Late Effects of Polio

By Sarah Mengel l Accredited Exercise Physiologist
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This is a summary of the Late Effects of Polio presented by Paul Cavendish from Polio Australia at the Toowoomba Base Hospital in March, 2018. 

Poliomyelitis or Polio as it’s more commonly termed is a motor neuron disease which most commonly attacks the cells in the anterior horn of the spinal cord. These cells become damaged and can spread throughout the body by either muscle innervation or spinal cord innervation. This results in an increase in fatigue, muscle atrophy and pain. The disease can be “live for up to 6 weeks and can take anywhere from months to years to recover. 

There are several different types of polio: 

  1. Non-paralytic
  2. Paralytic
  3. Bulbar

The blog topic focusses on paralytic polio which goes through a degradation and then recovery phase. The recovery phase involves growth of new terminal sprouting to myofibril hypertrophy, and then a spread of motor units and changes in muscle fibre to aid in nerve rebuilding and new innervations. The Type two fast twitch muscles fibres are most affected which leads to Type IIa fibres being most relied on and an increased susceptibility to fatigue. 

Most commonly paralytic polio patients have back pain due to neurological muscle weakness through decline trunk muscle activation and a change in physiological biomechanics. 

Post Polio Syndrome is the “gradual or abrupt onset of weakness in polio-affected muscles which may or may not be accompanied by generalised fatigue, muscle atrophy, joint and muscle pain, decreased endurance and diminished function” – Polio Australia. This usually occurs following a period of functional stability post polio (15-40 years later). 

The late effects of polio result in:

  • Decreased muscle endurance and fatigue
  • Overuse compensatory muscle groups
  • Muscle pain and/or spasms
  • Joint pain and/or degradation such as arthritis
  • Biomechanics deformity such as kypho-scoliosis
  • Muscle contracture
  • Osteopenia or osteoporosis
  • Shortness of breath due to chest deformities
  • Respiratory insufficiency due to sleep apnoea
  • Weakening respiratory muscles
  • Hypoventilation due to early damage to the respiratory control centre
  • Muscle atrophy
  • Muscle twitching/fasciculation
  • Compression neuropathy
  • Preservation of sensation irrespective of muscle loss

The current recommendations of a persons with late effects of polio regarding exercise according to Polio Australia are: 

Post Polio

Recommended to remain in one-on-one sessions rather than group for treatment. Beginning at 1x per week with conservative treatment, monitoring fatigue during and post exercise. If they can’t complete three repetitions when strengthening won’t work and will lead to a decline in function.

Accredited Exercise Physiologists undergo training to provide individualised exercise prescriptions to persons with late effects of Polio. To learn more about how exercise can benefit yourself or a friend with the late effects of Polio, please get in touch with our Accredited Exercise Physiologists on 0745 993 165. 


Cavendish, P. (2018, March 9). Late effects of polio clinical practice workshop. Lecture presented at the Toowoomba Base Hospital, Toowoomba, QLD.