The effect of home exercise on the posture and mobility of people with HAM/TSP: a randomized clinical trial

Abstract

Background: Physical therapy has positive results in people with tropical spastic paraparesis (TSP). However, mobility and distance from rehabilitation centers limit the participation in outpatient programs. Objective: To evaluate the impact of a home exercise program on the posture and functional mobility of people with TSP. Methods: A randomized controlled trial comparing three groups of people who performed guided exercises from a guidebook for six months: supervised (SG), unsupervised (WG), and control (CG). Primary outcomes: postural angles (SAPO®) and functional mobility (TUG). Secondary outcomes: gait parameters (CVMob®). Results: The protocol described in the guidebook improved postural angles and functional mobility. There were also positive gait parameter effects (p<0.05). SG presented better responses than WG did, but both were preferable to CG. Conclusion: Home exercises oriented by a guidebook may benefit posture, functional mobility and gait parameters in people with TSP, and physiotherapist supervision can ensure better results.

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.…”

Impaired flexibility in patients with tropical spastic paraparesis/HTLV-associated myelopathy: evaluation via pendulum fleximeter

“…It is possible that the TSP/HAM group exhibited superior performance as a result of the regular physical therapy (supervised physical therapy once a week, and athome exercises from the HTLV-1 exercise book guide) provided to these patients. 48 A limitation of this study was the lower number of individuals in the HTLV-1 (þ) without myelopathy and HTLV-1 (-) groups. Another limitation is the lack of associations with specific factors that underline the loss of flexibility in individuals with myelopathy.…”

Integrative and Multidisciplinary Care for People Living With Human T-Cell Lymphotropic Virus in Bahia, Brazil: 20 Years of Experience

“…Nevertheless, a randomized crossover clinical trial demonstrated that Pilates exercises can improve lower back pain and QoL in PLHTLV ( 73 ). In addition, it was demonstrated that home exercises oriented by a guidebook may benefit posture, functional mobility and gait parameters in people with TSP ( 36 ).…”

“…Other diseases, such as polymyositis, sinusitis, keratoconjunctivitis sicca (KCS) and a variety of pulmonary disorders, including bronchiectasis, have also been associated with HTLV-1 ( 8 , 29 , 30 ). The myelopathy associated with HTLV-1 infection leads to a series of systemic alterations, including urologic changes (nocturia, frequency, urgency, and urinary incontinence), constipation and sexual dysfunction ( 31 – 33 ), as well as pain, muscle spasticity, postural changes and reduced muscle strength, functional mobility and flexibility ( 34 – 36 ). Moreover, it has been reported that HTLV-1-infected individuals may present some degree of immunosuppression, since several infectious diseases, such as tuberculosis, strongyloidiasis and scabies occur more frequently or are more severe in affected individuals ( 5 , 8 , 37 , 38 ).…”