ROLE OF PHYSIOTHERAPY

IN
MANAGEMENT OF POLIO
Amandeep Singh
MPT 1ST year
Department Of Physiotherapy,
Punjabi University,Patiala.
 INTRODUCTION
 Poliomyelitis or polio or infantile paralysis
 is an acute viral disease
 spread from person to person, primarily via the faecal-oral route.
 involves CNS, producing serious illness and flaccid paralysis by
causing destruction of motor neurons in spinal cord.
 The term derives from the Greek words
 poliós  meaning "grey“
 myelós  referring to the "spinal cord"
 suffix -itis, which denotes inflammation.
The disease of poliomyelitis
has a long history. The first
example may even have been
more than 3000 years ago. An
Egyptian stele dating from the
18th Egyptian dynasty (1580 -
1350 BCE) shows a priest with
a deformity of his leg
characteristic of the flaccid
paralysis typical of
poliomyelitis.
 ETIOLOGY
 Poliomyelitis is caused by infection with a member of the
 genus Enterovirus  known as poliovirus (PV).
 This group of RNA viruses colonize the gastrointestinal tract
— specifically the oropharynx and the intestine.
 Three serotypes of poliovirus have been identified—poliovirus
type 1 (PV1), type 2 (PV2), and type 3 (PV3)
 The incubation time :- 3 - 35 days with a more common span
of 6 - 20 days.
 How Polio presents
 Initial symptoms of polio include
 fever,
 fatigue,
 headache,
 vomiting,
 stiffness in the neck,
 pain in the limbs,
 paralysis, in a small proportion of cases which is often
permanent.
Main Problems of The Patient
 Fatigue (Commonest)  Respiratory problems
 Weakness  Swallowing problems
 Muscle pain  Cold intolerance
 Gait disturbance  Sleep apnoea
 MANAGEMENT
 Limit infection and dissemination
 Improve general hygiene: Clean water supply

 Polio Vaccines
 Killed virus injected (Salk vaccine)
 Live attenuated virus (Sabin vaccine)
PHYSIOTHERAPY MANAGEMENT
 Exercises-
 Strengthening exercises (isometric, isotonic, isokinetic)
 Aerobic exercises
• Strengthening exercises increases both the strength as well as
the endurance of the muscles in polio patients.
• Aerobic exercise increases the functional capacity, reduces
fatigue, and improves quality of life in patients.
Neuro-physiological techniques:-

• Techniques like PNF are very beneficial in the strengthening of the

muscles as well as enhancing the coordination between different muscle
groups to perform the movement in smooth and rhythmical way.
 Pain management strategies:-
• A variety of therapeutic modalities such as ultrasound, interferential
therapy, TENS, short wave diathermy, laser are effective in treating many
orthopaedic problems that arise indirectly from the residual polio-related
weakness, such as joint inflammation, tendonitis, and ligament laxity.
Pool therapy/aquatic therapy:-
• The warmth of the water helps to promote blood circulation and muscle
relaxation. Weight bearing in water dramatically decreases the mechanical
stress placed on the lower limb joints. Aquatic exercises increases the
dynamic muscle strength in the the polio patients.
• Stretching exercises:-
• These exercises induce relaxation in the muscles and maintain the integrity
of muscle function. In the post-polio population, hip and knee flexion
contractures, as well as ankle plantarflexion deformity, are the most
common to develop. Stretching exercises reduces the tightness in the
muscles and thus improves the function of the muscles.
Postural correction exercises:-

• These exercises are aimed at relieving muscle tension and

preventing unnecessary joint stresses. These include toning
and/or stretching exercises for the paraspinal and abdominal
muscles, as well as postural exercises for the neck and
shoulder girdle region.
 CONCLUSION
Polio is one of crippling conditions in the developing
countries. It is transmitted by droplet infection and oral
ingestion. The symptomatic illness following infection is due
to the destruction of the anterior horn cells of the spinal cord
and the brain stem. The involvement is predominant in the
lower limbs. Physiotherapy, as a part of a multidisciplinary
rehabilitation team play an important role in the management
of polio.