Morning appointments may be better than afternoon. Try to schedule testing for the same period of the day or document the time and the results. Polio muscles fatigue easily. Stronger on the first repetitions, weaker after five or six tries. Grades should be assigned after the first or second try or document that you had to do it six times to assess the patient's strength.
Surgical procedures are common in Polio Survivors, i.e. joint fusion, muscle-tendon transfers.
Therapists should be familiar with these procedures so the muscle that they want to be testing is the right one. A muscle that should be doing one movement may be doing another. Video taping the patient's gait allows the therapist to review and examine without fatiguing the patient. Remember that any physical change is accompanied by emotional change and some patients with the late effects of Polio may have difficulties adapting to new disabilities. On the Net Foundation HON, an international initiative and non-profit organisation headquartered in Geneva, Switzerland, dedicated to realising the benefits of the Internet and related technologies in the fields of medicine and healthcare.