Major Research Findings

Post-polio syndrome (PPS) is characterized by new muscle weakness and/or muscle fatigability that occurs many years after the initial poliomyelitis illness. 25 An individualized approach to rehabilitation management is critical. 25 Interventions may include rehabilitation management strategies, adaptive equipment, orthotic equipment, gait/mobility aids, and a variety of therapeutic exercises. 25 The progression of muscle weakness in PPS is typically slow and gradual; however, there is also variability in both the natural history of weakness and functional prognosis. 25 Further research is required to determine the effectiveness of selected medical treatment. 25

PPS patients are at increased risk for falls and associated hip and femoral fractures as a result of lower bone mineral density, decreased lean muscle mass, and musculoskeletal deformities. 20 Current evidence suggests that treatment modalities for femoral fractures should emphasize fixation that allows early progressive weight-bearing and ambulation to optimize functional outcomes. 20

Adding whole-body vibration (WBV) exercises to a home exercise program can be effective in increasing knee muscle strength in PPS patients, although it does not seem to be superior to home exercise alone except for reducing the effect of fatigue on the patient's life. 10

An anthroposophic multimodal treatment for chronic pain in PPS outpatients was found to be safe and effective as an analgesic, particularly when associated with an experimental transdermal gel (ETG). 21 This multimodal approach also corresponded to better efficacy for both pain reduction and improvement in quality of life and resilience.

The use of prosthetics can be a valid means of managing bilateral equinus foot. 8 A biobehavioral approach through telerehabilitation may be a useful option to improve psychological, physical and functional variables in PPS patients. 11

Treatment Summary

Treatment for PPS may include rehabilitation management strategies, adaptive equipment, orthotic equipment, gait/mobility aids, a variety of therapeutic exercises, and whole-body vibration exercises. 25 , 10 The effectiveness of specific medical treatments for PPS is still being investigated. 25

Anthroposophic multimodal treatment, which includes external therapies, art therapies, and neurofunctional reorganization, has shown promise in reducing pain and improving quality of life in PPS patients. 21

Intravenous immunoglobulin (IVIG) may be a beneficial option for managing pain in PPS patients, and pain reduction might be responsible for the improvement of muscle strength or function. 16

Treatment modalities for femoral fractures in PPS patients should emphasize fixation that allows early progressive weight-bearing and ambulation to optimize functional outcomes. 20

Benefits and Risks

Benefit Summary

Treatment for PPS can improve quality of life, reduce pain, and improve muscle strength and function. 25 , 10 , 21 , 16

Risk Summary

Some treatments for PPS can have side effects. For example, whole-body vibration exercises may cause nausea and dizziness, and video game-based therapies can lead to falls or injuries. 10 , 19

Comparison between Studies

Commonalities among Studies

These studies are all focused on understanding and treating PPS. They share a common goal of improving the quality of life for PPS patients.

Differences between Studies

These studies differ in terms of the specific treatments investigated, the populations studied, and the outcomes measured. Some studies focus on the effectiveness of specific treatments, while others explore the safety or feasibility of different approaches. These differences make it difficult to directly compare the results of these studies. However, the findings contribute to the growing body of knowledge about PPS and its treatment.

Consistency and Contradictions in Results

The results of these studies are not always consistent. For example, one study found that whole-body vibration exercises were effective in increasing muscle strength, while another study found that this type of therapy had no significant benefit compared to home exercise alone. 10 , 26 These inconsistencies may be due to differences in the populations studied, the treatment protocols used, or the outcome measures employed.

Application in Real Life: Considerations

The findings from these studies can be applied in real life to help PPS patients manage their symptoms and improve their quality of life. It is important to consult with a healthcare professional to determine the most appropriate treatment approach for each individual patient. The specific treatments and their benefits and risks should be carefully considered on a case-by-case basis.

Limitations of Current Research

There is still a lot we don't know about PPS, and more research is needed to develop effective and safe treatments. Some limitations of current research include the small sample sizes of some studies, the lack of long-term follow-up in many studies, and the heterogeneity of the PPS population.

Future Research Directions

Future research should focus on:

• Identifying the most effective treatments for specific symptoms of PPS
• Developing personalized treatment plans tailored to individual patient needs
• Conducting large-scale, long-term studies to evaluate the long-term effectiveness and safety of different treatments

Conclusion

PPS is a complex condition that can significantly impact a person's quality of life. While there is no one-size-fits-all treatment for PPS, a variety of approaches, including rehabilitation, exercise, and medication, may help to manage symptoms and improve function. Ongoing research is essential to better understand PPS and develop more effective treatments.

If you are living with PPS, it is important to work with a healthcare professional to develop a comprehensive management plan. Early intervention can help to prevent further decline and maximize function.

Treatment List

Rehabilitation, adaptive equipment, orthotic equipment, gait/mobility aids, therapeutic exercises, whole-body vibration exercises, anthroposophic multimodal treatment, intravenous immunoglobulin (IVIG), L-citrulline, transcranial direct current stimulation (tDCS), repetitive transcranial magnetic stimulation (rTMS), prosthetic treatment, biobehavioral physiotherapy through telerehabilitation, and surgical management of femoral fractures.