A 3-Year Physiotherapy Management of a Case of Spinal Poliomyelitis Referred at Three Months Post Paralysis

Abstract

Background: Poliomyelitis is known to bring about huge complications that foist debilitating disabilities on a patient with poliomyelitis. Most post-polio survivors live with disabilities throughout a lifetime with an attendant social and economic consequence. Objective: Based on the findings from subjective assessment and physical examination, the objective of the current study focused on early physiotherapy intervention measures for preventing complications such as contracture, joint stiffness, muscle wasting, severe gait abnormality, vertebral mal-alignment, and unusual pain. Case Description: A 4-month-old patient referred for physiotherapy evaluation following an inability to functionally move the two lower limbs and lifting of the left upper limb. There was no history of previous treatment before referral to physiotherapy management. The physical therapists reviewed the available literature, consulted with medical and physical therapist experts and the patient, and elected to use an approach combining the use of low intensity, short duration, and intermittent activity or exercise performed within patient’s limit of fatigue, weakness, and pain. Intervention: The child was on low-intensity exercises, electrical muscle stimulation and heat therapy 3 times per week for 12 months, 2 times per week for12 months, once a week, and once in two weeks for 6 months. Outcomes:  Patient was able to achieve one-minute ambulation without walking aid in 33 months. Significantly, patient attained 5-minute ambulation in 36 months’ time. Also, ranges of motion were intact with no records of contracture in any tendon. Discussion: The outcome of this study demonstrated that early physiotherapy intervention and long-term follow-up are beneficial in preventing/reducing complications, thereby regaining of millstones and achieving functional independence in patients with acute flaccid paralysis such as polio.