Diagnosis

Diagnosis of PPS is currently based on March of Dimes criteria, a modified

version of the Halstead criteria. It includes:

1. Prior paralytic poliomyelitis with evidence of motor neuron loss, as

confirmed by history of the acute paralytic illness, signs of residual
weakness and atrophy of muscles on neuromuscular examination, and
signs of nerve damage on electromyography (EMG). Rarely, persons
have subclinical paralytic polio, described as a loss of motor neurons
during acute polio but with no obvious deficit. That prior polio now
needs to be confirmed with an EMG. Also, a reported history of
nonparalytic polio may be inaccurate.
2. A period of partial or complete functional recovery after acute paralytic
poliomyelitis, followed by an interval (usually 15 years or more) of
stable neuromuscular function.
3. Gradual onset of progressive and persistent new muscle weakness or
abnormal muscle fatigability (decreased endurance), with or without
generalized fatigue, muscle atrophy, or muscle and joint pain. Onset
may at times follow trauma, surgery, or a period of inactivity, and can
appear to be sudden. Less commonly, symptoms attributed to post-polio
syndrome include new problems with breathing or swallowing.
4. Symptoms that are present for at least a year.
5. Exclusion of other neurologic, medical, and orthopeadic problems as
causes of symptoms
[11]

Physical Therapy Management

Physical therapy management for post-polio syndrome (PPS) involves a
multidisciplinary approach to address the various symptoms and challenges
faced by individuals with PPS. It is essential to individualize the treatment
approach based on the patient's specific needs, preferences, and response to
interventions. Regular reassessment and collaboration with other healthcare
professionals are crucial for optimal care.
Physical Therapy Management Considerations

 It is important to recognize the difficulty of sustaining high exercise

intensities for prolonged periods, particularly in severely fatigued
individuals. Training regimes must be highly individualized and
exercise prescription can be based on certain individual markers such as
Aerobic Threshold (AT) or Rate of Perceived Exertion (RPE) .
 Efficiently evaluate muscle function which includes endurance and
strength. Understanding that improvements in muscle function may be
challenging in persons with PPS due possibility of hypertrophied muscle
fiber