|
Richard L. Bruno, HD, PhD Director, International Centre for Polio Education and author of The Polio Paradox Hosts The Post-Polio Coffee House on Facebook. Bruno Bytes are his Q&A's of PPS information. |
NOTE: We collaborate with Dr. Bruno to publish Bruno Bytes Quarterly.
- Every issue of Bruno "Bytes" is available in PDF format at the bottom of this page.
- Feel free to download and share them.
Bruno Bytes - First Quarter, 2023
Topics Include: Chronic Pain, Muscle Fibers, Muscle Sprouts, Muscle Spasms and the Types of Polio
Topics Include: Chronic Pain, Muscle Fibers, Muscle Sprouts, Muscle Spasms and the Types of Polio
On the topic of Chronic Pain
Dr. Bruno’s Original Post: "Flexibility" is the Key to Mental Wellbeing In Spite of Chronic Pain.
Research has found the biggest threat to the mental health of people living with chronic pain isn’t necessarily how intense their pain is, but the extent to which it interferes with their daily life . . .
From Australia’s Edith Cowan University:
“Chronic pain impacts around 20 per cent of the population. Along with the medical and physical effects it can have far-reaching consequences for employment, lifestyle and mental health. A new Edith Cowan University (ECU) study has found that for people living with chronic pain it’s not necessarily how intense their pain is, but the extent to which it interferes with their daily life that can pose the biggest threat to their mental health.”
"The findings from this study have implications for informing public health policy developments and public health campaigns focused on promoting psychological strengths rather than deficits, for example positive self-care messaging related to pain management.”
For the Complete Article go to: Source
On the Topic of Muscle Sprouts and “Fibers
SPROUTS AND FIBERS: The “Diet” of Polio Recovery
Neurons in older non-polio survivors have been found to be less able to make sprouts and, when they do, the sprouts are thinner and are not covered with myelin, the fatty insulation separating one sprout from another. What's more, fewer muscle fibers are
reconnected to the new sprouts and less acetylcholine (the chemical that "tells" muscle fibers to contract) is released.
However, even if sprouts were insulated, fat and fully functioning, the muscle fibers they are supposed to turn on are not. Everyone who gets older, not just polio survivors, loses muscle fibers. Remaining fibers atrophy, get smaller in size. And aging muscle is not as pliable or as able to contract quickly as does younger muscle. These changes cause a loss of muscle strength, reduced muscle contraction speed and decreased muscle endurance as everyone ages. These effects of aging can further overwork polio survivors' decreasing number of damaged motor neurons and reduce polio survivors’ muscle strength.
Given this description of the state of muscle fibers and motor neurons, is it any wonder that overexertion and exercise are the number one causes of PPS?
On the Topic of Muscle Fibers and Polio
Question: When looking at people from the African nations we see a significant number of medal-winning long distance runners …obviously due to their genetic makeup. So, this brings my thoughts to PPS: Did the poliovirus attack slow twitch, i.e., Type 1 endurance muscles more often than it attacked Type II fast acting muscles? Could one’s muscle type leave one more genetically predisposed to contracting poliomyelitis?
Dr. Bruno’s Response: MUSCLE FIBERS and POLIO: SURPRISING CONNECTIONS
When we talk about polio and PPS, the focus is almost always on the damage poliovirus did to motor neurons, damage that prevented their stimulating muscle fibers and causing weakness or paralysis. But there's more to be said about post-polio muscle fibers. Let me try to give an oversimplified, but I hope understandable, description.
MUSCLE FIBER TYPES
Muscles contains two types of fibers that contract when stimulated by motor neurons:
For example, typically the anterior tibialis (the muscle in the front of your lower leg that, when its motor neurons are damaged by polio, causes foot drop) has about 75% of the "slow" Type I fibers and 25% of “fast” Type II fibers. When walking, the anterior tibialis’ Type I fibers contract many times with each step, while Type II fibers contract only during rapid walking and then usually just a few times.
POLIO AND MUSCLE FIBERS
The poliovirus did not attack muscle fibers. It attacked motor neurons. Yet muscle fibers were affected.
The above description of how Type I and Type II fibers function in walking is not the same for affected -- but still working -- post-polio muscles. Surviving motor neurons sent out “sprouts”, like little telephone lines, to activate muscle fibers that were orphaned when their motor neurons died. This process of sprouting causes what's called "fiber type grouping". One study of the anterior tib muscle in polio survivors found that Type I "endurance" fibers predominated. Polio survivors had nearly 21% more Type I fibers as compared to nondisabled controls.
This Type I fiber "grouping" is seen in most other polio affected muscles where sprouting occurs. And grouping makes functional sense. Apparently the Type I muscle fibers “knew” that polio survivors needed endurance more than they needed the ability to sprint.
ETHNICITY AND…MUSCLE FIBERS?
In his 2000 book Taboo, journalist Jon Entine makes a painstaking case that race and genetics are indeed ''significant components'' of the ''stunning and undeniable dominance of black athletes.‘’
Said Jim Holt in the “New York Times”, “Entine cites credible research, for example, that blacks of West African ancestry (which would include most African-Americans) have a higher ratio of (Type II) muscle fibers than whites do, which gives them an edge at leaping and sprinting. East African blacks have more energy-producing enzymes in their muscles and seem to process oxygen more efficiently, which translates into greater (Type I fiber) endurance.”
“But why conclude that such differences are encoded in the genes? Mightn't there be an environmental explanation? It is true that Kenyans have won every Boston Marathon since 1990, but these runners come from a mountainous region whose altitude is perfect for building aerobic capacity.”
The achievements of African runners “obviously due to their genetic makeup?” Be careful not to separate nurture and nature.
On the topic of Muscle Spasms
Question: I had polio at age 3 in 1954, affecting the left quadricep and ankle. I have not had to use assistive devices until now and I use a cane when I want to walk faster. I have just started doing Pilates but I am having muscle spasms making my left foot quiver a bit at rest. Is this related ? This has not happened before.
Additional Post: When I was diagnosed in 1999 I had an evaluation by the PT who treated the patients with neurological issues. One of the things she told me was not to take yoga. I also have muscle spasms, cramps, fasciculations, muscles that seize up. Sometimes the pain & acting up happens only when I'm at rest; other times it happens with activity, like when I'm trying to put on a coat or pull a shirt over my head. If I were you, I'd take those muscle spasms as a warning.
Dr. Bruno’s Response: The easiest thing to do is stop Pilates and see what happens with the muscle spasms in your foot.
On the Topic of the “Types” of Polio
Question: Can you get multiple “types” of Polio?
Dr. Bruno’s Response: Yes, you can be infected at the same time with more than one type of poliovirus. But, polio survivors should be very careful about their belief, often without evidence or as part of family lore, regarding the “types” of polio they had. This is especially important now that poliovirus from the oral vaccine has been found in wastewater in Canada, Israel, the UK and US, and you may be deciding if you need polio vaccination.
During the polio epidemics, and still today, there is confusion with there being three types of poliovirus and three types of clinical polio:
Three Types Of Polioviruses
You could have been infected by one (or very rarely more than one) polioviruses:
Three Types Of Clinical Polio
The symptoms that you experienced were not predetermined by the type of poliovirus that got into your body. When you talk to your doctor about the need for polio vaccination, don't depend on your original polio symptoms or family memory to decide the type of poliovirus you had and type of vaccine you may need now.
Check Your State's Health Department and CDC Websites and Talk To Your Doctor About The Need For Vaccination.
Dr. Bruno’s Original Post: "Flexibility" is the Key to Mental Wellbeing In Spite of Chronic Pain.
Research has found the biggest threat to the mental health of people living with chronic pain isn’t necessarily how intense their pain is, but the extent to which it interferes with their daily life . . .
From Australia’s Edith Cowan University:
“Chronic pain impacts around 20 per cent of the population. Along with the medical and physical effects it can have far-reaching consequences for employment, lifestyle and mental health. A new Edith Cowan University (ECU) study has found that for people living with chronic pain it’s not necessarily how intense their pain is, but the extent to which it interferes with their daily life that can pose the biggest threat to their mental health.”
"The findings from this study have implications for informing public health policy developments and public health campaigns focused on promoting psychological strengths rather than deficits, for example positive self-care messaging related to pain management.”
For the Complete Article go to: Source
On the Topic of Muscle Sprouts and “Fibers
SPROUTS AND FIBERS: The “Diet” of Polio Recovery
- “As polio survivors recovered strength after the initial onslaught, their individual muscles fibers grew and were on average twice the size of fibers in those who didn't have polio. Fibers also looked abnormal, appearing "moth eaten" and showing damage typically found only in heavy weight lifters. What's more, thanks to axonal sprouting, the remaining motor neurons turn on about 16 times more muscle fibers than in someone who didn't have polio.” From The Polio Paradox
Neurons in older non-polio survivors have been found to be less able to make sprouts and, when they do, the sprouts are thinner and are not covered with myelin, the fatty insulation separating one sprout from another. What's more, fewer muscle fibers are
reconnected to the new sprouts and less acetylcholine (the chemical that "tells" muscle fibers to contract) is released.
However, even if sprouts were insulated, fat and fully functioning, the muscle fibers they are supposed to turn on are not. Everyone who gets older, not just polio survivors, loses muscle fibers. Remaining fibers atrophy, get smaller in size. And aging muscle is not as pliable or as able to contract quickly as does younger muscle. These changes cause a loss of muscle strength, reduced muscle contraction speed and decreased muscle endurance as everyone ages. These effects of aging can further overwork polio survivors' decreasing number of damaged motor neurons and reduce polio survivors’ muscle strength.
Given this description of the state of muscle fibers and motor neurons, is it any wonder that overexertion and exercise are the number one causes of PPS?
On the Topic of Muscle Fibers and Polio
Question: When looking at people from the African nations we see a significant number of medal-winning long distance runners …obviously due to their genetic makeup. So, this brings my thoughts to PPS: Did the poliovirus attack slow twitch, i.e., Type 1 endurance muscles more often than it attacked Type II fast acting muscles? Could one’s muscle type leave one more genetically predisposed to contracting poliomyelitis?
Dr. Bruno’s Response: MUSCLE FIBERS and POLIO: SURPRISING CONNECTIONS
When we talk about polio and PPS, the focus is almost always on the damage poliovirus did to motor neurons, damage that prevented their stimulating muscle fibers and causing weakness or paralysis. But there's more to be said about post-polio muscle fibers. Let me try to give an oversimplified, but I hope understandable, description.
MUSCLE FIBER TYPES
Muscles contains two types of fibers that contract when stimulated by motor neurons:
- Type I fibers are metabolically suited for sustained muscle activity that provides endurance.
- Type II fibers are metabolically suited for rapid movements, like sprinting, rather than running a marathon.
For example, typically the anterior tibialis (the muscle in the front of your lower leg that, when its motor neurons are damaged by polio, causes foot drop) has about 75% of the "slow" Type I fibers and 25% of “fast” Type II fibers. When walking, the anterior tibialis’ Type I fibers contract many times with each step, while Type II fibers contract only during rapid walking and then usually just a few times.
POLIO AND MUSCLE FIBERS
The poliovirus did not attack muscle fibers. It attacked motor neurons. Yet muscle fibers were affected.
The above description of how Type I and Type II fibers function in walking is not the same for affected -- but still working -- post-polio muscles. Surviving motor neurons sent out “sprouts”, like little telephone lines, to activate muscle fibers that were orphaned when their motor neurons died. This process of sprouting causes what's called "fiber type grouping". One study of the anterior tib muscle in polio survivors found that Type I "endurance" fibers predominated. Polio survivors had nearly 21% more Type I fibers as compared to nondisabled controls.
This Type I fiber "grouping" is seen in most other polio affected muscles where sprouting occurs. And grouping makes functional sense. Apparently the Type I muscle fibers “knew” that polio survivors needed endurance more than they needed the ability to sprint.
ETHNICITY AND…MUSCLE FIBERS?
In his 2000 book Taboo, journalist Jon Entine makes a painstaking case that race and genetics are indeed ''significant components'' of the ''stunning and undeniable dominance of black athletes.‘’
Said Jim Holt in the “New York Times”, “Entine cites credible research, for example, that blacks of West African ancestry (which would include most African-Americans) have a higher ratio of (Type II) muscle fibers than whites do, which gives them an edge at leaping and sprinting. East African blacks have more energy-producing enzymes in their muscles and seem to process oxygen more efficiently, which translates into greater (Type I fiber) endurance.”
“But why conclude that such differences are encoded in the genes? Mightn't there be an environmental explanation? It is true that Kenyans have won every Boston Marathon since 1990, but these runners come from a mountainous region whose altitude is perfect for building aerobic capacity.”
The achievements of African runners “obviously due to their genetic makeup?” Be careful not to separate nurture and nature.
On the topic of Muscle Spasms
Question: I had polio at age 3 in 1954, affecting the left quadricep and ankle. I have not had to use assistive devices until now and I use a cane when I want to walk faster. I have just started doing Pilates but I am having muscle spasms making my left foot quiver a bit at rest. Is this related ? This has not happened before.
Additional Post: When I was diagnosed in 1999 I had an evaluation by the PT who treated the patients with neurological issues. One of the things she told me was not to take yoga. I also have muscle spasms, cramps, fasciculations, muscles that seize up. Sometimes the pain & acting up happens only when I'm at rest; other times it happens with activity, like when I'm trying to put on a coat or pull a shirt over my head. If I were you, I'd take those muscle spasms as a warning.
Dr. Bruno’s Response: The easiest thing to do is stop Pilates and see what happens with the muscle spasms in your foot.
On the Topic of the “Types” of Polio
Question: Can you get multiple “types” of Polio?
Dr. Bruno’s Response: Yes, you can be infected at the same time with more than one type of poliovirus. But, polio survivors should be very careful about their belief, often without evidence or as part of family lore, regarding the “types” of polio they had. This is especially important now that poliovirus from the oral vaccine has been found in wastewater in Canada, Israel, the UK and US, and you may be deciding if you need polio vaccination.
During the polio epidemics, and still today, there is confusion with there being three types of poliovirus and three types of clinical polio:
Three Types Of Polioviruses
You could have been infected by one (or very rarely more than one) polioviruses:
- Type I (Mahoney, the epidemic strain that caused most cases of polio),
- Type II (Lansing) or
- Type III (Leon).
Three Types Of Clinical Polio
- Bulbar Polio - Indicates the virus affected your brain stem and would cause trouble swallowing and breathing;
- Spinal Polio - Indicates the virus primarily affected your spinal cord and would cause limb paralysis;
- Bulbar-Spinal Polio - Indicates the virus affected both your brain stem and your spinal cord, which would cause limb paralysis and trouble swallowing and breathing.
The symptoms that you experienced were not predetermined by the type of poliovirus that got into your body. When you talk to your doctor about the need for polio vaccination, don't depend on your original polio symptoms or family memory to decide the type of poliovirus you had and type of vaccine you may need now.
Check Your State's Health Department and CDC Websites and Talk To Your Doctor About The Need For Vaccination.
- Adults who are unvaccinated or are unsure if they have been fully immunized (including polio survivors, who likely had only one type of polio) would need a total of 3 vaccine doses.
- Adults who only have had 1 or 2 doses of the polio vaccine would need to get all 3 doses.
- Adults who are at increased risk of exposure to poliovirus and who have previously completed a routine series of polio vaccine can consult with a health care provider and receive one lifetime "booster" dose of Injectable polio vaccine.
"Post-Polio Fatigue" Log Here
- - - - - -
- - - - - -
Complete "Bruno Bytes" from Previous Months - in easily shared and printed PDF format below
2023 2022 2021
|
2020
|
2019
|
2018
|
|
2017
|
2016
|
2015 and 2014
|
“Bruno Bytes” – How it all began
Bruno Bytes are published quarterly, through a collaborative effort between Dr. Richard L. Bruno, HD, PhD (biography above) and the PA Polio Survivor’s Network. They are answers to questions posted in the “Post-Polio Coffee House” (on Facebook).
This partnership began in November, 2014.
Bruno Bytes help to teach polio survivors, spouses, caregivers and health care professionals about the many and varied topics related to the physical and emotional issues associated with having had polio and about the importance of managing PPS.
Note: Bruno Bytes are for education only. Any personal treatment plan must be determined in association with a PPS knowledgeable health care professional.
Bruno Bytes are published quarterly, through a collaborative effort between Dr. Richard L. Bruno, HD, PhD (biography above) and the PA Polio Survivor’s Network. They are answers to questions posted in the “Post-Polio Coffee House” (on Facebook).
This partnership began in November, 2014.
Bruno Bytes help to teach polio survivors, spouses, caregivers and health care professionals about the many and varied topics related to the physical and emotional issues associated with having had polio and about the importance of managing PPS.
Note: Bruno Bytes are for education only. Any personal treatment plan must be determined in association with a PPS knowledgeable health care professional.