In fact, for the many thousands of people around the world suffering the effects of Polio, or Post Polio Syndrome (more on this later), you’d perhaps be mad not to though.
Polio, or Poliomyelitis to give it its correct name, is a disease, that whilst having been eradicated in Europe in the early 2000s, still causes pain and is massively life-changing for so many even 17 years on. Polio is a very infectious disease, and was primarily contracted orally, and in years gone by, swimming pools were often blamed for predominantly children contracting it. In up to 70% of cases, there would be no symptoms beyond an extreme cold or flu, or problems with the stomach. In a significant percentage however, the symptoms were severe, and caused a whole range of issues. There was a significant difference between what was known as ‘abortive Poliomyelitis’, where the symptoms, whilst debilitating didn’t lead to paralysis, and ‘paralytic Poliomyelitis’, where as the name suggests, paralysis was a feature. Most often, this was spinal paralysis, and was caused by a viral invasion of the motor neurones in the spinal column. Despite the severity in a large number of cases, many of those who suffered, even badly, as a child, recovered in the main to enter adulthood without the disease.
It is important to note that there is no cure for Polio, and whilst there is a very successful vaccination programme in place in many parts of the world, this isn’t the case globally. The World Health Organisation were hoping for global eradication of the disease by now, we are not quite there yet. As recently as 2015 in the Ukraine, there were 2 new cases of the disease.
The fact that Polio is something of a historic disease, does not mean that we are free from the ‘aftermath’ all these years on. There are believed to be in excess of 100,000 sufferers in the UK alone of a viral infection known as Post Polio Syndrome (PPS). As the name suggests, this is something that arises in adults, usually about 15 to 30 years after they first had polio, and the impact upon health, mobility and lifestyle is hugely significant, as this also has no cure, and the effects of it simply have to be managed, and by this, I by no means suggest that the management of it is simple in any way, shape or form.
Because the vaccination programme didn’t really kick in until the mid 1950s and early 1960s, we still have a large number of PPS sufferers living today, and many have these have significant mobility issues. One of the problems with PPS, is that it is quite difficult to diagnose, as it shares many of its symptoms with Chronic Fatigue Syndrome (CFS), and also in fact is often simply put down to signs of ageing. Unlike CFS however, PPS is progressive, and thus often results in significant loss of muscle strength. Diagnosis can now be done using electromyography, or an EMG as it is more commonly known, or MRI in certain cases. The really bad news for PPS sufferers, is that there is no reversive therapy, thus once diagnosed, it is all about treatment and management of the condition, as opposed to trying to get ‘better’ from it.
This is where Orthotic intervention comes in here. I used the image from Mad Max at the head of this post, as it shows the Max character wearing some kind of futuristic leg brace – futuristic for when the film was made I would hasten to add, and in fact, the range of Knee, Ankle Foot Orthoses (KAFO) today, is far more technologically advanced that anything available in the dystopian world of the mid 21st century envisaged by its makers in 1979! As with many of the conditions I have explored in this blog, the treatment is entirely bespoke and is specific to the individual, so there is definitely no single approach to how PPS is managed in any given person. Ankle Foot Orthoses (AFO) and KAFOs are designed to really do several jobs, and these include the desire to maximise energy efficiency, so really to ensure that any energy used by the wearer has the best outcome, to reduce pain, and of course to protect the limb and the joints from any unexpected or unusual forces, which actually we all encounter naturally as we go about our daily lives, but which have to be managed in cases such as PPS.
The great news, is that technological advances have meant that KAFOs and AFOs are now far stronger and lighter than ever before. Materials such as titanium and carbon fibre are now common in the manufacture of these Orthoses, where callipers used to be made of leather and steel, which were themselves very heavy and cumbersome. Orthotic insoles (FFOs), as well as shoe design and manufacture, all mean that now being prescribed an KAFO, with FFOs, and needing shoes wide and deep enough to accommodate all of this, is no longer an issue of being subject to instruments akin to those used in torture, and having to say farewell to any semblance of style.
Some PPS sufferers reject the PPS label, and prefer to be recognised as still suffering from the Polio that affected them as children or young adults, and there is also some resistance to orthotic intervention in their treatment, as they see this as ‘giving in’. This couldn’t be further from the truth, as this is about maximising mobility and stability, maintaining the highest level of independence, and enhancing lifestyle and making the most of what we can. We haven’t quite reached the dystopian nightmare offered in Mad Max, and even in changing times, we still have so much to enjoy, and the right Orthotics, prescribed by a qualified, experienced and HCPC registered Orthotist, will help you to do this.
If you think that you may be suffering from PPS, or you are experiencing mobility issues of any kind, make that appointment and see your Orthotist as soon as possible, because contrary to the Mad Max title track, we DO need another hero, and it might just be you, and like Max himself, you won’t be much use if you are not wearing your Orthotics!!