Home-based exercise program in TSP/HAM individuals: a feasibility and effectiveness study

Lívia D Facchinetti; Abelardo Q Araújo; Marcus TT Silva; Ana Claudia C Leite; Mariana F Azevedo; Gisele L Chequer; Raquel VC Oliveira; Arthur S Ferreira; Marco Antonio Lima

doi:10.1590/0004-282X20170022

Arquivos de Neuro-Psiquiatria, Table of Contents

CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2017; 75(04): 221-227
DOI: 10.1590/0004-282X20170022

ARTICLE

Home-based exercise program in TSP/HAM individuals: a feasibility and effectiveness study

Programa de exercícios domiciliares em indivíduos com PET/MAH: um estudo de viabilidade e efetividade

Lívia D Facchinetti

¹Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Serviço de Fisioterapia, Rio de Janeiro RJ, Brasil;

,

Abelardo Q Araújo

²Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Laboratório de Pesquisa Clínica em Neuroinfecção, Rio de Janeiro RJ, Brasil;

,

Marcus TT Silva

²Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Laboratório de Pesquisa Clínica em Neuroinfecção, Rio de Janeiro RJ, Brasil;

,

Ana Claudia C Leite

²Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Laboratório de Pesquisa Clínica em Neuroinfecção, Rio de Janeiro RJ, Brasil;

,

Mariana F Azevedo

¹Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Serviço de Fisioterapia, Rio de Janeiro RJ, Brasil;

,

Gisele L Chequer

¹Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Serviço de Fisioterapia, Rio de Janeiro RJ, Brasil;

,

Raquel VC Oliveira

³Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Laboratório de Epidemiologia Clínica, Rio de Janeiro RJ, Brasil;

,

Arthur S Ferreira

⁴Centro Universitário Augusto Motta, Programa de Pós-Graduação em Ciências da Reabilitação, Laboratório de Simulação Computacional e Modelagem em Reabilitação, Rio de Janeiro RJ, Brasil;

⁵Universidade Salgado de Oliveira, Programa de Graduação em Fisioterapia, Rio de Janeiro RJ, Brasil.

,

Marco Antonio Lima

²Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Laboratório de Pesquisa Clínica em Neuroinfecção, Rio de Janeiro RJ, Brasil;

› Author Affiliations

Abstract

ABSTRACT

Objective

To investigate the feasibility and effectiveness of a home-based exercise program in TSP/HAM individuals.

Methods

Twenty-three TSP/HAM individuals divided in two groups according to Timed Up and Go (TUG) score (<20s vs ≥20s) performed a 20-week home-based exercise program. The primary outcomes were exercise adherence, maximum voluntary isometric contraction of lower limbs (MVIC), Barthel Index and SF-36. Secondary outcomes were adverse effects and barriers to exercise practice.

Results

MVIC and the social functioning domain in SF-36 improved significantly in TUG <20s group. The individuals in the TUG ≥20s group improved significantly their physical functioning domain in SF-36. The total adherence to the 20-week home-based exercise program was 90%. There were mild to moderate adverse events related to exercise program. There were no adverse events related to MVIC test.

Conclusions

The home-based exercise program was feasible and effective in improving disability and quality of life in individuals with TSP/HAM.

RESUMO

Objetivo

Investigar a viabilidade e eficácia de um programa de exercícios domiciliares (PED) em indivíduos com PET/MAH.

Métodos

23 indivíduos com PET/MAH divididos em dois grupos conforme teste Timed Up and Go - TUG (<20s vs ≥20s) realizaram o PED durante 20 semanas. Desfechos primários – adesão aos exercícios, contração isométrica voluntária máxima dos membros inferiores (CIVM), Índice de Barthel e SF-36. Desfechos secundários – ocorrência de eventos adversos e presença de barreiras à prática de exercícios.

Resultados

CIVM e componente “Aspectos Sociais” da SF-36 aumentaram significativamente no grupo TUG <20s. Os indivíduos do grupo TUG ≥20s aumentaram significativamente componente “Capacidade Funcional” da SF-36. A adesão ao PED foi de 90%. Foram observados eventos adversos de intensidade leve a moderada relacionados ao PED. Não foram encontrados eventos adversos relacionados à CIVM.

Conclusões

O PED é viável e eficaz em melhorar a incapacidade e a qualidade de vida de indivíduos com PET/MAH.

paraparesis, tropical spastic - physical therapy speciality - exercise; muscle strength - quality of life

paraparesia espástica tropical - fisioterapia - exercício - força muscular - qualidade de vida

Full Text

References

References
1 Gessain A, Barin F, Vernant JC, Gout O, Maurs L, Calender A et al. Antibodies to human T-lymphotropic virus type-I in patients with tropical spastic paraparesis. Lancet. 1985;2(8452):407-10. https://doi.org/10.1016/S0140-6736(85)92734-5
2 Osame M, Usuku K, Izumo S, Ijichi N, Amitani H, Igata A et al. HTLV-I associated myelopathy, a new clinical entity. Lancet. 1986;1(8488):1031-2. https://doi.org/10.1016/S0140-6736(86)91298-5
3 Franzoi AC, Araújo AQ. Disability profile of patients with HTLV-I-associated myelopathy/tropical spastic paraparesis using the Functional Independence Measure (FIM). Spinal Cord. 2005;43(4):236-40. https://doi.org/10.1038/sj.sc.3101677
4 Facchinetti LD, Araújo AQ, Chequer GL, Azevedo MF, Oliveira RV, Lima MA. Falls in patients with HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Spinal Cord. 2013;51(3):222-5. https://doi.org/10.1038/sc.2012.134
5 Shublaq M, Orsini M, Puccioni-Sohler M. Implications of HAM/TSP functional incapacity in the quality of life. Arq Neuropsquiatr. 2011;69(2A):208-11. https://doi.org/10.1590/S0004-282X2011000200013
6 Martins JV, Baptista AF, Araújo AQ.. Quality of life in patients with HTLV-1 associated myelopathy /tropical spastic paraparesis. Arq Neuropsquiatr. 2011;70(4):257-61. https://doi.org/10.1590/S0004-282X2012005000006
7 Castro-Costa CM, Araújo AQ, Menna-Barreto M, Penalva-de-Oliveira AC. [Guide of clinical management of HTLV patient: neurological aspects]. Arq Neuropsiquiatr. 2005;63(2B):548-51. Portuguese. https://doi.org/10.1590/S0004-282X2005000300036
8 Franzoi AC, Araújo AQ. Disability and determinants of gait performance in tropical spastic paraparesis/HTLV-I associated myelopathy (HAM/TSP). Spinal Cord. 2007;45(1):64-8. https://doi.org/10.1038/sj.sc.3101919
9 Martin F, Fedina A, Youshya S, Taylor GP. A 15-year prospective longitudinal study of disease progression in patients with HTLV-1 associated myelopathy in the UK. J Neurol Neurosurg Psychiatry. 2010;81(12):1336-40. https://doi.org/10.1136/jnnp.2009.191239
10 Rimmer JH, Rubin SS and Braddock D. Barriers to exercise in African American women with physical disabilities. Arch Phys Med Rehabil. 2000;81(2):182-8. https://doi.org/10.1016/S0003-9993(00)90138-2
11 Scelza WM, Kalpakjian CZ, Zemper ED, Tate DG. Perceived barriers to exercise in people with spinal cord injury. Am J Phys Med Rehabil. 2005;84(8):576-83. https://doi.org/10.1097/01.phm.0000171172.96290.67
12 DeBolt LS, McCubbin JA. The effects of home-based resistance exercise on balance, power, and mobility in adults with multiple sclerosis. Arch Phys Med Rehabil. 2004;85(2):290-7. https://doi.org/10.1016/j.apmr.2003.06.003
13 Dolbow DR, Gorgey AS, Ketchum JM, Moore JR, Hackett LA, Gater DR. Exercise adherence during home-based functional electrical stimulation cycling by individuals with spinal cord injury. Am J Phys Med Rehabil. 2012;91(11):922-30. https://doi.org/10.1097/PHM.0b013e318269d89f
14 De Castro-Costa CM, Araújo AQ, Barreto MM, Takayanagui OM, Sohler MP, Silva EL et al. Proposal for diagnostic criteria of tropical spastic paraparesis/HTLV-I-associated myelopathy (TSP/HAM). AIDS Res Hum Retroviruses. 2006;22(10):931-5. https://doi.org/10.1089/aid.2006.22.931
15 Bezner J. Prevention and promotion of health, wellness and fitness. In: Brody LT, editor. Therapeutic exercise: moving toward function. 3rd ed. Baltimore: Lippincott Williams & Wilkins; 2011.
16 Bello-Haas VD, Florence JM, Kloos AD, Scheirbecker J, Lopate G, Hayes SM et al. A randomized controlled trial of resistance exercise in individuals with ALS. Neurology. 2007;68(23):2003-7. https://doi.org/10.1212/01.wnl.0000264418.92308.a4
17 Viosca E, Martínez JL, Almagro PL, Gracia A, González C. Proposal and validation of a new functional ambulation classification scale for clinical use. Arch Phys Med Rehabil. 2005;86(6):1234-8. https://doi.org/10.1016/j.apmr.2004.11.016
18 Kurtzke JF. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology. 1983;33(11):1444-52. https://doi.org/10.1212/WNL.33.11.1444
19 Lima MA, Bica RB, Araújo AQ. Gender influence on the progression of HTLV-I associated myelopathy/tropical spastic paraparesis. J Neurol Neurosurg Psychiatry. 2005;76(2):294-6. https://doi.org/10.1136/jnnp.2004.035709
20 Podsiadlo D, Richardson S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142-8. https://doi.org/10.1111/j.1532-5415.1991.tb01616.x
21 Mahoney FI and Barthel DW. Functional evaluation: the barthel index. Md State Med J. 1965;14:61-5.
22 Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30(6):473-83. https://doi.org/10.1097/00005650-199206000-00002
23 Khalil H, Quinn L, Deursen R, Dawes H, Playle R, Rosser A et al. What effect does a structured home-based exercise programme have on people with Huntington’s disease? A randomized, controlled pilot study. Clin Rehabil. 2013;27(7):646-58. https://doi.org/10.1177/0269215512473762
24 Jurkiewicz MT, Marzolini S, Oh P. Adherence to a home-based exercise program for individuals after stroke. Top Stroke Rehabil. 2011;18(3):277-84. https://doi.org/10.1310/tsr1803-277
25 McAuley E, Wöjcicki TR, Gothe NP, Mailey EL, Szabo AN, Fanning J et al. Effects of a DVD-delivered exercise intervention on physical function in older adults. J Gerontol A Biol Sci Med Sci. 2013;68(9):1076-82. https://doi.org/10.1093/gerona/glt014
26 Galvão-Castro AV, Boa-Sorte N, Kruschewsky RA, Grassi MF, Galvão-Castro B. Impact of depression on quality of life in people living with human T cell lymphotropic virus type 1 (HTLV-1) in Salvador, Brazil. Qual Life Res. 2012;21(9):1545-50. https://doi.org/10.1007/s11136-011-0066-6
27 Bridle C, Spanjers K, Patel S, Atherton NM, Lamb SE. Effect of exercise on depression severity in older people: systematic review and meta-analysis of randomised controlled trials. Br J Psychiatry. 2012;201(3):180-5. https://doi.org/10.1192/bjp.bp.111.095174
28 Mulroy SJ, Thompson L, Kemp B, Hatchett PP, Newsam CJ, Lupold DG et al. Strengthening and optimal movements for painful shoulders (STOMPS) in chronic spinal cord injury: a randomized controlled trial. Phys Ther. 2011;91(3):305-24. https://doi.org/10.2522/ptj.20100182
29 Carter AM, Daley AJ, Kesterton SW, Woodroofe NM, Saxton JM, Sharrack B. Pragmatic exercise intervention in people with mild to moderate multiple sclerosis: a randomised controlled feasibility study. Contemp Clin Trials. 2013;35(2):40-7. https://doi.org/10.1016/j.cct.2013.04.003
30 Dalgas U, Stenager E. Exercise and disease progression in multiple sclerosis: can exercise slow down the progression of multiple sclerosis? Ther Adv Neurol Disord. 2012;5(2):81-95. https://doi.org/10.1177/1756285611430719