Care and mobility considerations
Acute Poliomyelitis
Following an acute paralytic attack recovery takes place over 12 months and in many cases there are ultimately minimal or mild functional restrictions only. People are able to care for themselves and are not restricted in their ability to walk.
The severity and extent of the functional restrictions after recovery depends on whether both upper and lower limbs are affected, which limb(s) are weak or paralysed, and whether respiratory problems causing shortness of breath persist.
The person who is left with a shortened wasted leg may be restricted in their ability to stand for prolonged periods, to walk far and to bend down. Use of aids such as callipers, orthoptic splints, walking sticks etc. can improve the ability to stand and walk. Some people with severe weakness of both legs may need to use a wheel chair. They may also be prone to falls and unable to walk without support.
Paralysis and weakness of one or both upper limbs may cause difficulties in reaching, lifting, carrying, griping and carrying out fine movements. The person may need help with washing, dressing, personal hygiene and preparing food. People who have functional restrictions affecting both upper and lower limbs will have a greater need for help from others.
People who require assisted ventilation on a long-term basis may need help from others to use the equipment at home. This is more likely to be the case if they have upper limb weakness or paralysis. Assisted ventilation may only be required overnight. People with residual respiratory difficulties may be short of breath and fatigued when they walk.
Late Effects of Polio and the Post Polio Syndrome
The severity of the functional restrictions in a person with late polio will depend to a large extent on the nature and extent degree of the original disabling effects (see acute poliomyelitis guidance). It is necessary to consider which limbs are affected, whether there is spinal and/or chest deformity and whether there are bulbar symptoms affecting breathing. It is unlikely that existing care needs will lessen significantly in most cases, although replacement of arthritic joints may improve individual limb function.
Mild Functional Restriction
| Category | Description |
|---|---|
Effects |
In people with weakness or wasting in one limb only, or with lesser degrees of weakness in two limbs, functional restrictions may be mild. |
Mobility |
They are able to walk reasonable distances without undue difficulty. Function may be improved by provision of new aids, joint replacement and rehabilitation as described above. |
Care |
They are able to care for themselves. Function may be improved by provision of new aids, joint replacement and rehabilitation as described above. |
Moderate Functional Restriction
| Category | Description |
|---|---|
Effects |
The degree of functional restriction is likely to be greater if the function of more than one limb is affected by the original illness, or by the presence of arthritis or deformity of the non-affected limb. Increased muscle weakness and wasting in affected limbs will further restrict function. Moderate functional restriction will also be present if pain from spinal deformities and spinal arthritis affects arm and/or leg use. Fatigue and shortness of breath may also restrict activities. |
Mobility |
If the lower limbs are affected there may be restricted walking, that is exacerbated by pain, fatigue and shortness of breath. |
Care |
People with moderate functional restrictions may take longer to carry out tasks than previously. Many are likely to need some help with certain aspects of self-care and/or food preparation. |
Severe Functional Restriction
| Category | Description |
|---|---|
Effects |
Severe functional restriction is most likely when both upper and lower limbs are weak, wasted and paralysed. Associated spinal conditions, deformity of the spine and/or chest may be present. |
Mobility |
People are likely to be using wheelchairs and other aids or walking may be significantly reduced by pain, fatigue and shortness of breath. |
Care |
They may already have home adaptations to aid function and enable independent living. The use of mechanical ventilation at home is likely to an indication of more severe levels of functional restriction. The time taken to carry out tasks may be significantly reduced by pain, fatigue and shortness of breath. People with severe functional restrictions are likely to need help with all aspects of dressing, personal hygiene and food preparation. They may need help to feed and to drink, and with using aids e.g. to assist respiration. Help may be needed to move around the house, to manage stairs, to rise from a chair, to use the toilet and to get in and out of wheel chair. |
Amended June 2008
