Post Polio Syndrome - Management & Treatment in Primary
Post Polio Syndrome - Management & Treatment in Primary
Post Polio Syndrome - Management & Treatment in Primary
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28 <strong>Post</strong> <strong>Polio</strong> <strong>Syndrome</strong><br />
Activity levels have been shown to correlate highly with pa<strong>in</strong><br />
therefore a reduction may be of benefit. Ma<strong>in</strong>ta<strong>in</strong><strong>in</strong>g a healthy weight is<br />
advisable as one study demonstrated that a higher BMI was associated<br />
with a higher risk of jo<strong>in</strong>t pa<strong>in</strong>. 15 Education about posture and back care<br />
may help to m<strong>in</strong>imize aggravat<strong>in</strong>g factors.<br />
Appropriate use of aids and appliances<br />
Aids and appliances should be provided with the aim of improv<strong>in</strong>g<br />
abnormal body mechanics, and correct<strong>in</strong>g and m<strong>in</strong>imis<strong>in</strong>g postural and<br />
gait deviations mechanically. An appropriate orthosis has been shown<br />
to significantly reduce overall pa<strong>in</strong> levels. 29 A “comfy” grip crutch may<br />
improve the wrist and hand position.<br />
Use of electro-physical agents<br />
Heat has been shown to help to relieve pa<strong>in</strong>. 14 Stretch<strong>in</strong>g can be helpful<br />
but should be used carefully as particular patients may benefit from<br />
shorter muscle length and associated reduced range of movement that<br />
improve stability. TENS is also recommended.<br />
Hydrotherapy<br />
Exercise <strong>in</strong> water is recommended for management of pa<strong>in</strong> <strong>in</strong> prior<br />
polio <strong>in</strong>dividuals. 16 Water provides a resistance but m<strong>in</strong>imises stress on<br />
muscles and jo<strong>in</strong>ts. The properties of water allow assisted, resisted or<br />
supported exercise, often enabl<strong>in</strong>g those limited by weakness on land<br />
to exercise with m<strong>in</strong>imal assistance. The heat <strong>in</strong> hydrotherapy pool may<br />
also be beneficial. Prior polio patients who exercised <strong>in</strong> water for up<br />
to 8 months demonstrated a positive functional impact, a subjective<br />
positive experience, less pa<strong>in</strong>, and a lower heart rate at a submaximal<br />
work level <strong>in</strong> a controlled trial, lend<strong>in</strong>g evidence to this form of<br />
treatment. 44 Hydrotherapy may also result <strong>in</strong> <strong>in</strong>creased strength without<br />
exacerbat<strong>in</strong>g fatigue or pa<strong>in</strong>. 46 It is essential that the <strong>in</strong>dividual’s overall<br />
physical condition is assessed prior to commenc<strong>in</strong>g a hydrotherapy<br />
programme. 45<br />
PPS Mngt and Treat.<strong>in</strong>db 28 02/07/2007 16:07:51