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Catalogue [by source]

IMPORTANT NOTES FOR FIRST-TIME READERS

INDEX - G
Galski, Thomas, Ph.D.
Gawne, Anne Carrington, MD
Gendron, Daniel
GP
Grant, C., BSC(Physio)
Grimby, Gunnar, MD, PhD
Gronley, JoAnne K., M.A., R.P.T.

Galski, Thomas, Ph.D.

For articles with Galski, Thomas, Ph.D. as co-author or contributor see the following catalogue entries:

Gawne, Anne Carrington, MD

Dr. Gawne is Medical Director of the Roosevelt Warm Springs Institute for Rehabilitation.

Title: Electrodiagnostic Findings in 108 Consecutive Patients Referred to a Post-Polio Clinic - The Value of Routine Electrodiagnostic Studies

Author(s): Anne C. Gawne, Bao T. Pham, and Lauro S. Halstead.
Original Publication: The Post-Polio Syndrome: Advances in the Pathogenesis and Treatment Volume 753 pp 383-385 of the Annals of the New York Academy of Sciences May 25, 1995.
Abstract/Extract: Many patients with a history of polio develop new symptoms including weakness, pain, fatigue, and changes in function, or post-polio syndrome (PPS). Before a diagnosis of PPS is made, other diagnoses must first be ruled out. Assessment must be done in a comprehensive and coordinated manner. Therefore, as part of our routine evaluation, we do an electromyogram/nerve conduction study (EMG/NCS) on every patient. During examinations on our clinic patients we began to notice (1) electrodiagnostic evidence of polio in limbs not previously felt to be involved; (2) a normal EMG, or evidence of another disease; and (3) EMG evidence consistent with additional neurological lesions, including compression neuropathies, peripheral neuropathies, and radiculopathies. A prospective study using a routine, standardized four-extremity electrodiagnostic protocol was done to quantify the frequency of these occurrences.

Title: Post-Polio Syndrome: Pathophysiology and Clinical Management

Special Note: This is a long article (226K). We have also produced a multi-document version comprising fifteen separate shorter documents which reflect the section headings of the original article. Multi-document Version
Author(s): Anne Carrington Gawne and Lauro S. Halstead.
Original Publication: Critical Reviews in Physical and Rehabilitation Medicine, 7(2):147-188 (1995).
Abstract/Extract: Post-polio syndrome (PPS) is a progressive neuromuscular syndrome characterized by symptoms of weakness, fatigue, pain in muscles and joints, and breathing and swallowing difficulties. Survivors of poliomyelitis experience it many years after their initial infection. Although the etiology for these symptoms is unclear, it may be due to motor unit dysfunction manifested by deterioration of the peripheral axons and neuromuscular junction, probably as result of overwork. An estimated 60% of the over 640,000 paralytic polio survivors in the U.S. may suffer from the late effects of polio. Their physical and functional rehabilitation care presents a challenge for practitioners in all disciplines. To evaluate these symptoms, a comprehensive assessment must be done, as frequently PPS is a diagnosis of exclusion. Care of the patient with PPS is best carried out by an interdisciplinary team of rehabilitation specialists. This article reviews the epidemiology, pathophysiology, characteristics, assessment, and rehabilitation care of the patient with PPS.

Title: Strategies for Exercise Prescription in Post-Polio Patients

Author(s): Anne Carrington Gawne, M.D.
Original Publication: Reprinted from POST-POLIO SYNDROME, edited by Halstead & Grimby, © 1995 Hanley & Belfus, Inc., Philadelphia, PA. Chapter 9, pp 141-164.
Abstract/Extract: Appropriate exercises have been shown to improve muscular strength and endurance, improve range of motion, and reduce functional deficits associated with many disabilities. In dealings with the patient with a history of polio, however, several questions arise: How much exercise is enough, and when is it too much? What kinds of exercise are best? What kinds of exercise may he harmful? And are there any guidelines to prescribe a safe and effective exercise program? To answer these questions, it is helpful to first understand the basic principles of exercise physiology, as well as the pathophysiology involved in post-polio syndrome. Following a discussion of these issues is a review of the literature on the effects of exercise in neurologically intact and post-polio individuals. Finally, a new classification system is presented, which will facilitate the prescription of exercise regimens that are both safe and effective in this population.

For articles with Gawne, Anne Carrington, MD as co-author or contributor see the following catalogue entries:

Gendron, Daniel

For articles with Gendron, Daniel as co-author or contributor see the following catalogue entries:

GP

Title: Polio returns to haunt G.P.'s

Author(s): Thomas Moore
Original Publication: GP November 1992
Abstract/Extract: Up to two thirds of people who suffered paralytic polio as children are likely to develop new symptoms similar to motor neurone disease.

Grant, C., BSC(Physio)

For articles with Grant, C., BSC(Physio) as co-author or contributor see the following catalogue entries:

Grimby, Gunnar, MD, PhD

Professor of Rehabilitation Medicine, Sahlgrenska University. See GÖTEBORGS UNIVERSITET / GÖTEBORG UNIVERSITY Avdelningen för rehabiliteringsmedicin / Department of Rehabilitation Medicine.

Title: Endurance Training Effect on Individuals With Postpoliomyelitis

Author(s): Brian Ernstoff, MD, Hakon Wetterqvist, MD, PhD, Henry Kvist, MD, PhD, Gunnar Grimby, MD, PhD
Original Publication: Arch Phys Med Rehabil 1996;77:843-8.
Abstract/Extract:

Objective: To determine the effects of an endurance training program on the exercise capacity and muscle structure and function in individuals with postpolio syndrome.

Design: Preexercise and postexercise testing was performed with muscle strength evaluations using isokinetic testing as well as hand-held Myometer. Muscle fatigue was determined by use of isokinetic testing, and endurance was determined by exercise testing. Enzymatic evaluation was performed with muscle biopsies taken at the same site; preexercise and postexercise muscle cross-sectional area was measured by computed tomography. Disability and psychosocial evaluation was performed by a Functional Status Questionnaire.

Setting: A university.

Subjects: Seventeen postpolio subjects ranging in age from 39 to 49 years volunteered for a 6-month combined endurance and strength training program. They had a history of acute poliomyelitis at least 25 years earlier and were able to walk with or without aid.

Intervention: Twelve of the subjects (mean age 42 years) completed the program, attending an average of 29 sessions, which were offered for 60 minutes twice a week.

Main Outcome Measures: Strength, endurance, enzymatic activity, and cross-sectional area were measured 3 months before the beginning of training, just before training, and at the completion of the exercise program.

Results: Knee extension was reduced to an average of 60% of control values and did not change with training. Strength measured with a hand-held Myometer increased significantly for elbow flexion, wrist extension, and hip abduction. Exercise test on a bicycle-ergometer showed significant reduction (6 beats/min) in heart rate at 70W and increase (12 beats/min) in maximal heart rate with training. The training program could be performed without major complications and resulted in an increase in muscle strength in some muscle groups and in work performance with respect to heart rate at submaximal work load.

© 1996 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

Title: Muscle Function, Muscle Structure, and Electrophysiology in a Dynamic Perspective in Late Polio

Author(s): Gunnar Grimby, MD, PhD, Erik Stålberg, MD.
Original Publication: Reprinted from POST-POLIO SYNDROME, edited by Halstead & Grimby, © 1995 Hanley & Belfus, Inc., Philadelphia, PA. Chapter 2, pp 15-24.
Abstract/Extract: The muscular impairment in patients with a history of polio varies from none to severe. The relationship between the degree of initial involvement and the effect of various compensatory mechanisms determines the clinical picture, which changes dynamically. Early and late recovery after poliomyelitis depend on a number of factors. Clinical improvement that appears within a few weeks after the acute phase is probably due to recovery in the excitability of functional, but not degenerated, motor neurons. Degeneration of neurons, causing peripheral denervation, is compensated by collateral sprouting, i.e., by nerve twigs branching off from surviving motor units overlapping with the denervated ones. This is most likely the main factor explaining recovery within the first 6-12 months. Another late compensatory process is the increase in size of the muscle fibers. As a result of these processes, normal muscle strength and presumably normal muscle volume can be seen despite a calculated loss exceeding 50% of the number of motor neurons.

See also Dynamic water exercise in individuals with late poliomyelitis - Offsite article.

Gronley, JoAnne K., M.A., R.P.T.

Title: Gait Analysis Techniques

Author(s): JoAnne K. Gronley and Jacquelin Perry.
Original Publication: The Journal of American Physical Therapy Assn. Vol. 63, No. 12, December 1984 1831-1838.
Abstract/Extract: In the gait laboratory at Rancho Los Amigos Hospital, the emphasis is on patient testing to identify functional problems and determine the effectiveness of treatment programs. Footswitch stride analysis, dynamic EMG, energy-cost measurements, force plate, and instrumented motion analysis are the techniques most often used. Stride data define the temporal and distance factors of gait. We use this information to classify the patient's ability to walk and measure response to treatment programs. Inappropriate muscle action in the patient disabled by an upper motor neuron lesion is identified with dynamic EMG. Intramuscular wire electrodes are used to differentiate the action of adjacent muscles. We use the information to localize the source of abnormal function so that selection of treatment procedures is more precise. Force and motion data aid in determining the functional requirement and the muscular response necessary to meet the demand. Determining the optimum mode of locomotion and developing criteria for program planning have become more realistic with the aid of energy-cost measurements. Microprocessors and personal computer systems have made compact and reliable single-concept instrumentation available for basic gait analysis in the standard clinical environment at a modest cost. The more elaborate composite systems, however, still require custom instrumentation and engineering support.

For articles with Gronley, JoAnne K., M.A., R.P.T. as co-author or contributor see the following catalogue entries:

NOTES

It is the intention of the Lincolnshire Post-Polio Network to make all the information we collect available regardless of our views as to it's content. The inclusion of a document in this library should not therefore be in any way interpreted as an endorsement.

People who had polio and are experiencing new symptoms need to be assessed by medical professionals who are experienced in Post-Polio to determine what is wrong and to give correct advice. We can only make these documents available to you. YOU must then take what you believe to be relevant to the medical professional you are seeing. We are collecting and collating everything we can to enable medical professionals to make informed decisions. Other medical conditions must be looked for first, Post-Polio Syndrome is by diagnosis of exclusion.

"Source" in the context of this catalogue primarily means original author. In a few cases it will be an organisation or conference.

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© Copyright The Lincolnshire Post-Polio Network 1997 1998 1999 2000 2001 2002

Document preparation: Chris Salter, Original Think-tank, Cornwall, United Kingdom.
Primary Document Reference: <URL:http://www.ott.zynet.co.uk/polio/lincolnshire/library/cs_g.html>
Secondary Document Reference: <URL:http://www.zynet.co.uk/ott/polio/lincolnshire/library/cs_g.html>
Last modification: 7th January 2002
Last information content change: 11th March 2001