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

Abstract

Katia N Sá,1 Maíra C Macêdo,1 Rosana P Andrade,2 Selena D Mendes,1 José V Martins,3 Abrahão F Baptista1,4 1Neuromusculoskeletal Research Group, Bahian School of Medicine and Human Health, Salvador, Brazil; 2Edgard Santos University Hospital, Federal University of Bahia, Salvador, 3Deolindo Couto Institute of Neurology, Federal University of Rio de Janeiro, Rio de Janeiro, 4Biomorphology Department, Health Sciences Institute, Federal University of Bahia, Salvador, Brazil 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. Keywords: HTLV-1, HAM/TSP, physical therapy modalities, quality of life, pain, sensory-motor dysfunction, urinary symptoms