Physiotherapy for human T-lymphotropic virus 1-associated myelopathy: review of the literature and future perspectives

Abstract

Human T-lymphotropic virus 1 (HTLV-1) infection may be associated with damage to the spinal cord – HTLV-associated myelopathy/tropical spastic paraparesis – and other neurological symptoms that compromise everyday life activities. There is no cure for this disease, but recent evidence suggests that physiotherapy may help individuals with the infection, although, as far as we are aware, no systematic review has approached this topic. Therefore, the objective of this review is to address the core problems associated with HTLV-1 infection that can be detected and treated by physiotherapy, present the results of clinical trials, and discuss perspectives on the development of knowledge in this area. Major problems for individuals with HTLV-1 are pain, sensory-motor dysfunction, and urinary symptoms. All of these have high impact on quality of life, and recent clinical trials involving exercises, electrotherapeutic modalities, and massage have shown promising effects. Although not influencing the basic pathologic disturbances, a physiotherapeutic approach seems to be useful to detect specific problems related to body structures, activity, and participation related to movement in HTLV-1 infection, as well as to treat these conditions.

Avaliação da função sexual e qualidade de vida de mulheres infectadas pelo o vírus HTLV-I / Evaluation of sexual function and quality of life in HTLV-I infected women

“…Apesar de não tratar diretamente os processos patológicos consequente da infecção, afisioterapia tem um papel significativamente importante no desfecho do quadro clínico do paciente, reduzindo os sintomas, melhorando a funcionalidade e prevenindo deformidades, o que acarreta em uma grande melhora na qualidade de vida (33) .Sendo assim, é necessário conhecimento por parte dos profissionais da saúde para administração do tratamento necessário e importante papel da fisioterapia na minimização dos sintomas decorridos da doença, que afetam diretamente a resposta ou sensação sexual, causando alterações na sensibilidade genital, diminuição da lubrificação vaginal e orgasmo.Pois sentir prazer não se trata apenas de bem-estar, mas envolvem questões ligadas à qualidade de vida e saúde.…”

HTLV-1, the Other Pathogenic Yet Neglected Human Retrovirus: From Transmission to Therapeutic Treatment

“…Thus, combined therapies using valproate deserve better evaluation since they could offer better therapeutic options. Finally, because the treatments aiming at reducing proviral load and clinical outcomes are not fully efficient, and because multiple ranges of symptoms are associated with TSP/HAM, a physiotherapeutic approach seems useful to reduce pain, flaccidity, sedentariness, bowel and bladder troubles, and to improve patients’ overall quality of life [ 200 ].…”

Therapeutic effects of virtual reality video gaming on functional mobility, balance, and gait speed in individuals with tropical spastic paraparesis: A randomized crossover clinical trial

“…Secondary to HTLV-1 infection 10 , 3-5% of affected individuals develop HAM/TSP, with a higher prevalence in women aged ≥ 40 years 6 , 9 . Nevertheless, HTLV-1 remains a neglected disease, and rehabilitation in HAM/TSP is crucial to promote functional improvement in affected individuals 4 , 11 , 12 .…”