The Late Effects of Polio: Managing Muscles and Mobility

Polio Australia commissioned this clinical practice resource module for health professionals to inform the broader primary care community about good practice in the management of individuals living with polio, the Late Effects of Polio (LEoP) and/or Post-Polio Syndrome (PPS). The module will also be of interest to those working with individuals with other neurological or musculoskeletal issues, and those living with the late effects of disability.

The module’s content is drawn from three sources: the contemporary practice wisdom of Australia’s current allied health polio specialists; the expert knowledge of those living with polio and its aftermath; and the evidence-based literature. Currently, only hard copies of this resource are available by complete this Order Form. However, an e-book version will be made available for purchase soon.

The Late Effects of Polio: Introduction to Clinical Practice
This on-line resource module for health professionals was commissioned by Polio Australia and completed in October 2012. “The Late Effects of Polio: Introduction to Clinical Practice has been professionally written and reviewed by a team of volunteer medical professionals and has drawn from a large number of pre-existing resources based on best practice principles. It is intended that this initial module be promoted to a range of health service providers to assist in the management of the Late Effects of Polio for their patients. The content provides an overview of the broad range of symptoms associated with the Late Effects of Polio and Post-Polio Syndrome.

The Late Effects of Polio – Information For GPs (Queensland Health)
In 2002 the Queensland Department of Health published the manual “The Late Effects of Polio: Resource Manual for Medical and Allied Health Professionals” in a dedicated polio section of its website. The web pages were developed so that the information contained in the manual could be downloaded and made available to all Queensland Health employees, and other health professionals. Unfortunately, in 2013 Queensland Health removed the manual, and the supporting polio reference material, from its website. Polio Australia is negotiating with Queensland Health to have this still-relevant material reinstated. In the meantime, you can download the manual here.

The manual aims to present contemporary concepts for the assessment, diagnosis and management of the client with a history of polio. It endeavours to assist the health professional to deal with many of the issues these clients may present with.

Lincolnshire Post-Polio Network Library for Medical Professionals
It is the intention of the Lincolnshire Post-Polio Network to make all the information we collect available regardless of our views as to its 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. The section Advise your Doctors of the Catalogue For the Polio Survivor, Friends and Family includes articles (for medical professionals) additional to those listed here, Non-Paralytic Polio and PPS being one significant example. We cannot emphasise enough that medical professionals should read the articles in that section as well as those below.

Catalogue Entry Index

Polio and Post-Polio Primers

Population Surveys

Post-Polio Patient Management

PPS Fatigue

Polio and PPS Psychology

Polio and PPS Physiology

Polio Above The Neck – article by Dr Susan Perlman
Previously much attention has been given to post-polio problems involving the limbs – a weak leg, fatiguing arms, etc. These manifestations of Post-Polio Syndrome (PPS) occur in people who had spinal poliomyelitis – the acute infection that affected anterior horn cells in the spinal cord segmentally.

 Polio Services Victoria – Fact Sheets
Polio Services Victoria (PSV) is located at St. Vincent’s Hospital Melbourne in Melbourne, Australia. PSV Clinics provide initial specialised assessment and care planning, and offer long term review of people who have had polio. A medical referral from a GP or specialist is required before being seen in the clinic. On line fact sheets include:

Post-Polio Health International – Information for Health Professionals

PPS Identifying Best Practices in Diagnosis and Care
In May 2000, the March of Dimes Birth Defects Foundation (March of Dimes), in collaboration with the Roosevelt Warm Springs Institute for Rehabilitation, held an international conference on post-polio syndrome (PPS) in Warm Springs, Ga, USA. The purpose of the conference was to review current information on the syndrome’s causes and promote information exchange on best practices regarding diagnosis, treatment and management of PPS. The two day conference convened many of the world’s leading experts on various aspects of PPS, including causes; diagnostic criteria; features of the disorder, including neurological, musculo-skeletal and respiratory problems; and treatments such as physiotherapy, occupational therapy, coping skills and nutrition. This report derives from that conference.

Treatment for Postpolio Syndrome
This Cochrane review was prepared and maintained by The Cochrane Collaboration and published in The Cochrane Library 2011, Issue 2. Postpolio syndrome (PPS) is a condition that can affect polio survivors years after recovery from an initial paralytic attack by the polio virus. PPS is characterised by progressive or new muscle weakness or decreased muscle endurance in muscles that were previously affected by the polio infection and in muscles that seemingly were unaffected, generalised fatigue and pain. These symptoms often lead to a decline in physical functioning.This review found inadequate evidence from randomised controlled studies to make definite conclusions on the effectiveness of different treatment options in people with PPS. Results indicate that drugs like IVIG and lamotrigine or muscle strengthening and static magnetic fields may be beneficial but need further investigation.

Post Polio Syndrome: Management and Treatment in Primary Care
This document was prepared by the Post Polio Support Group, Ireland and published in 2007 and 2010. It takes a multidisciplinary and holistic approach and is targeted towards helping to enrich the practitioner client relationship to the benefit of both.