# Strength training and PPS (PPMA) **URL:** \ **Category:** Medical Q&A \[Moderated\]\ **Created:** [December 14, 2018, 10:08pm UTC](https://forum.barbellmedicine.com/t/strength-training-and-pps-ppma/4336 "2018-12-14T22:08:19Z")\ **Posts on this page:** 3\ **Page:** 1
**Author:** ![bbmnube](https://sea1.discourse-cdn.com/flex001/user_avatar/forum.barbellmedicine.com/bbmnube/32/781_2.png) [@bbmnube](https://forum.barbellmedicine.com/u/bbmnube)\ **Post date:** [December 14, 2018, 10:08pm UTC](https://forum.barbellmedicine.com/t/strength-training-and-pps-ppma/4336/1 "2018-12-14T22:08:19Z")
First time poster, been lurking for a while! I really enjoy the content that BBM has been putting out, so thanks! Any thoughts would be welcome, I understand that medical advice can be a touchy issue! I know a 70 year old male who claims that his post polio muscle atrophy is preventing him from being able to exercise or strength train due to the risk of damaging existing motor unit neurons. It seems his underlying idea is that one of his legs is at an extremely high risk of losing function due to it operating with a significantly reduced number of motor neurons and that training to increase muscle mass would result in the overworking and loss of the existing motor unit neurons. A quick search seems to show that these claims are not proven in scientific literature. One of the questions that comes to mind is whether “exercise” or strength training have been shown to have positive outcomes in a similar scenario. Any thoughts? ---
**Author:** ![Austin\_Baraki](https://sea1.discourse-cdn.com/flex001/user_avatar/forum.barbellmedicine.com/austin_baraki/32/1095_2.png) [@Austin\_Baraki](https://forum.barbellmedicine.com/u/Austin_Baraki)\ **Post date:** [December 15, 2018, 12:44am UTC](https://forum.barbellmedicine.com/t/strength-training-and-pps-ppma/4336/2 "2018-12-15T00:44:36Z")
Hi there. Good question. Post-polio syndrome is characterized by fatigue, new-onset weakness, and several other symptoms in a patient who has recovered from prior paralytic polio. There is thinking that “excessive” or highly fatiguing exercise may increase the risk of PPS (possibly related to overwhelming the compensatory motor unit expansion due to collateral re-innervation), _ **however** _ it is _not_ true that these patients must avoid exercise. Based on the current evidence, lower intensity strength training has benefit for this population, see: > **[Randomized controlled trial of strength training in post-polio patients - PubMed](https://pubmed.ncbi.nlm.nih.gov/12635120/)** > > Many post-polio patients develop new muscle weakness decades after the initial illness. However, its mechanism and treatment are controversial. The purpose of this study was to test the hypotheses that: (1) after strength training, post-polio... > **[Strength gains without muscle injury after strength training in patients with...](https://pubmed.ncbi.nlm.nih.gov/8808654/)** > > We evaluated changes in the dynamic and isometric strength in the newly weakened quadriceps muscles and asymptomatic triceps muscles of 6 patients with postpolio muscular atrophy (PPMA) after 10 weeks of progressive resistance strength training.... > **[Low-intensity, alternate-day exercise improves muscle performance without...](https://pubmed.ncbi.nlm.nih.gov/8645440/)** > > The purpose of this study was to examine the effect of a low-intensity, alternate-day, 12 wk quadriceps muscle-strengthening exercise program on muscle strength and muscle and motor unit integrity in 12 postpolio patients. Patients performed six to... > **[The effects of long-term non-fatiguing resistance exercise in subjects with...](https://pubmed.ncbi.nlm.nih.gov/1758792/)** > > Measures of torque were used to evaluate changes in muscle strength and endurance in 17 patients with post-polio syndrome who did prescribed resistance exercise for up to 2 years. Exercise compliance averaged 75%, with 16 subjects increasing the... > **[The use of nonfatiguing strengthening exercises in post-polio syndrome - PubMed](https://pubmed.ncbi.nlm.nih.gov/3620629/)** > > This study has been done to determine if there is any beneficial effect from the use of nonfatiguing strengthening exercises in the presence of post-polio syndrome. Following accurate identification by EMG of muscles that could be called "post-polio... > **[Strength, endurance, and work capacity after muscle strengthening exercise in...](https://pubmed.ncbi.nlm.nih.gov/9228868/)** > > This home exercise program significantly increased strength, endurance, and TTI without apparently adversely affecting the motor units or the muscle, as the EMG and CK variables did not change. ---
**Author:** ![bbmnube](https://sea1.discourse-cdn.com/flex001/user_avatar/forum.barbellmedicine.com/bbmnube/32/781_2.png) [@bbmnube](https://forum.barbellmedicine.com/u/bbmnube)\ **Post date:** [December 15, 2018, 8:07pm UTC](https://forum.barbellmedicine.com/t/strength-training-and-pps-ppma/4336/3 "2018-12-15T20:07:37Z")
This is excellent information, thank you sir! As a bonus, this got me trying out the advanced search feature on PubMed. Barbell Medicine is really doing great things for the community. Cheers!