ROLE OF PHYSIOTHERAPY IN

MANAGEMENT OF POLIOAmandeep Singh

MPT 1ST yearDepartment Of Physiotherapy,

Punjabi University,Patiala.

INTRODUCTION Poliomyelitis or polio or infantile paralysis is an acute viral disease spread from person to person, primarily via the faecal-oral route. involves CNS, producing serious illness and flaccid paralysis by

causing destruction of motor neurons in spinal cord. The term derives from the Greek words poliós  meaning "grey“ myelós  referring to the "spinal cord" suffix -itis, which denotes inflammation.

The disease of poliomyelitis has a long history. The first example may even have been more than 3000 years ago. An Egyptian stele dating from the 18th Egyptian dynasty (1580 - 1350 BCE) shows a priest with a deformity of his leg characteristic of the flaccid paralysis typical of poliomyelitis.

ETIOLOGY

Poliomyelitis is caused by infection with a member of the  genus Enterovirus  known as poliovirus (PV).

This group of RNA viruses colonize the gastrointestinal tract— specifically the oropharynx and the intestine.

Three serotypes of poliovirus have been identified—poliovirus type 1 (PV1), type 2 (PV2), and type 3 (PV3)

The incubation time :- 3 - 35 days with a more common span of 6 - 20 days.

How Polio presents Initial symptoms of polio include fever, fatigue, headache, vomiting, stiffness in the neck, pain in the limbs, paralysis, in a small proportion of cases which is often

permanent.

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Main Problems of The Patient

Fatigue (Commonest) Weakness Muscle pain Gait disturbance

Respiratory problems Swallowing problems Cold intolerance Sleep apnoea

MANAGEMENT

Limit infection and disseminationImprove general hygiene: Clean water supply

Polio Vaccines Killed virus injected (Salk vaccine)Live attenuated virus (Sabin vaccine)

PHYSIOTHERAPY MANAGEMENT

Exercises- Strengthening exercises (isometric, isotonic, isokinetic) Aerobic exercises• Strengthening exercises increases both the strength as well as

the endurance of the muscles in polio patients.• Aerobic exercise increases the functional capacity, reduces

fatigue, and improves quality of life in patients.

Neuro-physiological techniques:-

• Techniques like PNF are very beneficial in the strengthening of the muscles as well as enhancing the coordination between different muscle groups to perform the movement in smooth and rhythmical way.

Pain management strategies:-• A variety of therapeutic modalities such as ultrasound, interferential

therapy, TENS, short wave diathermy, laser are effective in treating many orthopaedic problems that arise indirectly from the residual polio-related weakness, such as joint inflammation, tendonitis, and ligament laxity.

Pool therapy/aquatic therapy:- • The warmth of the water helps to promote blood circulation and muscle

relaxation. Weight bearing in water dramatically decreases the mechanical stress placed on the lower limb joints. Aquatic exercises increases the dynamic muscle strength in the the polio patients.

• Stretching exercises:-• These exercises induce relaxation in the muscles and maintain the integrity

of muscle function. In the post-polio population, hip and knee flexion contractures, as well as ankle plantarflexion deformity, are the most common to develop. Stretching exercises reduces the tightness in the muscles and thus improves the function of the muscles.

Postural correction exercises:-

• These exercises are aimed at relieving muscle tension and preventing unnecessary joint stresses. These include toning and/or stretching exercises for the paraspinal and abdominal muscles, as well as postural exercises for the neck and shoulder girdle region.

CONCLUSION Polio is one of crippling conditions in the developing

countries. It is transmitted by droplet infection and oral ingestion. The symptomatic illness following infection is due to the destruction of the anterior horn cells of the spinal cord and the brain stem. The involvement is predominant in the lower limbs. Physiotherapy, as a part of a multidisciplinary rehabilitation team play an important role in the management of polio.