Kozo HANAYAMA

Department of Rehabilitaion Medicine, Tokai University School of Medicine

(Received 29 August 2003)

Abstract: Many individuals in Japan have suffered from so-called post-polio syndrome (PPS) since the early 1980s, because poliomyelitis epidemics occurred in Japan up to the late 1950s. PPS is defined as the development of new weakness and fatigue in the skeletal or bulbar muscles arising from an unknown cause at 25-30 years after an acute attack of paralytic poliomyelitis. PPS is hypothesized to arise when the remaining motor neurons in the post-polio state can no longer maintain all of their distal axonal sprouts. Electrophysiological studies have confirmed the presence of ongoing denervation and chronic reinnervation. The symptoms and signs of PPS include new muscle weakness and atrophy (post-poliomyelitis progressive muscular atrophy; PPMA), as well as other musculoskeletal symptoms such as fatigue, skeletal deformity, and pain. Psychological problems may also modify the other symptoms. Weight control, avoiding overwork, proper posture and alignment, lifestyle modification and the use of orthoses or other devices are helpful for the management of PPS. In addition, muscle strengthening and aerobic exercises have been reported to be useful even in PPS patients with a current exercise regimen. Exercise should be based on the status of each limb and the regimen should be modified if any new weakness, pain, or fatigue appears.

Key words: poliomyelitis, post-polio syndrome, overwork weakness, neuromuscular disease