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F In a study of 6 male postpolio patients, an association between hip bone density and hip muscular strength was reported. j? These conditions should be identified and treated. 67 Exercise is discussed in detail in Chapter 9. 2· 22- 25 The recommended exercise program for a patient is dependent on a number of factors. Isotonic or isokinetic strengthening can be used to strengthen muscles that are 2: 3 on the Medical Research Council (MRC) scale. Isometric exercise can be used to strengthen muscles 26 Evaluating and Treating Symptomatic Postpoho Patients over a painful joint.
4. Bach JR, Alba A: Pulmonary dysfunction and sleep-disordered breathing as posrpolio sequelae: Evaluation and management. Orthopedics 14:1329-1337, 1991. 5. Bennett RL, Knowlton GC: Overwork weakness in partially denervated skeletal muscle. Clin Orthop 12:22-29, 1958. 6. Borg GV: Perceived exertion as an indicator of somatic stress. Scand J Rehab Med 21:82-98, 1970. 7. Braun NMT, Arora MS, Rochester DF: Respiratory muscle and pulmonary function in polymyositis and other proximal myopathies. Thorax 38:616-623,1983.
L'' The PT can also work with the patient in a swimming pool. The benefits of aquatic therapy include increasing strength, flexibility, and endurance. It can also help to normalize movement and provide muscle re-education, relaxation of muscles, and tone reduction. It may offer improvements in the functional abilities, trunk stability, quality of gait, balance, and posture as well as pain reduction and enhanced psychological well-being. OCCUPATIONAL THERAPIST The occupational therapist assesses patients' independence with ADLs such as dressing, bathing, cooking, and driving.