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National Rehabilitation Hospital Postpolio Limb Classification

Class of Polio

Remote History

Recent History

Physical Examination

Neurological Examination

I
No clinical

No weakness

No new weakness

Good-to-normal strength, normal sensation and reflexes, no atrophy.

Normal using standard screening examination.

II
Subclinical

No weakness or, if effected, full clinical recovery.

Chronic denervation consistent with anterior horn cell disease, no evidence of acute denervation.

III
Clinically stable

Weakness with variable recovery.

Poor-to-good strength, normal sensation, normal-to-decreased reflexes, may have atrophy.

Chronic denervation consistent with anterior horn cell disease, may have evidence of acute denervation.

IV
Clinically unstable

New weakness

V
Severely Atrophic

Weakness with little recovery.

May have new weakness

Trace-to-poor strength, normal sensation, areflexic, severe atrophy.

Decreased insertional activity, few to no motor unit action potentials, may have acute denervation.