THE TREATMENT of the motor aspects of acute and subacute anterior poliomyelitis has changed strikingly within the past 10 yr. Present modes of therapy place stress on maintenance of muscle length by range-of-motion and stretching exercises. These techniques are in direct contrast with the traditional routine of immobilizing affected structures in positions designed to prevent chronic deformities due to paresis.Although Sister Kenny's principles of therapy were largely responsible for the present emphasis on early physical therapy and the discarding of immobilization, they are by no means new. Lovett,1 in 1916, clearly advocated muscle training as an integral part of treatment. However, Townsend,2 in the same year, and Kendall and Kendall,3 in 1938, enthusiastically endorsed long-term bed rest and fixation of involved extremities. Lovett's principles seemed in less vogue than the latter up to the present decade, when Sister Kenny's advent and highly publicized preachments in part reestablished them.The Kenny system of therapy centers attention upon the outstanding muscle syndromes : combinations of motor weakness, shortening of muscles, and diminution in motor efficiency. Unfortunately, such therapy, sound in clinical application, is tied to a kite tail of extremely tenuous hypothesis as to the pathologic mechanisms underlying the clinical phenomena of poliomyelitis. It was to be expected that a physiologically naïve but intelligent observer, such as Sister Kenny, should recognize the clinical highlights but misinterpret their significance. After 1940, impressed by the usefulness of her mode of treatment, a great many physicians adopted her techniques. This is perhaps an example of creditable elasticity on the part of members of the medical profession, and the wisdom of their choice is shown by the improved clinical results.
