Poliomyelitis (Spine)

Examination

Look

• Walking Aids:
  • Observe for the use of crutches, braces, or other aids.
• Muscle Wasting:
  • Global wasting, with particular attention to the Quadriceps.
• Limb Length Discrepancy:
  • Assess for differences in leg length.
• Flexion Deformity of Knee:
  • Check for over-pulling by hamstrings.
• Foot Deformities:
  • Note any type of deformity (e.g., pes cavus or claw toes).
• Scars:
  • Inspect hips, knees, and feet for surgical or traumatic scars.
• Spine:
  • Check for scoliosis.
• Gait:
  • Look for:
    • Asymmetric gait.
    • Reduced cadence.
    • Changes in foot progression angle.
    • Trendelenberg gait (indicating abductor weakness).
    • Quadriceps-deficient gait (knee hyperextension during stance phase).
    • Foot drop.
    • Compensatory movements at the pelvis, hip, knee, and ankle.

Feel (Lying Down)

• Pain:
  • Assess for tenderness or discomfort in affected areas.
• Sensory Examination:
  • Test dermatomes and peripheral nerves; sensory function is typically intact.
• Motor Power:
  • Assess strength in myotomes and peripheral nerves.
• Upper Motor Neuron (UMN) Signs:
  • Check for Clonus, Babinski sign, and altered reflexes.

Move (Lying Down)

• Range of Motion (ROM):
  • Evaluate ROM in all joints.
• Hip Dislocation:
  • Screen for any signs of dislocation.
• Correctibility of Deformities:
  • Test whether deformities can be corrected manually.

Finishing Steps

• Take a full history.
• Document findings systematically.