Lincolnshire Post-Polio Library [The Late Effects of Polio

Lincolnshire Post-Polio Library - A Service of The Lincolnshire Post-Polio Network

The Late Effects of Polio

The British Polio Fellowship

From Guidelines - February 1997

As of February 1997, a page of information about the late effects of polio, in a publication called "Guidelines", will be distributed to all G.P. surgeries in February, June and October each year. "Guidelines" has been introduced to assist clinicians in drawing up practice and locality primary care clinical guidelines. As well as being distributed to G.P.s the total circulation includes members of Clinical Audit Groups; Pharmaceutical Advisers, Medical Advisers and Public Health Directors at Health Executives and Health Authorities; Clinical Directors and Hospital Pharmacists; and the NHS Executive.

Following extensive rehabilitation, many survivors of the earlier epidemics have been able to lead useful independent lives, often having little contact with the medical profession. They were encouraged to make light of their disabilities and lead as normal a life as possible. 20-30 years later some of these people are now experiencing new symptoms for which they need to seek help. These are not age related, and may be:

Lack of strength and endurance, with increased muscle weakness and fatigue.
Pain in muscles and joints.
Respiratory difficulties (particularly in those who spent some time in an iron lung ventilator). This may present with symptoms relating to sleep.

These late effects of polio are now being recognised and investigated. Much can be done to alleviate some of the symptoms and enable the retention of an independent life, albeit with some modification of the life style.

Investigation

The diagnosis is entirely clinical with the following criteria.

Patient should have a history of poliomyelitis.
Residual weakness with normal sensation in at least one limb.
New symptoms of pain or weakness.
No other clinical explanation for symptoms.

GENERAL

Management

Energy Management - striking a balance between rest and activity. It is important to keep mobile, so preventing further muscle wasting and stiffening of joints, particularly after surgery and any illness which results in periods of immobilisation. However, overactivity causing undue fatigue can weaken muscles further. Activity should, therefore, always be followed by periods of adequate rest.

Advice on general health - loss of weight if appropriate, stopping smoking, keeping warm.

Review existing aids. Much has improved in the last 30 years and new lighter calipers etc have been developed. The use of assistive devices may be helpful.

Social and psychological support. Sometimes it is not easy to come to terms with disability particularly if some recovery has been achieved initially. This takes time.

Information on facilities and help available for disabled people is always useful.

Extra care when using Benzodiazepines, Beta Blockers, sedation techniques and general anaesthesia.

Referral if appropriate	a) Physiotherapist
	b) Chiropodist
	c) Orthopaedic surgeon
	d) Pain clinic
	e) Rehabilitation consultant
	f) Respiratory medicine consultant or specialist respiratory unit

Full guideline available from
The Brilish Polio Fellowship, Unit A, Eagle Office Centre, The Runway, South Ruislip, Middlesex. HA4 6SE 0181 842 1898

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Document preparation: Chris Salter, Original Think-tank, Cornwall, United Kingdom.
Document Reference: <URL:http://www.zynet.co.uk/ott/polio/lincolnshire/library/bpf/guidelines.html>
Created: March 1997
Last modification: 1st March 2000