Serviço de Fisioterapia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de JaneiroRJ, Serviço de Fisioterapia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ.
Serviço de Neurologia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de JaneiroRJ, Serviço de Neurologia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ.
Rev Soc Bras Med Trop. 2014 Jan-Feb;47(1):24-9. doi: 10.1590/0037-8682-0245-2013.
Human T cell lymphotropic virus type I-associated myelopathy/tropical spastic paraparesis (HAM/TSP) can impact the independence and motricity of patients. The aims of this study were to estimate the effects of physiotherapy on the functionality of patients with HAM/TSP during the stable phase of the disease using proprioceptive neuromuscular facilitation (PNF) and to compare two methods of treatment delivery.
Fourteen patients with human T cell lymphotropic virus type I (HTLV-I) were randomly allocated into two groups. In group I (seven patients), PNF was applied by the therapist, facilitating the functional activities of rolling, sitting and standing, walking and climbing and descending stairs. In group II (seven patients), PNF was self-administered using an elastic tube, and the same activities were facilitated. Experiments were conducted for 1h twice per week for 12 weeks. Low-back pain, a modified Ashworth scale, the functional independence measure (FIM) and the timed up and go test (TUG) were assessed before and after the interventions.
In the within-group evaluation, low-back pain was significantly reduced in both groups, the FIM improved in group II, and the results of the TUG improved in group I. In the inter-group analysis, only the tone was lower in group II than in group I.
Both PNF protocols were effective in treating patients with HAM/TSP.
人类 T 细胞嗜淋巴细胞病毒 I 型相关性脊髓病/热带痉挛性截瘫（HAM/TSP）可影响患者的独立性和运动能力。本研究的目的是使用本体感觉神经肌肉促进（PNF）评估物理疗法在疾病稳定期对 HAM/TSP 患者功能的影响，并比较两种治疗方法。
14 名人类 T 细胞嗜淋巴细胞病毒 I 型（HTLV-I）患者被随机分为两组。在组 I（7 名患者）中，治疗师应用 PNF 促进滚动、坐立和站立、行走和上下楼梯等功能活动。在组 II（7 名患者）中，使用弹性管进行自我 PNF，促进相同的活动。实验在 12 周内每周进行两次，每次 1 小时。在干预前后评估腰痛、改良 Ashworth 量表、功能独立性测量（FIM）和计时起立行走测试（TUG）。
在组内评估中，两组患者的腰痛均明显减轻，组 II 的 FIM 改善，组 I 的 TUG 结果改善。在组间分析中，只有组 II 的肌张力低于组 I。
两种 PNF 方案均有效治疗 HAM/TSP 患者。
