Nonoperative Therapy
Nonoperative therapy can be grouped into acute and recovery stages.
Acute stage
Treatments In the acute stage of poliomyelitis usually involve medical interventions done by pediatric physicians. The main objectives of the therapy is to provide treatment for any type of respiratory disease, prevention of secondary respiratory infection, and to offer general supportive treatment for the pyrexia and irritation. The paralyzed legs are usually supported by plaster splints or pillows and sandbags to ensure the hip joints are in 5° of flexion and in neutral rotation. The knee joint should be healthy as 5° of flexion, and the foot supported in a 90° position. Splinting helps reduce pain and spasm and prevents the development of deformities.
Recovery stage
In the recovery stage, treatment is usually by the orthopedics department. It mostly involves splinting and physiotherapy. Treatments in this stage should be done with an objective. Objectives of treatment include:
- To facilitate the recovery process of paralyzed muscles by remedial exercises
- To prevent deformities by using orthotic devices
Your doctor will first run a check up to determine the severity of muscle paralysis by charting the power of various groups of muscles. The check-up will then be graded according to the international nomenclature (Medical Research Council grading) as follows:
- 0 – Complete paralysis
- 1 – Slight flicker of contraction present
- 2 – Muscles can move a joint only when gravity is absent.
- 3 – Muscle can move a joint against gravity
- 4 – Muscle can move a joint against gravity and resistance
- 5 – Full normal power
A total assessment of your limbs must be done before treatment begins. This usually includes:
- Shortening of the limb
- Charting the muscle power grades
- Method of ambulation
- Extent of contractures and deformities
The main treatment in the recovery stage is physiotherapy. Exercise therapy, hydrotherapy, and electrical stimulation of muscles are very important in managing paralytic polio.