This page contains links to articles and some posts about Exercise.
Aerobic Exercise Training in Post-Polio Syndrome: Process Evaluation of a Randomized Controlled Trial
Post-Polio Health - A Statement about Exercise for Survivors of Polio
eMedTV - Post-Polio Syndrome and Exercise
Sunny Roller - To Reap the Rewards of Post-Polio Exercise
Livestrong.com - Aerobic Exercise & Post-Polio Syndrome
Pubmed - Short-term effects of aerobic exercise on functional capacity, fatigue, and quality of life in patients with post-polio syndrome.
Polio Survivors Network - Exercise - What is right for you?
Post-Polio Syndrome Central - PPS: Exercise - Harmful or Beneficial?
Subject: Resistance Training and Polio
From: Scout
Business Portal 24 (press release) - Bad Lausick,Sachseri,Germany
Article Dashboard
Resistance Training and Polio
By: Lanny Schaffer, Ph.D-4885
[Dr. Lanny Schaffer is an Exercise Physiologist and the President of
the International Fitness Academy.]
http://tinyurl.com/ypsdpo
Excerpts:
Polio victims have the capability to compensate for their condition. This is done by two methods:
*Muscle fiber hypertrophy. This most likely occurs when a load is placed on an already weakened muscle. The muscle responds similar to heavy lifting. Muscle fibers significantly increase in size but not in number.
*Nerve fiber re-innervation. Nerves are capable of re-innervating four to ten times the number of muscle fibers they service. Polio sufferers can acheive this phenomena through resistance training.
While Polio victims are capable of enlarging their muscle fibers just like healthy people, endurance can be a problem as the mitochondria (power houses of the cells) don't increase simultaneously. Endurance training can result in a chronic fatigue-like syndrome and long lasting weakness."
-----
Subject: Exercise and Gain?
From: Eddie Bollenbach
I agree with Diana when she says burning within muscle is likely the
result of lactic acid and it's consequent anaerobic (without oxygen)
reactions inside muscle cells. Diana also mentioned that exercise in a
polio patient is all pain and no gain. I've never believed this as it
was counterintuitive to me and I felt that if one rested muscles too
much the same sort of damage polio did in the first place,that is if
the muscle is not completely paralyzed, would continue to occur. I was
37 when PPS struck and I went from a normal looking walking individual
to a wheelchair due to weakness in my back and legs. But I started
swimming (I have no respiratory loss) and now swim competitively in open
water distance swim races. I feel much better then when PPS ruled until
I "scientifically" started moving. I never went beyond a pain point I
thought would come back and bite me and I even discovered other cues
(like a tightening on the side of my lower leg) which told me I was
going to have pain for a few days. Most credentialed knowledgeable
physicians today recommend exercise for PPS patients. I was doing it
before this happened; the stubborn brute I am.
Below you will find a link to a paper in the Journal of Physiology which
took mice and destroyed up to 80% of their spinal cord including areas
of the cord that innervated their forelegs or hindlegs. They allowed one
group to move around freely in their cages (exercise group) and used a
paralyzing agent, Tetradoxin, to completely immobilize (rest) other
partially enervated muscle fibers. Guess what? The rest group produced
many fewer to no synapses (nerve end fibers) from damaged nerve to
muscle and lost more and more connections, while the normal movement
(exercise group) developed increased sprouting and even new axon
regeneration.So entire motor units were replaced. Hmmmmm!!! Other
papers by Cashman, et alia, avulsed (damaged) spinal cord and then
exercised mice to exhaustion every day and found they too lost more end
fibers --- this was stated as experimental proof for the no exercise at
all overuse theory of PPS. It is more complicated than that and this is
good news, not bad. As we find the reason some people get PPS and others
don't we can treat the cause.
http://jp.physoc.org/cgi/content/full/543/2/655
Eddie
Subject: A PPS Non-Fatiguing Exercise Protocol
At various times in the past when the subject of exercise comes up on the list I have often meant to send in this exercise protocol - it never happened. I was scrolling through some files today - saw it - thought I'd send it now. I received it along with some specific for me exercises when I was diagnosed in 1996 at the PPS clinic at the Spaulding Rehabilitation Hospital in Boston. It has worked quite well for me.
Richard
* * * * *
Non-Fatiguing
Exercise Protocol
for Patients with Post-Polio
Syndrome
Developed
by Linda Wobeskya, P.T.
Spaulding
Rehabilitation Hospital
Boston,
Massachusetts USA
This exercise
protocol is designed for
patients with a previous history of poliomyelitis. It is used for
patients
with or without post-polio syndrome. Patients have been seen to benefit
from a daily exercise program of 1/2 hour in length (or less).
Information
gained from manual muscle testing is used to choose exercises which
target
major muscle groups that impact functional activities. The patient
repeats
each exercise until they report the muscle begins to fatigue. Subtract
2 -3 repetitions and assign that number to the patient. For example, a
patient performs 10 repetitions of knee extensions in sitting and
reports
slight fatigue by the 10th repetition. Assign 8 repetitions. As the
patients
strength improves, the repetitions are increased by twos up to 25 or 30
repetitions. At this point, the exercise is progressed to use a 1 pound
weight* and the repetitions decreased to 10. Repetitions are increased
to 25 or 30, weight is added, the repetitions decreased to 10, and so
on.
If the patient can initially perform 25 repetitions, they
begin
with
the amount of weight and number of repetitions they can perform without
fatigue. If the strength of a particular muscle group is less than
fair,
the same protocol is used with an exercise in the gravity-eliminated
position.
However, no weights are used until the patient is able to perform 25
repetitions
of the exercise in the anti-gravity position. The patient should
experience
NO fatigue after an individual exercise or after the exercise program.
In addition, the patient's overall fatigue at the end of the day should
not increase.
Note: * In my case,
I was given an
special
elastic band to add resistance to my repetitions when I reached that
point,
instead of a weight. The same protocol applied; reduce to 10 or less,
work
back up to 25 or 30, then go up the the next graded resistance elastic
band. The elastic bands come in increasing graded resistances
identified
by color. I began with the least resistance yellow band.
Richard
Subject One way to determine when over-doing it
From moonshadow
Along with the discussions on diagnosing pps this bit that I picked up from the March of Dimes publication "Post-Polio Syndrom.. identifying best practices in diagnosis & care (2001). this was put out after their coference of 2000.
Anyway the very last page is called Appendix B (you can find a copy of the brochere at their website) Borg Rating of Percieved Exertion
I am going to copy it here as it is on the page... this chart has helped me cut through my denial system (such and such isn't reallly that hard or fatiguing or...) and helped me be more honest with myself as PPS slowly progresses and I find I need to take another look at things I'm doing and how I'm doing them.
here it is:
To avoid excessive muscular and general fatigue, patients can monitor their perception of fatigue by using the Borg Rating of Perceived Exertion (RPE). This scale is a useful measure of effort, and therefore an aid in limiting exercise in PPS and other conditions. To prevent excessive fatigue, injury and overuse syndromes, PPS patients should end that activities at an RPE level of 14 or lower. ...
06
07 Very, very easy
08
09 Very easy
10
11 Fairly Easy
12
13 Somewhat Difficult
14
15 Difficult
16
17 Very Difficult
18
19 Very very difficult
20
*********************************************************************
I don't know why but when I ask myself how such and such activity feels
using this scale it is hard for me not to be honest... I know when its
actually somewhat difficult, difficult or very difficult.
I wish I could say that I seldom or even never do anything that is more than somewhat difficult but I can't. I still find myself often doing what is difficult.. just one more twist.. one more slice...one more...whatever. I can say that I seldom do anything that falls into very difficult and it is very very rare that I persist with what has become very very difficult.
In fact, it was using this scale before I got my powerchair that helped me realize just how really difficult doing all that walking and standing had become.
and.. for me.. this cuts through the well I 'can' still do it... yes, I can still do a lot of things but with varying degrees of difficulty I now ask myself .. 'is it worth it?'
It helped to give up doing the things that were really hurting me more than they were worth...and when it gets down to it anything that is increasing the speed in which I lose muscels/nerves isn't worth it....
hope this helps.
I have taken this booklet with me to doctor visits.. and it has helped them understand me better too... after all we pps-ers arn't the only type A's out there... and I some of the difficulty we run into in dealing with doctor's lies in their type A-ness... their belief in if you can then you should be doing it... tie this in with our long held desire to please the doc's and others we can easily 'show off' in their office.
in fact, I now tell them I will probably show off if they allow me to...but if they ask me how it feels with this scale they will see what is really happening faster.....
gentle hugs
ellen