Disability and determinants of gait performance in tropical spastic paraparesis/HTLV-I associated myelopathy (HAM/TSP).

STUDY

DESIGN

Cross-sectional.

OBJECTIVES

The aim of this survey is to describe the disability profile in a group of tropical spastic paraparesis/HTLV-I-associated myelopathy patients, identifying the requirements for community ambulation.

SETTING

Tertiary care unit, Rio de Janeiro, Brazil.

METHODS

Seventy-two patients were assessed (49 female and 23 male), referred by tertiary care centers, when a clinical protocol was applied.

RESULTS

The sample had an average age of 40 years and an average of 137 months of duration of the disease. The most prevalent aspects of disability found were in gait and sphincter control areas. A total of 72% of the patients were community ambulators and 17% were restricted to wheel chair. Age, strength and low-back pain interfere in activities of daily living (P<0.05). A positive correlation was found between community ambulation and the knee extensors (r=0.80) and ankle plantar flexors (r=0.74). Strength, age, low-back pain, duration of disease, asymmetric onset of the symptoms and spasticity interfered in the ability to walk (P<0.05). A rehabilitation program was proposed focusing on modifiable factors that affect disability level.

CONCLUSION

It was possible to describe the profile of disability in this group of patients, identifying the requirements to the community ambulation.