Review article : The late effects of poliomyelitis: aetiology and rehabilitation

Decades after their acute infection, many polio survivors are suffering renewed muscle weakness, increasing respiratory difficulties, musculoskeletal pain, fatigue and cold intolerance which lead to a 'second disability'. Some symptoms are due to chronic mechanical strain caused by using joints rendered unstable after the acute infection. The cause of others, such as postpoliomyelitis muscular atrophy, is . unknown although overuse, ageing, disuse atrophy and metabolic fatigue of axon sprouts in the abnormally large motor units may play a role. The aim of rehabilitation is to halt the progress of the condition and reduce its physical and psychological impact. Reduction in strenuous activity is important. The use of orthoses or a wheelchair may help to reduce pain and the energy cost of mobility. Respiratory aids such as the cuirasse can improve health. Counselling and peer group support can help the patient to accept his physical limitations.