Proprioceptive neuromuscular facilitation in HTLV-I-associated myelopathy/tropical spastic paraparesis

Abstract

introduction: Human T cell lymphotropic virus type I-associated myelopathy/tropical spastic paraparesis (HAM/TSP) can impact the independence and motricity of patients. The aims of this study were to estimate the effects of physiotherapy on the functionality of patients with HAM/TSP during the stable phase of the disease using proprioceptive neuromuscular facilitation (PNF) and to compare two methods of treatment delivery. Methods: Fourteen patients with human T cell lymphotropic virus type I (HTLV-I) were randomly allocated into two groups. In group I (seven patients), PNF was applied by the therapist, facilitating the functional activities of rolling, sitting and standing, walking and climbing and descending stairs. In group II (seven patients), PNF was self-administered using an elastic tube, and the same activities were facilitated. Experiments were conducted for 1h twice per week for 12 weeks. Low-back pain, a modifi ed Ashworth scale, the functional independence measure (FIM) and the timed up and go test (TUG) were assessed before and after the interventions. Results: In the within-group evaluation, low-back pain was signifi cantly reduced in both groups, the FIM improved in group II, and the results of the TUG improved in group I. In the inter-group analysis, only the tone was lower in group II than in group I. Conclusions: Both PNF protocols were effective in treating patients with HAM/TSP.

Using the International Classification of Functioning, Disability and Health as a tool for analysis of the effect of physical therapy on spasticity in HAM/TSP patients

“…Furthermore, the abnormal sensory input and motor neuron activity (15) were reduced more substantially when the PNF technique was utilized in this study. Therefore, strength exercises can reduce muscle spasticity and improve neural control while maintaining extensibility (13) , which was observed in the present study for the quadriceps muscles (Figure 1).…”

“…Studies have shown that the ICF provides a scientifi c basis for understanding and studying health (10) (11) (12) . However, the ICF and Ashworth Scale are rarely used in HAM/ TSP patients (13) .…”

Neurological manifestations in individuals with HTLV-1-associated myelopathy/tropical spastic paraparesis in the Amazon

“…4,20,21 The hip adductors, knee extensors and ankle plantar flexors were evaluated for the assessment of spasticity, which are the most commonly tested muscles for the evaluation of spasticity in the lower limbs. 11,[22][23][24] No significant difference in spasticity was found between the right and left legs (Table 1). Moreover, patients with HAM/TSP exhibited a slight increase in muscle tone (median score of 1+), although with variation.…”

Conventional physical therapy and physical therapy based on reflex stimulation showed similar results in children with myelomeningocele

“…Patterns were rolling supine to lateral, transition from sitting to standing, standing on one leg, weight shifting forward and backward, walking forwards, backwards and sideways, going up and down stairs 14 . The PNF improved muscle tone, low back pain, functional performance and gait speed 16 .…”

“…Skin receptors were stimulated by manual contact on the cutaneous region related to the specific muscle or motion desired, joint approximation or traction, and diagonal and rotational movement patterns 14 . Passive and assisted phases of rhythmic initiation stimulated rolling, sitting and crawling 14,16 . Manual assistance was performed on a minimum of two muscles or muscle regions, with a minimum of five repetitions, in every session.…”