ‘pacing’ their activities. With time, survivors can learn when to stop before they become over fatigued. Many survivors report feeling better after adapting assistive devices and interspersing activities with brief rest periods. Read more in PPS Guidelines for people who have had polio. http://www.polioaustralia.org.au/what-are-the-late-effects/

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