Orthotic Treatment Of Poliomyelitis

2. Orthotic Treatment
For Poliomyelitis
Prepared By:Amina Jamil
Bsc (hons) Orthotics And
Prosthetics
2nd year K.E.M.U

3. Contents
 Poliomyelitis
 Orthotic treatment of poliomyelitis
 Objectives of orthotic intervention
 Management of ankle foot complex
 Management of knee
 Management of hip
 Complications
 Orthotic treatment post complications

4. Poliomyelitis
Acute infection by the polio virus,
especially of the motor neurons in the
spinal cord and brainstem, leading to
muscle weakness, paralysis and
sometimes deformity.

5. Orthotic Treatment Of
Poliomyelitis
 The orthotic goal to halt increasing debility
may be to stop the motion at a joint to
compensate for failing compensatory
motion in order to increase safety and
stability, improve walking ability and
perceived walking safety with less overall
pain.

6. Objectives Of Orthotic
Intervention
 Correcting or accommodating and preventing
deformity
 Supporting the limb for stability
 Decreasing the stresses placed on the joints
 Decreasing the energy expenditure that is causing
the muscles to become fatigued
 To normalize the gait pattern, since normal gait is
the most energy-efficient and least stressful way
to walk.

7. Objectives Of Orthotic
Intervention
 The orthotic management of polio patients may
consist of return to functional orthoses, often after
many years of non use.
 Design incorporated increased function and
stability with decreased weight are desirable.

8. Management Of Ankle Foot
Complex
 The plantar surface of the foot should be carefully examined
for weight bearing.
 The presence of metatarsalgia or hypercalosity indicate the
needs for improvement of weight bearing.
 If the hip and knee are stable.painless and free from gross
deformity an AFO can be applied. When useful talocrural
motion is present, the articulating AFO can be applied if
there is weakness in pre tibial muscles, posterior leaf spring
AFO can be used.
 If the knee is relatively free from transverse plane deformity
and recurvatum. But weakness of CALF muscles present.an
Anterior Floor Reaction AFO may suffice.

10. Management Of Knee
 Polio survivors are aging and facing multiple pathologies.
With age, walking becomes more difficult, partly due to
locomotor deficits but also as a result of weight gain,
osteoarticular degeneration, pain, cardiorespiratory
problems or even post polio syndrome (PPS).
 These additional complications increase the risk of falls in
this population where the risk of fractures is already quite
high. The key joint is the knee.
 The muscles stabilizing this joint are often weak and
patients develop compensatory gait strategies, which could
be harmful to the locomotor system at medium or long term.

11. Management Of Knee
 Classically, knee recurvatum is used to lock the knee during
weight bearing; however, if it exceeds 10 degrees , the knee
becomes unstable and walking is unsafe.
 Thus, regular medical monitoring is necessary. Orthoses
play an important role in the therapeutic care of polio
survivors.
 The aim is usually to secure the knee, preventing excessive
recurvatum while respecting the patient's own gait.
 Orthoses must be light and pressure-free if they are to be
tolerated and therefore effective.
 Other joints present fewer problems and orthoses are rarely
indicated just for them.

12. Management Of Knee
 The main issue lies in the prior evaluation of treatments'
impact. Some deformities may be helpful for the patients'
gait .
 Therefore corrections may worsen their gait, especially if a
realignment of segments is attempted.
 It is therefore essential to carefully pre-assess any change
brought to the orthoses as well as proper indications for
corrective surgery. In addition, it is essential for the patient
to be monitored by a specialized team.

14. Management Of Hip
When the weakness also present on hip
muscle, ischial weight bearing KAFO often
used with Quardilateral style Brim.

16. Complications
Contracture or deformity, may develop,
such as:
 Cavus
 Forefoot aducts
 Halus valgus
 Equinus
 Pes valgus
 Genu recurvatum
 Genu valgum
 Genu varum
 Lordosis
 Scoliosis

17. Orthotic Treatment Post
Complication
 With the presence of contracture and deformity,
the orthotic treatment is to reduce / correct the
deformity , along with providing stability as well as
enhance mobility. So that patient can perform the
activity daily living.
 The use of carbon fibre material in the orthotic
treatment of polio patients seems to be supported
by the positive results.