Benefits of inspiratory muscle training under indirect home supervision in patients with human T-cell lymphotropic virus type 1

Abstract

Introduction: The presence of human T-cell lymphotropic virus type 1 (HTLV-1) associated with neuropathy (myelopathy/tropical spastic paraparesis - HAM/TSP), can generate morphological and functional changes in the respiratory system. As a preventive therapeutic possibility for respiratory dysfunctions, it is expected that the already conceptualized inspiratory muscle training, when performed at home, can be a therapeutic resource that favors adherence to treatment. Objective: To evaluate respiratory muscle strength in patients with HTLV-1 after participating in a home respiratory muscle training protocol under indirect supervision. Method: This was a clinical, longitudinal, prospective, quantitative, and single-center trial approved by the Research Ethics Committee of the State University of Pará, opinion no. 2.695.505 and registered in clinical trials NCT03829709. Six HTLV-1 patients participated in a 5-week home respiratory muscle training protocol lasting 30 minutes daily through a linear load inspiratory muscle trainer. For the characterization of the imposed load, they were submitted to manovacuometry during pre (T0), peri (T3), and post (T5) treatment. Results: Six individuals completed the program, of which 83.33% were female and 16.66% male. With the application of respiratory muscle training, it was possible to achieve a significant increase (p < 0.011) of the maximum inspiratory pressure as shown when comparing T0 (66.8±12.58) to T5 (115.08±31.78). Conclusion: This study identified an increase in inspiratory muscle strength after HTLV-1 patients participated in a home muscle training protocol under indirect supervision.

Nonpharmacological interventions and outcomes in the management of complications of human T-cell lymphotropic virus type 1-related myelopathy/tropical spastic paraparesis: A systematic review

“…Of the 11 studies extracted, 1 was a quasi-experimental study,[ 16 ] 5 were a randomized clinical trial,[ 14 17 18 19 20 ] and 5 were a randomized crossover clinical trial. [ 11 12 13 15 21 ] Furthermore, 18/18% of articles (2 cases) were of low quality[ 16 17 ] and 81/81% of articles (9 cases) were of high quality[ 11 12 13 14 15 18 19 20 21 ] [ Table 2 ].…”

“…In these studies, the main intervention approaches are physiotherapy, which includes exercise therapy,[ 11 19 20 ] specialized physiotherapy movement,[ 12 16 18 ] and electrotherapy. [ 14 ] One study also used combination interventions in the form of behavioral therapy, physical exercise, and electrotherapy.…”

“…In three studies, specialized physiotherapy movement[ 12 16 18 ] was selected as an intervention. In the study of Dias et al ., oral ventilation cycles with the help of a linear resistance device were considered physiotherapy exercises.…”

“…Each 45-min cycle was considered three times a week for 5 weeks. [ 18 ] In a study comparing two movement therapy approaches, subjects in the experimental group practiced for 12 weeks and twice a week for 1 hour under the supervision of a physiotherapist to facilitate the movements of rolling, sitting, standing, walking and climbing stairs. In the control group, a 2-meter elastic tube was used to facilitate the same operation.…”

Research scenario in physiotherapy for people with human t-cell lymphotropic virus (HTLV): scientometric study / Cenário das pesquisas em Fisioterapia para pessoas com Human T-Cell Lymphotropic Virus (HTLV): estudo cientométrico

“…As for the physical therapy resources used in the treatment, the use of individual outpatient kinesiotherapy was identified through functional exercises 36,37,38,39, home exercises 40 , proprioceptive neuromuscular facilitation 41,42 , Pilates 43,44 , virtual reality 45,46 , respiratory training 47 , electrical stimulation 48,39 , neuromodulation with tDCS 49 and rTMS 29 . Most of these resources have no side effects, are low cost, help to delay the evolution of dysfunctions and have a positive impact on quality of life.…”