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de Assis IM, Callegari B, de Sousa MS. Physiotherapy Methods Applied in the Prevention of Functional Loss Associated with Human T-Lymphotropic Virus 1 Infection: An Overview. Infect Dis Rep 2023; 15:478-493. [PMID: 37736995 PMCID: PMC10514819 DOI: 10.3390/idr15050048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 07/15/2023] [Accepted: 08/02/2023] [Indexed: 09/23/2023] Open
Abstract
To achieve the objective of this study, we conducted a narrative review on physical therapeutic modalities applied to prevent functional losses associated with human T-lymphotropic virus 1 (HTLV-1) infections to promote health education and viable and accessible alternatives in the development of health education technology adapted to the home environment. This study comprised a qualitative stage of theoretical development to construct a digital booklet with an observational basis based on studies that reiterate themes about educational technologies as tools to conduct a home protocol of guided exercises without the direct supervision of professional physical therapists. Results indicate a lack of research on the development of health education technologies to assist patients with HTLV-1 without tropical spastic paraparesis or HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). We believe that this narrative review can initiate a theoretical framework to conduct a home exercise program aimed at people with HTLV-1 who have subtle symptoms, and also at people without the clinical definition of HAM/TSP, helping to train human resources for care and research on the subject and increase scientific production in physical therapy.
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Affiliation(s)
| | - Bianca Callegari
- Institute of Health Sciences, Federal University of Pará, Belém 66055-240, Brazil;
| | - Maisa Silva de Sousa
- Center for Tropical Medicine, Federal University of Pará, Belém 66055-240, Brazil;
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Klautau AV, da Silva Pinto D, Santana BB, Freitas Queiroz MA, Rangel da Silva ANM, Vieira Cayres-Vallinoto IM, Ishak R, Rosário Vallinoto AC. Pilates exercise improves the clinical and immunological profiles of patients with human T-cell lymphotropic virus 1 associated myelopathy: A pilot study. J Bodyw Mov Ther 2020; 24:1-8. [PMID: 32825975 DOI: 10.1016/j.jbmt.2020.02.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 11/13/2019] [Accepted: 02/17/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is an infectious chronic-inflammatory disease, which can lead to lower limb motions. METHODS The study evaluated the effects of serial Pilates exercises on the clinical and immunological profiles of patients with HAM/TSP. Eight patients with ages ranging from 39 to 70 years old (2 males and 6 females), 2 wheelchair users and 6 with compromised gait, were evaluated. The patients were submitted to 20 Pilates sessions for 10 weeks. Data were collected at 3 time points (beginning of the study, after Pilates sessions and after 10 weeks without Pilates) and consisted of evaluations of the pain level, spasticity, motor strength, balance, mobility, functional capacity, quality of life and quantification of IFN-γ, IL-10 and IL-9 cytokines levels. RESULTS After the Pilates sessions, significant improvements in pain level, static and dynamic balance, trunk control, mobility and quality of life were observed, with simultaneous and significant reductions in the serum levels of the cytokines IFN-γ and IL-10. However, after 10 weeks without Pilates, there were significant changes in terms of increasing pain and regression of mobility, with no changes in strength, spasticity, functional capacity in any of the periods of the study. CONCLUSIONS The results suggest that Pilates may be a promising auxiliary physical therapy for patients with HAM/TSP.
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Affiliation(s)
- Altair Vallinoto Klautau
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Guamá, 66.075-110, Pará state, Brazil
| | - Denise da Silva Pinto
- Institute of Health Sciences, Federal University of Pará, Umarizal, 66.050-060, Pará state, Brazil; Division of Tropical Medicine, Federal University of Pará, Umarizal, 66.050-060, Belém, Pará state, Brazil
| | - Bárbara Brasil Santana
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Guamá, 66.075-110, Pará state, Brazil
| | - Maria Alice Freitas Queiroz
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Guamá, 66.075-110, Pará state, Brazil
| | | | | | - Ricardo Ishak
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Guamá, 66.075-110, Pará state, Brazil
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Balance Impairments in Patients with Human T-Cell Lymphotropic Virus Type 1 Infection. Sci Rep 2019; 9:11456. [PMID: 31391511 PMCID: PMC6685957 DOI: 10.1038/s41598-019-47920-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 07/24/2019] [Indexed: 01/29/2023] Open
Abstract
The human T-cell lymphotropic virus type 1 (HTLV-1) is a retrovirus from the Retroviridae family that infects cluster of differentiation 4 (CD4) T-lymphocytes and stimulates their proliferation. A severe consequence of this infection can be the HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP), which is associated with a progressive demyelinating disease of the upper motor neurons. The HAM/TSP conditions frequently present with neurological complaints such as gait impairment, sphincter disturbances, and several sensory losses. We compared findings from the posturographic evaluation from the asymptomatic HTLV-1 infected subjects, HTLV-1 infected subjects having HAM/TSP, and control group database. A force plate was used to record the postural oscillations. Analysis of variance and multivariate linear discriminant analysis were used to compare the data obtained from the three groups of participants. In general, HAM/TSP patients had worse postural balance control than did the HTLV-1 patients and the controls (p < 0.05). We found that in six out of ten parameters of the postural balance control, there was a gradual increase in impairment from control to HTLV-1 to HAM/TSP groups. All parameters had higher values with the subject’s eyes closed. The multivariate linear discriminant analysis showed there was a reasonable difference in results between the control and HAM/TSP groups, and the HTLV-1 group was at the intersecting area between them. We found that HAM/TSP patients had worse balance control than did HTLV-1 infected patients and the control group, but asymptomatic HTLV-1 infected patients represent an intermediate balance control status between controls and HAM/TSP patients. Posturographic parameters can be relied on to identify subtle changes in the balance of HTLV-1 patients and to monitor their functional loss. HTLV-1 is a tropical disease that can be transmitted by sexual intercourse, blood transfusion, and breast-feeding. Some infected subjects develop an HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), a condition characterized by spasticity, weakness in lower limbs, and difficulty in walking long distances and going up and down the stairs, besides the history of falls. We compared the body oscillations using a force plate to investigate the postural balance control. HTLV-1 infected patients had imbalance that could be identified by posturographic parameters. Patients with HAM/TSP clearly had balance impairments, while HTLV-1 without HAM/TSP had a subtle impairment that was not seen on clinical scales, suggesting that these patients were in the middle between healthy and HAM/TSP patients, and carried a risk of developing severe imbalance postural control. We suggest that more research should be done with the aim to identify the subtle signs in asymptomatic HTLV-1 patients to investigate if this group of patients need attention similar to the HAM/TSP patients.
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Silva IC, Pinheiro BT, Nobre AFS, Coelho JL, Pereira CCC, Ferreira LDSC, Almeida CPSD, Viana MDNDSDA, Almeida DSD, Falcão JR, Santos YCVD, Araújo MWLD, Borges MDS, Nascimento LD, Valentim LS, Casseb JSDR, Costa CAD, Sousa MSD. Moderate endemicity of the human T-lymphotropic virus infection in the metropolitan region of Belém, Pará, Brazil. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2018; 21:e180018. [PMID: 30328937 DOI: 10.1590/1980-549720180018] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 08/14/2017] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION The spread of the HTLV infection in families living in the metropolitan area of Belém, Pará, Brazil, and the lack of studies in the general population requires studies to better understand its prevalence in the region. METHODS An anti-HTLV-1/HTLV-2 antibodies test was carried out on random adults in public places in Belém between November 2014 and November 2015. A proviral DNA test detected if the person was infected, and then a clinical evaluation and an intrafamilial investigation were carried out. RESULTS Of the 1059 individuals being investigated, 21 (2.0%) had seroreagent samples, 15 (1.4%) had HTLV-1, 5 (0.5%) had HTLV-2, and proviral DNA was undetectable in one case. The mean age of the infected people (57.2) was higher than that of those that were uninfected (46.2) (p = 0.0010). The prevalence of infection increased with age, especially in individuals with a family income equal to or less than a minimum wage. Intrafamilial transmission seems to have occurred in all of the families being studied. Among the patients with HTLV-1, 30% (3/10) already had some symptom related to the infection. DISCUSSION The increase in prevalence rates according to age may be due to late seroconversion of a previously acquired infection, or the cumulative risk of new infections, especially in women. CONCLUSION There was a moderate prevalence of the HTLV infection among adult individuals from the metropolitan area of Belém, with a predominance of HTLV-1. This infection was associated with low income and increasingly older women. It also presented intrafamily spread and negligence in the diagnosis of associated diseases.
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Affiliation(s)
- Ingrid Christiane Silva
- Faculdade de Farmácia, Instituto de Ciências da Saúde, Universidade Federal do Pará - Belém (PA), Brasil
| | - Bruna Teles Pinheiro
- Faculdade de Farmácia, Instituto de Ciências da Saúde, Universidade Federal do Pará - Belém (PA), Brasil
| | - Akim Felipe Santos Nobre
- Programa de Pós-Graduação em Doenças Tropicais, Núcleo de Medicina Tropical, Universidade Federal do Pará - Belém (PA), Brasil
| | - Jaciana Lima Coelho
- Faculdade de Farmácia, Instituto de Ciências da Saúde, Universidade Federal do Pará - Belém (PA), Brasil
| | - Cássia Cristine Costa Pereira
- Programa de Pós-Graduação em Doenças Tropicais, Núcleo de Medicina Tropical, Universidade Federal do Pará - Belém (PA), Brasil
| | - Louise de Souza Canto Ferreira
- Programa de Pós-Graduação em Doenças Tropicais, Núcleo de Medicina Tropical, Universidade Federal do Pará - Belém (PA), Brasil
| | - Camila Pâmela Santos de Almeida
- Programa de Pós-Graduação em Doenças Tropicais, Núcleo de Medicina Tropical, Universidade Federal do Pará - Belém (PA), Brasil
| | | | - Danilo Souza de Almeida
- Programa de Pós-Graduação em Doenças Tropicais, Núcleo de Medicina Tropical, Universidade Federal do Pará - Belém (PA), Brasil
| | - Jairo Ribeiro Falcão
- Mestrado Profissionalizante em Análises Clínicas, Instituto de Ciências Biológicas, Universidade Federal do Pará - Belém (PA), Brasil
| | | | | | - Mariza da Silva Borges
- Faculdade de Enfermagem, Instituto de Ciências da Saúde, Universidade Federal do Pará - Belém (PA), Brasil
| | - Lisandra Duarte Nascimento
- Faculdade de Farmácia, Instituto de Ciências da Saúde, Universidade Federal do Pará - Belém (PA), Brasil
| | - Lorena Saldanha Valentim
- Faculdade de Farmácia, Instituto de Ciências da Saúde, Universidade Federal do Pará - Belém (PA), Brasil
| | | | - Carlos Araújo da Costa
- Programa de Pós-Graduação em Doenças Tropicais, Núcleo de Medicina Tropical, Universidade Federal do Pará - Belém (PA), Brasil
| | - Maísa Silva de Sousa
- Programa de Pós-Graduação em Doenças Tropicais, Núcleo de Medicina Tropical, Universidade Federal do Pará - Belém (PA), Brasil
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Costa KHA, Silva TBDV, Souza GDS, Barbosa RDFDM. Influence of proprioceptive neuromuscular facilitation on the muscle tonus and amplitude of movement in HTLV-1-infected patients with HAM/TSP. Rev Soc Bras Med Trop 2018; 51:550-553. [PMID: 30133644 DOI: 10.1590/0037-8682-0115-2017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Accepted: 04/24/2018] [Indexed: 05/29/2023] Open
Abstract
An HTLV-1-infected patient can develop paraparesis that limits their movements. Rehabilitation techniques could improve the motor abilities of these patients. The present study investigates five cases of physical therapy intervention in HTLV-1 patients to evaluate the influence of functional rehabilitation on the tonus and range of motion (ROM) of HTLV-1 patients with spasticity. The patients had a gain of ROM, especially in the lower limb, and reduction in hypertonia/spasticity after functional treatment. The reduction in hypertonia increased the ROM. Thus, functional methods may be valuable for the rehabilitation of HTLV-1 patients with neurological damage.
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Affiliation(s)
- Kelly Helorany Alves Costa
- Programa de pós-graduação em Doenças Tropicais (PPGDT), Laboratório de Neurologia Tropical, Universidade Federal do Pará, Belém, PA, Brasil
| | - Tatiane Bahia do Vale Silva
- Programa de pós-graduação em Epidemiologia em Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
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Vasconcelos BHB, Souza GS, Barroso TGCP, Silveira LCL, Sousa RCM, Callegari B, Xavier MB. Barefoot Plantar Pressure Indicates Progressive Neurological Damage in Patients with Human T-Cell Lymphotropic Virus Type 1 Infection. PLoS One 2016; 11:e0151855. [PMID: 26998608 PMCID: PMC4801362 DOI: 10.1371/journal.pone.0151855] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 03/04/2016] [Indexed: 01/26/2023] Open
Abstract
Background The human T-Cell Lymphotropic Virus Type 1 (HTLV-1) is a retrovirus associated with neurological alterations; individuals with HTLV-1 infection may develop HTLV-1 associated myelopathy / tropical spastic paraparesis (HAM/TSP). Frequent neurological complaints include foot numbness and leg weakness. In this study, we compared the distribution of the body weight on different areas of the foot in HTLV-1 patients with HAM/TSP, asymptomatic HTLV-1 patients, and healthy individuals. Methodology We studied 36 HTLV-1 infected patients, who were divided in two groups of 18 patients each based on whether or not they had been diagnosed with HAM/TSP, and 17 control subjects. The evaluation included an interview on the patient’s clinical history and examinations of the patient’s reflexes, foot skin tactile sensitivity, and risk of falling. The pressure distribution on different areas of the foot was measured with baropodometry, using a pressure platform, while the patients had their eyes open or closed. Main Findings The prevalence of neurological disturbances—altered reflexes and skin tactile sensitivity and increased risk of falling—was higher in HTLV-1 HAM/TSP patients than in HTLV-1 asymptomatic patients. The medium and maximum pressure values were higher in the forefoot than in the midfoot and hindfoot in both HTLV-1 groups. In addition, the pressure on the hindfoot was lower in HAM/TSP patients compared to control subjects. Conclusions The neurological disturbances associated with HTLV-1 infection gradually worsened from HTLV-1 asymptomatic patients to HAM/TSP patients. Baropodometry is a valuable tool to establish the extent of neurological damage in patients suffering from HTLV-1 infection.
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Affiliation(s)
| | - Givago S. Souza
- Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Pará, Brazil
- Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Pará, Brazil
| | | | - Luiz Carlos L. Silveira
- Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Pará, Brazil
- Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Pará, Brazil
- Universidade do Ceuma, São Luís, Maranhão, Brazil
| | | | - Bianca Callegari
- Instituto de Ciências da Saúde, Universidade Federal do Pará, Belém, Pará, Brazil
- * E-mail:
| | - Marília B. Xavier
- Universidade do Estado do Pará, Belém, Pará, Brazil
- Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Pará, Brazil
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Shublaq M, Orsini M, Puccioni-Sohler M. Implications of HAM/TSP functional incapacity in the quality of life. ARQUIVOS DE NEURO-PSIQUIATRIA 2011; 69:208-11. [DOI: 10.1590/s0004-282x2011000200013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2010] [Accepted: 10/05/2010] [Indexed: 12/14/2022]
Abstract
OBJECTIVE: To identify the functional status and quality of life of HAM/TSP patients. METHOD: We evaluated prospectively 30 HAM/TSP patients (20 females) seen in the Neuroinfection Clinic of the HUGG. The functional capacity was analyzed by the functional independence measure (FIM), the expanded disability status (EDSS) scale and the Osame's motor disability score (OMDS). The quality of life was assed by the Short-Form Health Survey 36 (SF-36)TM. RESULTS: All patients need assistance device. The FIM, OMDS and EDSS scores classified 70%, 67% and 67% of the patients as dependent, respectively. The lowest scores of the SF-36 survey were found in the domains related to the physical health (D1, D2), role-emotional functioning (D7) and social functioning (D6). CONCLUSION: Our data suggest that the HAM/TSP physical impairment has an impact in the emotional and social issues, considering the limitation in the daily activities.
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Affiliation(s)
- Marcia Shublaq
- University of State of Rio de Janeiro, Brazil; Centro Universitário da Cidade, Brazil
| | - Marco Orsini
- Federal Fluminense University; Grande Rio University, Brazil
| | - Marzia Puccioni-Sohler
- University of State of Rio de Janeiro, Brazil; Federal University of Rio de Janeiro, Brazil
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