summary Poliomyelitis is a disease caused by viral destruction of the anterior horn cells in the spinal cord and brain stem motor nuclei. Diagnosis is made clinically with presence of motor weakness with normal sensation in a patient with history of polio. Treatment may be nonoperative or operative depending on degree of functional limitation and presence of secondary contractures. Epidemiology Incidence has been eradicated in the United States with the use of a vaccine Etiology Associated conditions Postpolio syndrome an aging phenomenon where more nerve cells become inactive with time it does not represent reactivation of the virus occurs after middle age occurs in up to 50% of polio cases leads to increasing difficulty performing activities of daily living patients should exercise at sub-exhaustion levels to tone affected muscle groups without causing muscle breakdown Presentation Physical Exam hallmark is muscle weakness with normal sensation Treatment Postpolio Syndrome nonoperative limited exercise with periods of rest, +/-lightweight orthosis indications first line of treatment technique goal is to maintain but not overuse muscles operative tendon transfers, contracture releases, and arthrodesis indications used to optimize functional capacity Polio foot deformities nonoperative lightweight orthoses indications first line of treatment help patient remain functionally independent operative contracture release, tendon transfer, and arthrodesis indication if orthoses do not achieve satisfactory standard of living