Davoudi Malihe, Boostani Reza, Manzari Zahra Sadat
Department of Community Health Nursing, Nursing and Midwifery School, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Neurology, Faculty of Medicine, Qaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
J Res Med Sci. 2024 Feb 23;28:87. doi: 10.4103/jrms.jrms_300_22. eCollection 2023.
Human T-cell lymph tropic virus type 1 (HTLV-I)-related myelopathy/tropical spastic paraparesis (TSP) is a progressive inflammatory process affecting the spinal cord that occurs as a result of HTLV 1. The use of nonpharmacological approaches has always been one of the treatment strategies in these patients, but disagreement about these interventions and their results has led to their limited use. Therefore, this study aimed to identify nonpharmacological interventions and their consequences in these patients.
We followed the Cochrane Handbook for systematic reviews of interventions. The present report is organized according to the preferred reporting items for systematic reviews and meta-analyses. This study was conducted at PubMed, Cochrane Library, Web of Science, and Scopus, among all published studies by December 30, 2021. Keywords were: HTLV-1, Human T-lymph tropic virus 1, HTLV-I-associated myelopathy, HAM/TSP, tropical spastic paraparesis, nonpharmacological intervention, nonpharmacological treatment, massage, physiotherapy, acupuncture, acupressure, and exercise. The quality of the studies was assessed using JADAD.
Of 288 articles, 11 were eligible for data extraction published between 2014 and 2021. 90/9% of studies were randomized clinical trials. 81/8% of articles were of high quality. The total sample size was 253 people, of which 137 (54/15%) were women. Approaches such as exercise and motion therapy, electrotherapy, behavioral therapy, and virtual reality can be used for these patients. With these interventions, results such as improved mobility and balance, physical condition, pain, quality of life, muscle spasticity, maximum inspiratory pressure, and urinary symptoms can be achieved.
The most common physical therapy method used in studies was active and passive body movements, which are associated with positive results for patients. Due to the small sample size in this group of studies, it is necessary to conduct more clinical trials for more accurate conclusions. Furthermore, due to the limited number of studies that have used electrical stimulation or combined intervention packages, it is not possible to say with certainty what effect these methods have on patients. It is necessary to conduct more clinical trials.
人类嗜T细胞病毒1型（HTLV-I）相关脊髓病/热带痉挛性截瘫（TSP）是一种由HTLV-1引起的、影响脊髓的进行性炎症过程。使用非药物方法一直是这些患者的治疗策略之一，但对于这些干预措施及其效果存在分歧，导致其使用受限。因此，本研究旨在确定这些患者的非药物干预措施及其后果。
我们遵循Cochrane干预措施系统评价手册。本报告按照系统评价和荟萃分析的首选报告项目进行组织。本研究在PubMed、Cochrane图书馆、科学网和Scopus上进行，检索截至2021年12月30日发表的所有研究。关键词包括：HTLV-1、人类嗜T淋巴细胞病毒1型、HTLV-I相关脊髓病、HAM/TSP、热带痉挛性截瘫、非药物干预、非药物治疗、按摩、物理治疗、针灸、指压和运动。使用JADAD评估研究质量。
在288篇文章中，有11篇符合数据提取条件，发表于2014年至2021年之间。90.9%的研究为随机临床试验。81.8%的文章质量较高。总样本量为253人，其中137人（54.15%）为女性。运动疗法、电疗法、行为疗法和虚拟现实等方法可用于这些患者。通过这些干预措施，可取得改善活动能力和平衡、身体状况、疼痛、生活质量、肌肉痉挛、最大吸气压力和泌尿症状等结果。
研究中使用最普遍的物理治疗方法是主动和被动身体运动，这对患者产生了积极效果。由于这组研究的样本量较小，有必要进行更多临床试验以得出更准确的结论。此外，由于使用电刺激或联合干预方案的研究数量有限，无法确定这些方法对患者有何种影响。有必要进行更多临床试验。
