Post-polio syndrome (PPS) is a condition that affects polio survivors years after recovery from an initial acute attack of the poliomyelitis virus. Most often, polio survivors start to experience gradual new weakening in muscles that were previously affected by the polio infection. The most common symptoms include slowly progressive muscle weakness, fatigue (both generalized and muscular), and a gradual decrease in the size of muscles (muscle atrophy). Pain from joint degeneration and increasing skeletal deformities such as scoliosis (curvature of the spine) is common and may precede the weakness and muscle atrophy. Some individuals experience only minor symptoms while others develop visible muscle weakness and atrophy.
Post-polio syndrome is rarely life-threatening, but the symptoms can significantly interfere with an individual’s ability to function independently. Respiratory muscle weakness, for instance, can result in trouble with proper breathing, affecting daytime functions and sleep. Weakness in swallowing muscles can result in aspiration of food and liquids into the lungs and lead to pneumonia.
How is PPS treated?
There are currently no effective pharmaceutical treatments that can stop deterioration or reverse the deficits caused by the syndrome itself. However, a number of controlled studies have demonstrated that non-fatiguing exercises may improve muscle strength and reduce tiredness.
Exercise is safe and effective when carefully prescribed and monitored by experienced health professionals. Exercise is more likely to benefit those muscle groups that were least affected by polio. Cardiopulmonary endurance training is usually more effective than strengthening exercises, especially when activities are paced to allow for frequent breaks and strategies are used to conserve energy. Heavy or intensely resistive exercise and weight-lifting using polio-affected muscles may be counterproductive, as this can further weaken rather than strengthen these muscles.
Exercise prescriptions should include
- the specific muscle groups to be included,
- the specific muscle groups to be excluded, and
the type of exercise, together with frequency and duration.