2.23 PPS

Question 1

Who developed first polio vaccines?

Answer 1

Salk and Sabin

Question 2

polio transmission

Answer 2

fecal/oral

Question 3

iron lung

Answer 3

creates negative pressure to help them breathe

Question 4

Salk’s vaccine

Answer 4

• dead virus (currently, we get this one in first world)

- not as stable, not a good shelf life

Question 5

Sabin’s vaccine

Answer 5

• attenuated virus
• used more in underdeveloped areas now
• takes 3 doses to get full immunity

Question 6

What structure is affected with polio? Why is this problematic?

Answer 6

• anterior horn cells affected

- during growth, need muscle growth to help strengthen bones and make them grow

Question 7

Prior to vaccines, what was treatment for polio?

Answer 7

• treatments initially didn’t do well, mostly wait and see

- used a lot of bracing

Question 8

What do we usually treat nowadays?

Answer 8

post polio syndrome, not true polio

Question 9

If a post polio patient is below 3/5 strength, what must be done for treatment?

Answer 9

• must go slower (isometric, AAROM)
• don’t just make them do a ton right off the bat, can do a lot of damage
• SLOWLY build up strength

Question 10

results of polio

Answer 10

• scoliosis

- a lot of postural issues

Question 11

Why did people get strong in certain muscles after having polio?

Answer 11

peripheral nerve regeneration

Question 12

With polio, what happens when there’s a nerve still working, but it’s not getting enough activation?

Answer 12

collateral sprouting of nerves » giant motor units (GMUs)

Question 13

Problem with collateral sprouting and GMUs in polio survivers

Answer 13

• these begin to fail for polio survivors, don’t know why
• like putting too many plugs into one outlet, overloaded
• may or may not have an effect on the person

Question 14

What must be considered with any new weakness in a polio survivor?

Answer 14

post polio syndrome

Question 15

orthopedic issues with polio survivors

Answer 15

There will be a lot of orthopedic issues (aside from weakness) depending on how bad the polio was the first time

• Long term bracing, crutch use
• carpal tunnel, hand deformities, shoulder laxity, etc.

Question 16

The typical polio survivor is (personality)

Answer 16

• type AAAA go getters

- don’t like to take no for an answer

Question 17

If a post-polio patient is below 3/5 strength, what type of strengthening should be done?

Answer 17

• isometrics
• need to be in a biomechanically correct position to do isometrics
• align them as much as possible to norms (esp if laxity)

Question 18

How often will you see a post-polio pt?

Answer 18

• depends on severity

- Won’t usually see them a ton

Question 19

Pushing to fatigue in a post-polio patient with weakness

Answer 19

• will make muscles “go bye bye”
• More is no longer better for them
• Taking a step back from what they’ve done their entire lives

Question 20

What may result from the cognitive issues that may be seen in post-polio?

Answer 20

may need a nap to reset their body so they can keep going

Question 21

What are the 5 P’s

Answer 21

• planning
• prioritizing
• pacing
• position
• power

Question 22

What are the 5 P’s for?

Answer 22

energy conservation

Question 23

planning

Answer 23

• day, week
• being realistic about their day and what they can do
• fatigue muscles/brain, put at risk for injury or fall

Question 24

prioritizing

Answer 24

• What has to be done? (is it a want or a need)

- may need to delegate some tasks

Question 25

pacing

Answer 25

- spreading out of activities, not rushing | - maintain energy throughout the day

Question 26

position

Answer 26

- Can I do a task in a position that I normally wouldn't do it in to save energy - i.e. sitting down to take a shower, brush teeth, etc. - proper positioning of joints during exercise

Question 27

power

Answer 27

- (powered mobility and giving back power) - giving them back some of their power - may have to take some ambulation away from some - generally very difficult to talk them into something like this (once they get talked into it, they are typically happy with it)

Question 28

example of giving back power

Answer 28

switching from metal/leather KAFO to thermoplastics