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1994-07-06
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SPECIFIC RECOMMENDATIONS FOR POST-POLIOS
DO'S & 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 weakiness, 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 adaptatins 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 alcholol use,, particularly at bedtime; alcholol inhibits
swallowing, interfers 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 exercies 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 any 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 functin, 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, jointmobilization, and stretching
exercies--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 rehabilitate, 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 travelling to elevations above
3,000 feet.
--Post-polios with respiratory insufficiency are advised to receive the
influenza vaccinatin accordint 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 Poliomyelitis, 1984, ed by Gini Laurie,
-------- -- -- ----- ------- -- -------------
Frederick M. Maynard, M>D>, D. Armin Fischer, M.D., Judy Raymond;
published by Gazette International Networking Institute, St.Louis,