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  • Poliomyelitis (Polio)

    Posted: 05-01-2012 22:42

    polio

    Cause: Active infectious disease characterized by fever, permanent motor paralysis and irreversible muscle atrophy, destruction of anterior horn cell of spinal cord. Primarily
    children + young adults (2 – 4 years range) acute stage (Paralitic stage) – several days.
    Deep tendon reflexes because hyperactive then diminish.
    Progression of paralysis stops 48 hr's alter fever, initiates convalescent stage. Paralysed
    muscle atrophies within first 2 months. Slower growth due to decrease in circulation.
    Return of deep tendon reflexes and muscle power reaches limit by 8 months. Lower motor neuron lesion – flaccid, asymmetric paralysis with normal sensation. Polio patients highly motivated to be independent. Distribution of paralysis in lower limb usually involves longer muscle groups, quadriceps, tibialis anterior, triceps surae.
    Gluteus medius + minimus.
    Deformities             -Hip adduction contracture.
    seen with Polio          - Knee flexion contracture.
    - Iliotibial band contractures. (hip ext. rot. fl.)
    - Long C curve scoliosis.
    - Pelvic obliquity.

    Clinical Picture
    a / Flail ankle / foot complex with drop foot.
    b / Valgus center deformity with pescavus.
    c / Genu recurvatum and genu valgum.
    d / Several wasting of thigh and lower leg musculature.
    e / External rotation of foot on the leg.
    f / Leg length discrepancy due to decreased blood supply causing slowed growth.
    g / Trendelenburg gait to counter gluteus medius weakness.
    h / Hyperlordosis to counteract gluteus maximus weakness.

    Orthotic Management
    1 / AFOs to act on the foot / ankle complex when knee is functionally stable or can be made so with an AFO.
    - Trim AFO behind MT heads to allow any use of plantar flexion power during
    push off of gait.
    -    Genu recurvatum + Quad. weakness allow slight ankle plantar flexion.
    -    Combined Tibialis anterior + triceps surae weakness = Rigid AFO.

    2 / KAFO = If hip extensors unaffected may be used instead at Quads to maintain knee extension in stance.
    - Plastic KAFO.
    - Conventional KAFO

    Baca Selengkapnya, Tentang Poliomyelitis dan KAFO, Klik Disini