Post Polio Syndrome - Management & Treatment in Primary

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the role oF the orthotist Brian Kinsella The role of the Orthotist, is that of biomechanical back up to the clinical team. From the point of view of the person with post polio, the Orthotist provides orthoses (splints). These include insoles to persons’ shoes, foot orthoses, ankle-foot orthoses (AFO), knee ankle foot orthoses (KAFO) (short or long callipers), and spinal jackets. In some cases, orthopaedic footwear is also prescribed. Example of a knee-ankle-foot orthotis (KAFO) worn with a custom made shoe Example of an ankle-foot orthotis (AFO) worn with a custom made shoe Old style orthoses of sidebars and T-straps are not so common anymore. The majority of AFOs and KAFOs (callipers) are now made to a cast, and use lightweight plastics. These orthoses are normally lighter and fit directly inside footwear. This often means footwear does not have to be adapted and walking is made easier. The Orthotist, when making orthoses, considers skeletal alignment, joint integrity and ease of walking. PPS Mngt and Treat.indb 33 02/07/2007 16:07:52
the role oF the sPeeCh and Introduction language theraPist Ciara McWeeney The most relevant changes brought about by Post Polio Syndrome (PPS) to the Speech and Language Therapist (SLT) are in: ● swallowing 2 ● voice There is wide variability in reported prevalence rates of dysphagia 3 and dysphonia 4 for polio survivors, ranging from 20-60%. 5 It is probable that these changes may relate to residual weakness of the oral, pharyngeal, or laryngeal muscles from the original insult or as a result of further neuronal degeneration associated with PPS that appears with increasing age or continual use of the surviving motor neurons. 6 It is important to note that clinical experience in Ireland has not significantly supported these high prevalence rates. This chapter reviews the findings of studies on PPS that relate to swallowing and voice, and provides information on the role of the SLT in the evaluation and treatment of polio survivors who present with these difficulties. Swallowing The most frequently used definition of dysphagia is “difficulty moving food from mouth to stomach”. 7 Some SLTs have used an alternative definition that expands the meaning of dysphagia to include all of the behavioural, sensory, and preliminary PPS Mngt and Treat.indb 34 02/07/2007 16:07:52
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Post Polio Syndrome - Management & Treatment in Primary

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