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Post Polio Syndrome (PT Evalutation (Vitals (Respiratory Rate (Quality of…
Post Polio Syndrome
PT Evalutation
Endurance Testing
5x sit to stand
6MWT
MMT
Posture
LLD
Scoliosis
Vitals
Pain
Heart Rate
Blood Pressure
Respiratory Rate
Quality of breathing
Fatigue Severity Scale
Neurological Screen
Sensation
Reflexes
Modified Ashworth
Balance and Coordination
Modified CTSIB
Berg Balance
TUG (fall risk)
Assess Sleeping Patterns
RED FLAGS (direct access)
Cancer
Fractures (osteoporosis risk)
Screen for yellow flags
FABQ
GAD
PHQ
Medical Management
Pain Relievers
Nerve EMG
Differential Diagnosis
History of Polio Virus
Neuromuscular Examination
MRI/CT
Electrophysiology Studies
PHYSICAL THERAPY
X-rays/Chest x-ray
PT Intervention
Patient Education
Energy Conservation
Task Prioritization
Planned rest periods
Assistive Device Education
Leg Brace
Cane
Trunk Bracing
HEP
Sleep Apnea Educartion
Sleeping Position
Equipment
Deep Breathing Exercises
Lateral expansion breathing exercise (Scoliosis-Restrictive Lung Disease)
Incentive Spirometry
Paced Breathing
Transfer/Mobility Training
Cardiovascular Endurance Training
Monitor Symptoms
Slow Progression
Low to Moderate Intensity Exercise
45-60% HR response
Borg RPE of 13
Resistance Training
Avoiding Muscle Fatigue (monitor symptoms)
Slow progression
Moderate to low resistance
Focus on concentric exercise/cautious with eccentric
Include rest periods
Functional Training
Gravity neutral positions
STM
Referrals!
Speech
OT
Psych
Neuro
Signs and Symptoms
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Unaccustomed Fatigue
Muscular Atrophy
Slowly Progressive Muscle Weakness
Respiratory complications
Aspiration PNA
SOB
Pain
Joint Degeneration
Skeletal Deformities
Scoliosis
Restrictive Lung Disease
ICF Model
Restrictions in Participation
Difficulty getting to and from work due to fatigue
SOB during exercise that was previously tolerated
Cannot play sports with children
Limitations in Activities
Decreased ability to walk prolonged distances (distances greater
than 1 block)
Difficulty getting out of bed in the morning
Fatigued by mid afternoon
Environmental
2 children
Wife
Lives in small town
Personal
55 year old male
Father
Husband
Lawyer
Body Structures and Functions
Increased Fatigue
Increased Pain (Legs and Right arm)
Muscle Weakness (Legs and Right arm)
SOB with exercise
Moderately Severe Scoliosis
22 pounds overweight
CC: increased weakness and reduced endurance
3 cm limb length discrepancy
Pathophysiology
Infection of Polio Virus
Damage to Motor Neurons
Neurons sprout new fibers
Enlargment of surviving motor units
Muscle fiber function recovery
Increased stress over time (30-40 years)
Gradual deterioration of sprouted fibers and neuron
Malfunction of nerve terminals
1 more item...
Risk Factors
Age of initial onset of Poliomyelitis
Older age of onset increases likelihood of Post-Polio Syndrome
Severity of initial Polio infection
More severe initial infection increases likelihood of Post-Polio Syndrome
Recovery from initial infection
Greater initial recovery increases likelihood of Post-Polio Syndrome
Excessive physical activity
Increased stress on surviving motor neurons