Sunny Roller, M.A.
Polio Survivor, Program Manager
University of Michigan Health System
Frederick M. Maynard, M.D.
U.P. Rehabilitation Medicine Associates, PC
In this year, 2002, we know more about exercise for persons who have polio than we did fifteen years ago. There have been a variety of studies conducted by superb and caring scientists, along with numerous personal accounts from polio survivors, themselves, which warrant a new way of thinking about exercise.
Exercise is different than physical activity. For the purposes of this article on exercise, it may be helpful to define these two terms. Exercise is generally defined as planned, structured and repetitive bodily movement, whereas physical activity is the movement you do throughout the day. Physical activity does increase the amount of calories you burn, but unlike exercise, is not necessarily planned, structured or repetitive motion. One benefit of exercise can be an improved ability to take part in ongoing daily physical activity.
Whether you have a planned exercise program or simply rely on day to day physical activity to stay fit, the message to polio survivors today is "beware of inactivity!" In the 1980s polio survivors across the nation heard and heeded a strong medical warning about the dangers of doing exercise, especially too much exercise and/or physical activity, but now post-polio scientists have qualified their advice. New knowledge tells us that no matter what our level of disability is, we should be encouraged to value exercise, enterprising enough to come up with a highly customized plan and enduring enough to reap the rewards. When it comes to exercise, we need to be smart, not scared! One woman in our University of Michigan wellness study (www.med.umich.edu) told us that in the late 1980s she quit exercising completely out of fear of muscle loss, and gained 35 pounds. Dismayed, she joined the 1996 wellness study to find out what she could do to feel better and it worked! Exercise was put back on her list. She was guided to be selective and conservative as she designed her weekly plan for "working out." She found out that polio survivors need to:
- First, gather the best medical literature from post-polio researchers, educators and clinicians such as Grimby, Agre, Perry, Halstead, Headley, Maynard, Birk, and Yarnell. They will all say that we must each have a custom-tailored plan since we were all affected a little differently by the capricious poliovirus. (See Selected References on Post-Polio Exercise at the end of this paper.)
- Next, find professionals to work with. A well-selected physician and a physical therapist or exercise physiologist who each know or are willing to learn about post-polio issues would be most appropriate. There are no specific formulas for any individual that can be written in an overview article such as this. You must have one-on-one, in-person evaluation and testing to see what works and what does not work for you.
- Then, together, literature in hand, establish a plan for exercise.
- Start slowly, recognize limitations along the way, make adjustments in the weekly activity plan and keep going. Thomas Birk, Ph.D. (1997), recommends a two-month start up period in which your response to exercise is supervised and monitored by the professionals you have chosen to work with.