NOTE: This message was originally in conference "INTERNET - E-MAIL AREA"
      and was copied here by Tom Mckeever.
From:         amitchel@ATLWIN.COM
To:           Multiple recipients of list POLIO 
Date:         Sat, 26 Aug 1995 22:14:00 -0500
Subject:      Post-polio criteria
Organization: CyberNet Communications Corp.
 
Someone requested the current criteria for post-polio. Listed below is a
copy of the digest of a recent talk by Dr. Brigitta Jann, Medical
Director of Emory Rehabilitation Center. Since the original document was
created in Word 6.0a, the formatting did not come out just right for
Usenet mail, but hopefully it is readable.
 
Post-polio syndrome in general with emphasis on weakness in muscles and
the effect of exercise was the subject Dr. Brigitta Jann, Medical
Director of Emory Rehabilitation Center discussed in our July meeting.
The following are highlights from her interesting and informative talk.
Criteria currently accepted for diagnosis of post-polio syndrome are:
 
        Prior episode of paralytic polio
        EMG evaluation demonstrating a change in the anterior horn cells
        Period of stability usually lasting approximately 20 years
before onset of new muscle weakness
        Gradual or abrupt onset of new neurological, medical or
orthopedic problem
        Exclusion of any other neurological, medical or orthopedic
problems that could be causing the symptoms present
        The number one complaint by post-polio patients is fatigue. This
is borne out by independent studies at three clinicsuMadison, Syracuse
and Houston.
        It is generally recognized that the anterior horn cells of Polio
survivors were infected with a virus and those muscles controlled by the
anterior horn cells were weakened and often atrophied. Those muscles
weakened but not atrophied are often the ones affected at the onset of
post-polio. In addition, the natural aging process tends to break down
additional anterior horn cells.
        The weakness experienced is due to:
        Loss of motor units
        Loss of muscle fiber
        Disuse
        Overuse
        Weight gain
Dr. Jann presented predisposing factors and divides them into three
categories: (1) Known for sometime; (2) From recent studies; and (3) Not
previously recognized.
Known for sometime
        The greater the initial polio, the more likely to develop post-
polio
        Longer time since illness, the more likely to develop post-polio
From recent studies
        Recent weight gain can trigger post-polio
        Onset of muscle and/or joint pain especially with exercise
Previously not recognized
        Amount of recent physical activity
        Gender
The following areas for treatment of post-polio syndrome were outlined
by Dr. Jann:
Medical problems
        Administer flu shots
        Treat respiratory problems aggressively
        Treat secondary cardiac failure
        Treat other medical complicationsuanemia, thyroid and obesity
Excessive fatigue
        Institute energy conservation measures
        Provide medicine
        Weight loss, when appropriate
Protection of weakened muscles
        Reduction of overall activity
        Avoid excessive fatigue through pacing
Sleep disorders
        Support respiratory insufficiency
        Treat sleep apnea (also that of mate)
Muscular weakness and joint pain
        Decrease stress
        Take anti-inflammatory drugs
        Corrective surgery, when needed
        Exercise in water, but do not over use
        Stretching exercise and cardio-vascular exercises
        Heat massage
Emotional support
        Support groups
        Psychological help
A video copy of the entire text of Dr. Jann's report is available in our
library. Since this report condenses the content of her talk, APPA
members are encouraged to take advantage of the video library copy of
the complete talk.
 
Alan Mitchell             eMail:  alan.mitchell@atlwin.com
Atlanta, Georgia
 
* CMPQwk 1.42-R1 1598 *Bacteria: Rear entrance to a cafeteria.
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