SPECIFIC RECOMMENDATIONS FOR POST-POLIOS 
                 DO'S & DON'TS, GENERAL THERAPIES 
                       AND THINGS TO AVOID 

 
    What follows is a general, practical guide for post-polios to use 
and that summarizes in outline form the current thinking about 
post-polio.  It is not a substitute for individual medical evaluation or
therapy.  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, 
  take longer vacations. 
__If you are experiencing increasing muscle weakness, exercise only 
  under the supervision of a knowledgeable physician. 
--Make sure you get adequate nutrition. 
--Be alert to (not obsessed with) changes in your body, and heed your 
  body's signals. 
--Take note of any new symptoms plus clear or gradual changes. 
--Get enough exercise to prevent disuse atrophy, but not enough to 
  produce overuse damage. 
--Learn how to pace yourself. 
--Prevent the secondary complications of weakiness, particularly falls; 
  this might entail the use of crutches or a cane, or a wheelchair for 
  extended travel, or braces or other adaptive equipment. 
--Avoid weight gain; too much weight only aggravates stress on joints 
  and muscles. 
--Consider possible adaptatins to your life style; 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 alcholol use,, particularly at bedtime; alcholol inhibits 
  swallowing, interfers with nutrition, and causes falls and other 
  accidents. 
--Try to maintain a positive attitude toward your health; accept change,
  adapt, and never equate your self-worth with physical disabilities. 
--Post-polios with respiratory insufficiency should take common colds 
  very seriously. 
--Get enough 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 diseases.  Repeat 
  muscle testing is now advised every year, even if there is no obvious 
  change in strength. 
--The current recommendation is that all post-polios have a complete 
  medical evaluation covering the three major areas affected by polio: 
  neuromuscular, circulatory, and respiratory. 
--Problems with extremities or joint function may require special 
  consultation--from physiatrists, orthopedists 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 exercies are important 
  where there is muscle weakness. 
--Swimming is the best cardiovascular endurance and general conditioning
  exercise.  Water temperature should be warm (at least 90 degrees). 
--Discontinue any exercise that causes pain, weakness, or muscle 
  fatigue, including walking. 
--Muscles weakened by polio respond poorly to vigorous strengthening 
  programs.  Such programs--weight lifting, for example--often aggravate
  the condition. 
--Post-polios should know their own strength limits or endurance and 
  avoid going repeatedly to that limit. 
--Post-polios should avoid narcotics for any reason; aspirin is 
  preferred as an analgesic for muscle or joint pain. 
--Occupational therapists can help assess upper extremity functin, daily
  activities, and need for assistive devices--all to help achieve the 
  highest level of independence possible. 
--Rest is the best known treatment for aching muscles.  Moist heat, 
  anti-inflammatory medication, and avoiding exertion are also helpful. 
--Physical therapy--heat, massage, jointmobilization, and stretching 
  exercies--can help chronic lower back pain. 
--Change of gait pattern, such as using crutches, may be needed to 
  prevent recurrence of lower back pain. 
--Post-polios MUST learn to conserve energy. 
--Post-polios, even though once rehabilitate, must be re-evaluated and 
  learn new techniques to replace those that no longer work. 
--Body positioning during sleep is important for post-polios with severe
  weakness, postural or joint deformities. 
--Post-polios with marginal respiratory reserve at sea level should be 
  prepared to use respiratory aid when travelling to elevations above 
  3,000 feet. 
--Post-polios with respiratory insufficiency are advised to receive the 
  influenza vaccinatin accordint to U.S.Public Health Service guidelines
  and recommendations. 
 
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Compiled by the Post-Polio League for Information and Outreach (P-POLIO)
 
Sources: 
 
Handbook on the Late Effects of Poliomyelitis, 1984, ed by Gini Laurie, 
-------- -- -- ----- ------- -- ------------- 
    Frederick M. Maynard, M>D>, D. Armin Fischer, M.D., Judy Raymond; 
    published by Gazette International Networking Institute, St.Louis,