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The postpolio syndrome. An overuse phenomenon.

J Perry¹, G Barnes, J K Gronley

¹Rancho Los Amigos Medical Center, Downey, CA 90242.

Clinical Orthopaedics and Related Research

|August 1, 1988

Summary

Late-onset weakness in polio survivors may stem from muscle overuse. Dynamic electromyography (EMG) revealed excessive muscle strain during walking, supporting this theory for functional loss.

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Area of Science:

Neurology
Rehabilitation Medicine
Biomechanical Engineering

Background:

Polio survivors experience late-onset functional decline, including weakness, fatigue, and pain, decades after initial recovery.
The underlying cause of this progressive dysfunction remains a significant clinical challenge.

Purpose of the Study:

To investigate the hypothesis that muscle overuse contributes to late functional loss in polio survivors.
To quantify muscle activity during walking in symptomatic individuals using dynamic electromyography (EMG).

Main Methods:

34 polio survivors with new functional loss underwent dynamic EMG and foot-switch stride analysis during walking.
Muscle strength was manually assessed and categorized.
EMG data (intensity and duration) for key leg muscles were normalized and compared to laboratory norms to identify overuse.

Main Results:

Muscle overuse was detected in various leg muscles during walking, with biceps femoris (82%) and quadriceps (53%) showing the highest frequency.
Despite infrequent excessive activity, soleus muscle use was notably intense and prolonged.
Gait velocity was significantly reduced in patients with muscle weakness, correlating with functional impairment.

Conclusions:

The study provides evidence supporting muscle overuse as a primary factor in the late functional decline experienced by polio survivors.
Targeted interventions addressing muscle overuse may be crucial for managing long-term polio sequelae.

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