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Have you heard of Post Polio Syndrome (PPS) before? 

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Post Polio Syndrome (PPS) is a neurological disorder that develops years after recovery from the initial poliovirus infection. It is characterized by new or worsening muscle weakness, fatigue, and pain (Poleszak et al., 2019).

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What happened to Polio and why it could be coming back!

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The poliovirus targets the motor neurons in the anterior horn (ventral grey matter) of the spinal cord, which are responsible for controlling movement (Chopra & Banerjee, 2023)​.

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After the initial phase of poliomyelitis, the motor neurons that survive work to repair the damage by growing new branches to reconnect with muscle fibers. This helps the body regain movement and strength. However, these newly formed motor units are larger and take on more work than they were originally meant to handle. Over time, the extra strain can cause them to wear out, leading to the gradual return of muscle weakness and fatigue in PPS (Poleszak et al., 2019).

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A individual is more likely to develop Post-Polio Syndrome if they had a severe case of polio, were older at the time of infection, made a strong recovery, or have been physically active over many years. (Poleszak et al., 2019; Chopra & Banerjee, 2023)

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The most common first symptom of Post-Polio Syndrome is weakening of the muscles that were initially affected when the individual previously had Polio.

Other symptoms include:

Fatigue

Gradual muscle atrophy

Muscle pain and twitches

Joint pain

Skeletal deformities (i.e. scoliosis)

(Cleveland Clinic, 2023).

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There is no single test to confirm PPS. Diagnosis involves reviewing medical history, discussing symptoms including new muscle weakness or pain, and ruling out other possible conditions (Chopra & Banerjee, 2023).

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There is currently no specific treatment for Post-Polio Syndrome and medical management is focused on managing symptoms.

This treatment/management may include:

Physical Exercise: Non-fatiguing exercise is important to strengthen the weakened muscles. This may also include cardio type exercise to improve overall endurance to manage fatigue.

Mobility Aids: Devices such as walkers, scooters, or canes are used to help with mobility and avoid rapid muscle tiring.

Speech Therapy: If weakness arises with the muscles involved with speech.

(Cleveland Clinic, 2023)

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Treatment plans heavily focus on managing symptoms which involve working with both a physical therapist and an occupational therapist.

For PT/PTA:

The physical therapy team would work closely with the individual to develop a exercise routine that focuses on:

strengthening the weakened muscles through low-intensity, weight training

increase endurance and improve cardiovascular health through low intensity cardio such as swimming, walking or using a stationary bike

prevention of contractures and maintaining ROM through stretching

pain management using modalities such as heat/cold therapy, or TENS

For OT/OTA:

The occupational therapy team would help to develop energy conservation strategies that fit the individuals life. This could be done through:

a home visit to ensure their environment is optimized for daily tasks

providing energy conservation techniques or adapting a hobby or sport they enjoy to their ability

adaptive equipment training such as walkers, splints or devices such as reachers

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Podcast: Ologies with Ali Ward Episode: Post-Viral Epidemiology (LONG COVID) 

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Post-Viral Epidemiology (LONG COVID) Part 1 with Wes Ely

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Podcast: Stuff You Should Know Episode: How We Almost Got Rid of Polio 

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This link will take you to a new Padlet where you can reflect on your learning about PPS.

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Post-polio syndrome: What it is, symptoms & treatment. Cleveland Clinic. (2023, August 1). https://my.clevelandclinic.org/health/diseases/24584-post-polio-syndrome

Chopra, J. S., & Banerjee, A. K. (2023). Poliomyelitis. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK558944/

Poleszak, J., Szabat, P., Szabat, M., Wójcik, M., Boreński, G., & Milanowska, J. (2019). Current knowledge about Post-Polio Syndrome (PPS). Journal of Education, Health and Sport, 9(9), 1064–1075. https://doi.org/10.5281/zenodo.3463084