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CONDITION/DISORDER SYNONYMS

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  • Late effects of polio

  • Postpolio sequelae

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ICD-9-CM CODES

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  • 138 Late effects of acute poliomyelitis

  • 344 Other paralytic syndromes

  • 357.4 Polyneuropathy in other diseases classified elsewhere

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ICD-10-CM CODES1

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  • G14 Postpolio syndrome

  • G63 Polyneuropathy in diseases classified elsewhere

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PREFERRED PRACTICE PATTERNS

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  • 4A: Primary Prevention/Risk Reduction for Skeletal Demineralization

  • 5H: Impaired Motor Function, Peripheral Nerve Integrity, and Sensory Integrity Associated with Nonprogressive Disorders of the Spinal Cord

  • 5G: Impaired Motor Function and Sensory Integrity Associated with Acute or Chronic Polyneuropathies

  • 6B Impaired Aerobic Capacity/Endurance Associated with Deconditioning

  • 6E: Impaired Ventilation and Respiration/Gas Exchange Associated with Ventilatory Pump Dysfunction or Failure

  • 7A: Primary Prevention/Risk Reduction for Integumentary Disorders

  • 7B: Impaired Integumentary Integrity Associated with Superficial Skin Involvement

  • 7C: Impaired Integumentary Integrity Associated with Partial-Thickness Skin Involvement and Scar Formation

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PATIENT PRESENTATION

Diagnosed with polio 32 years ago, the client reports to physical therapy with left foot and ankle pain. She states that her left leg was primarily impacted by the disease, and she wore braces for about 3 years after the polio subsided. She does not participate in organized sports, but goes for twice daily walks with her dog, each ½ to ¾ miles. She notes that it is taking longer and longer to complete the walk. She has developed a flat foot on the left with little ability to achieve push-off during gait. After approximately 3 minutes of walking, she develops an audible foot slap on the left. Ankle strategies are delayed in both ankles during balance testing, though much slower on the left. She is able to maintain single-leg stance on the left leg for 3 to 4 seconds on a solid surface, but unable to maintain at all on a compliant surface. She is able to maintain single-leg stance on the right leg for 10 seconds on a solid surface, and 4 seconds on a compliant surface.

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KEY FEATURES

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Description
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  • Onset of polio symptoms in people who suffered the effects of the poliovirus in the past

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Essentials of Diagnosis
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  • The poliovirus was eradicated in the United States by 1994 due to the introduction of nationally required polio vaccines in 1955 and 1960.

  • Following are the two types of acute poliovirus infection:

    • Paralytic

    • Nonparalytic

  • The poliovirus attacks the motor neurons by destroying anterior horn cells. In the recovery process, anterior horn cells that survived the virus attempted to reinnervate muscle cells by extensive sprouting of any undamaged motor neurons.

  • In postpolio syndrome (PPS), the motor neurons with the extensive sprouting appear to be degenerating and the associated muscle cells are losing innervation.

  • Following are several hypotheses discussed for the onset of PPS:

    • The degree of loss of anterior horn cells with the initial virus is the primary factor.

    • Age-related changes ...

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