According to the National Institute of Neurological Disorders and Stroke (NINDS), post-polio syndrome affects about 25 percent to 50 percent of polio survivors, perhaps even more depending on how post-polio syndrome is defined.
Symptoms:
1.New muscle weakness in limbs that were originally affected or in limbs that didn’t seem to have been affected at the time of the initial illness
2.General fatigue and exhaustion with minimal activity
3.Muscle and joint pain
4.Breathing or swallowing problems
5.Sleep-related breathing disorders, such as sleep apnea
6.Decreased tolerance of cold temperatures
In most people, post-polio syndrome tends to progress slowly with new signs and symptoms followed by periods of stability.
How polio affects nerve cells
A polio infection often leaves many of these motor neurons destroyed or damaged. To compensate for the resulting neuron shortage, the remaining neurons sprout new fibers, and the surviving motor units become enlarged. This promotes recovery of the use of your muscles, but it also places added stress on the nerve cell body to nourish the additional fibers. Over the years, this stress may be more than the neuron can handle, leading to the gradual deterioration of the sprouted fibers and, eventually, the neuron itself.
Risk factors:
Factors that may increase your risk of developing post-polio syndrome include:
Severity of initial polio infection. The more severe the initial infection, the more likely that you’ll have signs and symptoms of post-polio syndrome.
Age at onset of initial illness. If you acquired polio as an adolescent or adult, rather than as a young child, your chances of developing post-polio syndrome increase.
Recovery. Paradoxically, the greater your recovery after acute polio, the more likely it seems that post-polio syndrome will develop. This may be because greater recovery places additional stress on motor neurons.
Physical activity. If you often perform physical activity to the point of exhaustion or fatigue, this may overwork already stressed-out motor neurons and increase your risk of post-polio syndrome.
Tests and diagnosis
To arrive at a diagnosis of post-polio syndrome, doctors look for three indicators:
Previous diagnosis of polio. This may require finding old medical records or getting information from older family members, because acute polio primarily occurs during childhood. The late effects of polio usually occur in people who were age 10 or older during the initial attack of polio and whose symptoms were severe.
Long interval after recovery. People who recover from the initial attack of polio often live for many years without further signs or symptoms. The onset of late effects varies widely, but typically begins 10 to 40 years after the initial diagnosis.
Gradual onset. Weakness tends to be imperceptible until it interferes with daily activities. You may awaken refreshed, but feel exhausted by the early afternoon, tiring after activities that were once easy.
In addition, because the signs and symptoms of post-polio syndrome are similar to those commonly associated with other disorders, your doctor will attempt to exclude other possible causes, such as arthritis, fibromyalgia, chronic fatigue syndrome and scoliosis.
Complications
Post-polio syndrome is rarely life-threatening, but severe muscle weakness can lead to complications:
Falls. Weakness in your leg muscles makes it easier for you to lose your balance and fall. A fall may result in a broken bone, such as a hip fracture, leading to other complications.
Malnutrition, dehydration, pneumonia. People who’ve had bulbar polio, which affects nerves leading to muscles involved in chewing and swallowing, often have difficulty with these activities as well as other signs of post-polio syndrome. Chewing and swallowing problems can lead to inadequate nutrition and dehydration, as well as aspiration pneumonia, which is caused by inhaling (aspirating) food particles into your lungs.
Acute respiratory failure. Weakness in your diaphragm and chest muscles makes it harder to take deep breaths and cough, which can ultimately lead to accumulation of fluid and mucus in your lungs. Obesity, curvature of the spine, anesthesia, prolonged immobility and certain medications can further decrease breathing ability, possibly leading to acute respiratory failure. This is characterized by a sharp drop in blood-oxygen levels and may require you to undergo ventilation therapy (positive pressure ventilation).
Treatments and drugs
Because the signs and symptoms often vary, there’s no one specific treatment for post-polio syndrome. The goal of treatment is to manage your symptoms and help make you as comfortable and independent as possible.
Energy conservation. This is probably the most important aspect of managing post-polio syndrome. It involves pacing your physical activity and combining it with frequent rest periods to reduce fatigue. Assistive devices, such as a cane, walker, wheelchair or motor scooter, also can help you conserve energy. A therapist can even show you ways to breathe that help conserve energy.
Physical therapy.
Your doctor or therapist may prescribe exercises for you that strengthen your muscles without inducing muscle fatigue. These usually include less strenuous activities, such as swimming or water aerobics, that you perform every other day at a relaxed pace. Exercising to maintain fitness is important, but be cautious in your exercise routine and daily activities. Avoid overusing your muscles and joints and attempting to exercise beyond the point of pain or fatigue. Otherwise, you may need several days’ rest to regain your strength.
Occupational therapy. A physical or occupational therapist can help you modify your home environment so that it’s safe and convenient for you. This may include installation of grab bars in the shower or a raised toilet seat. Your therapist may also help you rearrange furniture or rethink certain household or work-related tasks, decreasing the number of steps you must take and increasing your efficiency.
Speech therapy. A speech therapist can show you ways to compensate for swallowing difficulties.
Sleep apnea treatment. Treatment for sleep apnea, which is common among people with post-polio syndrome, may involve changing your sleeping patterns, such as avoiding sleeping on your back, or using a device that helps open up a blocked airway.
Medications. Medications, including aspirin and other nonsteroidal anti-inflammatory drugs, may ease muscle and joint pain. Studies of insulin-like growth factor-I (IGF-I), a medication designed to improve muscle strength, showed that although it doesn’t change strength or susceptibility to fatigue, it does improve recovery after exercise.
For many people, exercise is drudgery. Be sure you pick an exercise that you enjoy, and consider exercising with a buddy. Your buddy can encourage you to “keep moving” when you want to stop. You’ll also be more likely to exercise when another person is depending upon you to be there. 
