What is the common symptom for post-polio syndrome?
As mentioned previously a common symptom is muscle weakness, which can alter the walking pattern of the patient as they develop methods to compensate for their weaknesses. From the information stated in the referral letter, Robert’s gait pattern can be anticipated. Firstly, a dorsiflexor power three which is functional for swing phase, however, it will have an impact on stance phase, as the initial contact is not done by the heel and is done by the forefoot, which leads to the loss of the first rocker. Moreover, rapid plantarflexion during loading response as the dorsiflexors are not able to control the plantarflexion moment generated at the ankle. Secondly, the quadriceps of grade three which are again functional for the swing. However, during stance, as suggested by Perry, patients with quadriceps weakness tend to avoid knee flexion during loading response, so that they can develop stance phase stability by shifting the line of action of ground reaction force anterior to the knee joint which is known as hyperextension of the knee. This can have an impact on the gait, as in normal gait 60 degrees of knee flexion is produced during the initial swing to ensure foot clearance. However, if the patient is in recurvatum during stance, this leads to the creation of additional demand that is not easily achieved by the patient.
In cases where muscle weakness has a significant impact on gait and may cause pain, assistive devices such as orthoses can be prescribed to achieve an efficient gait and relieve the pain. In this case, the orthotic objective of the device prescribed is to allow controlled plantar flexion during stance. In addition, a heel raise, or shoe raise which is a footwear modification is used to account for the leg length discrepancy.