Advising all polio survivors not to exercise is as irresponsible as advising all polio survivors to exercise.
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Muscle stretching and joint range-of-motion exercises are important whenever there is muscle weakness. Preventing tightness, where muscles are weak, is important to maximize function and is particularly important in the chest wall and abdominal musculature if there is a limitation of breathing capacity. Preventing tightness in the hip and knee is important to maximize walking ability when there is significant weakness of the hip and thigh musculature.
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New breathing problems in aging polio survivors can be insidious and often not recognized by either polio survivors or health care professionals. Individuals who used an iron lung, or barely escaped one, during the acute phase should be aware of potential problems to avoid underventilation and possible respiratory failure. Those survivors who did not need ventilatory assistance during the acute phase, especially those who had high spinal polio and who have upper body weakness and/or diaphragm weakness, may also be at risk.
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Pulmonary function testing can be done in a pulmonary function laboratory. Simpler tests can also be done in a physician's office or in the home. Testing most often is used to identify airflow abnormality, reduced lung volume (restrictive abnormality), diffusing capacity changes (as in interstitial disease), and blood gas abnormality (too much carbon dioxide, too little oxygenation). The following tests are commonly performed.
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GENERAL INFORMATION LETTER FOR POLIO SURVIVORS
Why are "old polios" who were stable for years now losing function? What should they do about it?
Jacquelin Perry, MD, DSc (Hon), Rancho Los Amigos National Rehabilitation Center, Downey, California
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