Abstract
HAM/TSP patients experience impaired functional capacity. The use of categorical scales to accurately describe motor ability in these patients has been questioned.Aim: To evaluate the functional capacity of HAM/TSP patients by using the individual tests comprising the GDLAM protocol.Methods: Cross sectional study carried out in the CHTLV, Salvador, Brazil. Functional capacity was evaluated using the tests of the GDLAM protocol (timed 10-minute walk, getting up from a sitting position, rising from a prone position, getting up from a chair, and moving around the house). Functional classifications were made by comparing patient performance to that of uninfected control individuals.Results: Twenty-four HAM/TSP and 25 healthy individuals were enrolled. Only 75% HAM/TSP patients completed the GDLAM protocol. Six patients failed to perform the RPP test. Timed measurements were significantly higher in the HAM/TSP patients in comparison to uninfected controls.Conclusion: The use of alternative methods, such as the individual tests comprising the GDLAM protocol, may more accurately assess motor function in HAM/TSP patients.
Highlights
Human T lymphotropic virus type-1 (HTLV-1) is endemic worldwide and it has been recently estimated that 10 million people harbor this virus[1].HTLV-1 is etiologically linked to adult T cell leukemia (ATL)[2], tropical spastic paraparesis/HTLV-1associated myelopathy (HAM/TSP)[3,4], uveitis[5] and infective dermatitis[6]
The present study found that individuals diagnosed with HAM/TSP present reduced functional capacity, which is consistent with previously published results[12,14,22]
The low functional capacity observed in HAM/TSP individuals was expected, as myelopathy leads to significant motor limitations in these patients[23]
Summary
HTLV-1 is etiologically linked to adult T cell leukemia (ATL)[2], tropical spastic paraparesis/HTLV-1associated myelopathy (HAM/TSP)[3,4], uveitis[5] and infective dermatitis[6]. Other diseases, such as polymyositis, sinusitis, bronchoalveolar pneumonia, keratoconjunctivitis sicca and bronchiectasis have been associated with HTLV-1 infection, indicating the multi-systemic character of this infection[1,7,8,9]. HAM/TSP is a rare disease, occurring in about 1-2% of HTLV-1 infected individuals, which mostly affects women in the 4th decade of life[10] This disease is characterized by a slow and progressive demyelination of the spinal cord, mainly in the lower thoracic region, leading to motor abnormalities in the lower limbs[11]. Studies have reported that these patients’ limited mobility, loss of balance and muscle fatigue may lead to reduced functional capacity and impaired performance with respect to activities of daily living (ADL)[12,13,14]
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