Leg exercises for polio survivors are a controversial subject. On the one hand, there is a school of thought that polio survivors must exercise their polio-damaged legs to keep them from further deterioration. On the other hand, there are some advocates who strongly debunk a 2005 Mayo Clinic study that concluded people "who survive polio in childhood will not suffer further effects later in life." There seems to be an emerging middle ground that recommends exercise for polio survivors, as long as it is carefully monitored, especially leg exercises that may further weaken or kill motor neurons already damaged by polio.
Polio
According to Dr. Richard Bruno, director of the Post-Polio Institute, it was discovered in 1949 that the polio virus kills, on the average, 50 percent of motor neurons. This results in fatigue, pain and muscle weakness, particularly in the legs. Leg exercises that strengthen the limbs of most people can do further damage to polio survivors if the exercises are too vigorous, since the remaining muscle neurons may already be overworked in day-to-day activities.
Research
The controversial research about the value of leg exercises for polio survivors comes from roughly a handful of studies. A major conclusion from the studies is that exercise programs can significantly improve strength.
However, Dr. Bruno argues that conclusion is not supported by the facts. Just over half of one of the study's subjects increased leg muscle strength, about a quarter had no improvement and the final quarter found that their strength had decreased. Furthermore, in the one study that examined whether leg exercises increased polio survivors' fatigue, test subjects increased their leg strength but their fatigue increased as well. And in the one study that evaluated survivors' day-to-day ability to function in daily life, fatigue increased by as much as 300 percent without an increase in the ability to function.
Recommendations
According to research cited by Dr. Bruno, polio survivors with muscle weakness lose some 7 percent of their motor neurons each year. The researchers concluded that "polio survivors should not engage in fatiguing exercise or activities that further stress metabolically damaged neurons that are already overworking." Post-polio survivor expert and UCLA neurologist Dr. Susan Perlman writes, "The least fatiguing way for a polio survivor to exercise is in the pool. There are many published studies that show that polio survivors can exercise safely and gain better strength and endurance with non-fatiguing exercises." Other activities include cross-training and a mix of exercises that include strengthening and motion exercises.
Considerations
Dr. Bruno advises polio survivors to exercise their heart, which is not damaged by polio, in an appropriate fashion. He writes, "there is no benefit to running on a treadmill or riding a bicycle to exercise the heart if you thereby stress and kill off poliovirus-damaged motor neurons."
Instead of overworking the legs, Dr. Bruno suggests to improve cardio fitness with machines that work the arms, and also notes that it is critical for polio survivors to eat well and consume plenty of protein, especially at breakfast. Couple with non-carb snacks throughout the day, most of Dr. Bruno's polio survivors reported a sharp decrease in fatigue and other post-polio symptoms. Finally, all of the experts say that it is critical to develop an exercise program with your doctor that will fit you as an individual. Such a program should consist of low-to-moderate intensity exercise, at a slowly increasing pace, utilizing a range of activities. Pain or undue fatigue during exercise is a sign to stop exercising until you have spoken to your doctor.
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