DO'S AND DON'TS
GENERAL THERAPIES AND THINGS TO AVOID
The following information has been made available with the permission of the
Easter Seal Society of Washington. The opinions expressed are those of
the individual writers, and do not necessarily constitute an endorsement or
approval by the Easter Seal Society or Polio Outreach Advisory
Council or the Lincolnshire Post-Polio Network. Although it does
not imply endorsement, it is provided as a service for those seeking such
information. Always consult your doctor before trying anything recommended in
this information or any other publication.
What follows is a general, practical guide for post-polios to use, and
summarizes the current thinking about post-polio. It will be most valuable if
it stimulates you to seek further and more specific information.
- Take time to rest. Nap (if possible) during the day, work fewer hours, and
take longer vacations.
- If you are experiencing increasing muscle weakness, exercise only under
the supervision of a knowledgeable physician.
- Make sure your food intake is nutritious.
- Be alert to (but not obsessed with) changes in your body, and heed your
- Take note of any new symptoms plus clear or gradual changes.
- Get enough exercise to prevent disuse atrophy, but not enough to produce
- Learn how to pace yourself.
- Prevent the secondary complications of weakness, particularly falls; this
might entail the use of crutches or a cane, a wheelchair for extended travel,
or braces or other adaptive equipment.
- Avoid weight gain. Too much weight only aggravates stress on joints and
- Consider possible adaptations to your lifestyle, even minor adjustments
(changes in hobbies or modes of transportation) can help.
- Do not assume that every physician fully understands post-polio problems.
Educate yourself and never hesitate to ask questions.
- Minimize alcohol use, particularly at bedtime. Alcohol inhibits
swallowing, interferes with with nutrition, and causes falls and accidents.
- Maintain a positive attitude towards your health. Accept change, adapt,
and never equate your self-worth with physical disabilities.
- Take common colds very seriously.
- Get bulk-producing fiber in your diet. Avoid stimulant laxatives.
- Medical evaluation of post-polios should include a complete history,
physical exam, and appropriate lab studies.
- Muscle strength evaluation should be done by a registered physical
therapist or someone familiar with neuromuscular disease. Muscle testing is now
advised every year even if there is no obvious change.
- The current recommendation is that all post-polios have a complete medical
evaluation covering the three major areas affected by the polio; neuromuscular,
circulatory and respiratory.
- Problems with extremities or joint function may require special
consultation from physiatrist, orthopaedist, and/or neurologists familiar with
skeletal deformities and muscle weakness.
- Experienced physical or occupational therapists can help determine
functional losses and how best to adapt.
- Muscle stretching and joint range-of-motion exercises are important where
there is muscle weakness.
- Swimming is the best cardiovascular endurance and general conditioning
exercise. Water should be warm (at least 90 degrees).
- Discontinue any exercise that causes pain, weakness, or muscle fatigue,
- Muscles weakened by polio respond poorly to vigorous strengthening
programs. Programs such as weight lifting often aggravate the condition.
- Each of you should know your own strength limits or endurance, and avoid
going repeatedly to that limit.
- You should avoid narcotics for any reason; aspirin is preferred as an
analgesic for muscle or joint pain.
- Occupational therapists can assess extremity function, daily activities,
and the need for assistive devices to help achieve the highest level of
- Rest is the best known treatment for aching muscles. Moist heat,
anti-flammatory medication, and avoiding exertion are also helpful.
- Physical therapy - heat, massage, joint mobilization, and stretching
exercises - can help chronic lower back pain.
- Change of gait pattern, such as using crutches, may be needed to prevent
recurrence of lower back pain.
- You MUST learn to conserve energy.
- Even though you were once rehabilitated, you must be re-evaluated and
taught new techniques to replace those that no longer work.
- Body positioning during sleep is important for post-polios with severe
weakness and postural joint deformities.
- Those with marginal respiratory reserve at sea level should be prepared to
use respiratory aid when travelling above 3,000 feet.
- Everyone with respiratory insufficiency is advised to get flu vaccination
according to Public Service guidelines and recommendations.
Compiled by the Post Polio League.
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Information Service for Polio Survivors and Medical Professionals
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Original Think-tank, Cornwall,
Document Reference: <URL:http://www.zynet.co.uk/ott/polio/lincolnshire/library/easterseal/dodont.html>
15th January 1997
Last modification: 25th January 1999