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Updated: Jun 8 2021


  • summary
    • Poliomyelitis is a disease caused by viral destruction of the anterior horn cells in the spinal cord and brain stem motor nuclei.
    • Diagnosis is made clinically with presence of motor weakness with normal sensation in a patient with history of polio.
    • Treatment may be nonoperative or operative depending on degree of functional limitation and presence of secondary contractures. 
  • Epidemiology
    • Incidence
      • has been eradicated in the United States with the use of a vaccine
  • Etiology
    • Associated conditions
      • Postpolio syndrome
        • an aging phenomenon where more nerve cells become inactive with time
          • it does not represent reactivation of the virus
          • occurs after middle age
          • occurs in up to 50% of polio cases
        • leads to increasing difficulty performing activities of daily living
        • patients should exercise at sub-exhaustion levels to tone affected muscle groups without causing muscle breakdown
  • Presentation
    • Physical Exam
      • hallmark is muscle weakness with normal sensation
  • Treatment
    • Postpolio Syndrome
      • nonoperative
        • limited exercise with periods of rest, +/-lightweight orthosis
          • indications
            • first line of treatment
          • technique
            • goal is to maintain but not overuse muscles
      • operative
        • tendon transfers, contracture releases, and arthrodesis
          • indications
            • used to optimize functional capacity
    • Polio foot deformities
      • nonoperative
        • lightweight orthoses
          • indications
            • first line of treatment
            • help patient remain functionally independent
      • operative
        • contracture release, tendon transfer, and arthrodesis
          • indication
            • if orthoses do not achieve satisfactory standard of living
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