Effective vaccines for the polio virus were introduced in the United States in 1955, ending national polio epidemics. A 2006 report prepared for the Post-Polio Health International organization estimated that 426,000 Americans are polio survivors. Fifty-three percent are over the age of 65. Years after polio was eliminated in the United States, long-term polio survivors began experiencing new symptoms, in which muscles previously affected by their initial polio infections started weakening again. The exact cause of post-polio syndrome is unknown and no universally accepted physical therapy regimen has been developed.
Post-Polio Syndrome
Polio is caused by a virus. Ninety-five percent of all polio attacks have flu-like symptoms and do not cause any permanent damage, but a minority of polio attacks escalate into temporary or permanent paralysis and sometimes death. Post-polio syndrome appears 10 to 40 years after a polio attack and is not contagious. For some polio survivors the symptoms are minor; others experience progressive muscle weakness, atrophy and pain, fatigue, joint degeneration, skeletal deformities such as curvature of the spine, breathing and swallowing difficulties, sleep-related breathing problems and increased sensitivity to cold temperatures.
Survivors' Responses
Your attitude determines how quickly post-polio syndrome is diagnosed and how you handle it. "Post-Polio Syndrome," a 2004 book by Drs. Julie K. Silver and Anne C. Gawne describes "identifiers," who have been confined to wheelchairs since their original polio attack and dread the loss of independence caused by new symptoms; "passers" who have worked hard to hide lingering polio effects from others and become distraught at having to go public about being polio patients when their post-polio syndrome appears; and "minimizers" who have always had mild, publicly acknowledged disabilities from polio, which they have minimized by denying pain and physical challenges, and who sometimes resist accepting necessary new help, such as wheelchairs.
Exercise Therapy
Treatment options for post-polio syndrome are being developed. As of 2011, no theory on the cause of post-polio syndrome or the best treatment regimen have been universally accepted. A 2010 study done by French researchers found that exercising in water, or aquatic therapy, helped post-polio syndrome patients relieve pain and assisted their muscle function. A 2010 study carried out in Sweden warned that although physical therapy and exercises help post-polio syndrome patients, health care providers must balance keeping such patients fit against the fact that over-exercise can exhaust weakened muscles and subsequently cause long periods of inactivity. You should not avoid exercise if you have post-polio syndrome because exercise avoidance results in muscle wasting and loss of cardiorespiratory fitness.
Current Exercise Consensus
Health insurer Cigna outlines the current consensus position on physical therapy and exercise for post-polio syndrome patients. On the one hand, weight-lifting, moderate aerobic exercise, stretching and muscle relaxation exercises, swimming and aquatic exercises have been helpful to post-polio syndrome patients. On the other hand, patients must stop exercising as soon as they become tired, or the exercises may backfire by creating more fatigue and pain. You should consult a physical therapist to create an individualized physical therapy and exercise program for you, because each polio survivor experiences different symptoms.
References
- National Institute of Neurological Disorders and Stroke: NINDS Post-Polio Syndrome Information Page
- Post-Polio Health International: Polio Survivors in the U.S.; Lawrence C. Backer; October 2006
- "Lancet Neurology": Management of Postpolio Syndrome; H. Gonzalez, M.D., et al.; June 2010
- "Post-Polio Syndrome"; Julie K. Silver, M.D., and Anne C. Gawne, M.D.; 2004
- "Physical and Rehabilitation Medicine": Post-Polio Syndrome; Vincent Tiffreau, M.D., et al.; February 2010
- Cigna: Post-Polio Syndrome
