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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2020; 78(03): 149-157
DOI: 10.1590/0004-282X20190169
Article

The effect of home exercise on the posture and mobility of people with HAM/TSP: a randomized clinical trial

Efeitos de exercícios domiciliares sobre a postura e mobilidade de pessoas com HAM/TSP: ensaio clínico randomizado
Renata de Sousa MOTA 
1   Universidade Federal do Recôncavo da Bahia, Centro de Ciência e Tecnologia em Energia e Sustentabilidade, Feira de Santana BA, Brazil.
,
Maíra Carvalho MACÊDO 
2   Instituto do Cérebro - Fundação para Neurologia e Neurocirurgia, Salvador BA, Brazil.
,
Sandra CORRADINI 
3   Universidade de Campinas, Campinas SP, Brazil.
4   Escola Bahiana de Medicina e Saúde Pública, Departamento de Fisioterapia, Salvador BA, Brazil.
5   Universidade Federal da Bahia, Salvador BA, Brazil.
,
Naiane Araújo PATRÍCIO 
6   Escola Bahiana de Medicina e Saúde Pública, Departamento de Tecnologias de Saúde, Salvador BA, Brazil.
,
Abrahão Fontes BAPTISTA 
7   Universidade Federal do ABC, Centro de Matemática, Computação e Cognição, São Paulo SP, Brazil.
,
Katia Nunes SÁ 
4   Escola Bahiana de Medicina e Saúde Pública, Departamento de Fisioterapia, Salvador BA, Brazil.
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Abstract

Background: Physical therapy has positive results in people with tropical spastic paraparesis (TSP). However, mobility and distance from rehabilitation centers limit the participation in outpatient programs. Objective: To evaluate the impact of a home exercise program on the posture and functional mobility of people with TSP. Methods: A randomized controlled trial comparing three groups of people who performed guided exercises from a guidebook for six months: supervised (SG), unsupervised (WG), and control (CG). Primary outcomes: postural angles (SAPO®) and functional mobility (TUG). Secondary outcomes: gait parameters (CVMob®). Results: The protocol described in the guidebook improved postural angles and functional mobility. There were also positive gait parameter effects (p<0.05). SG presented better responses than WG did, but both were preferable to CG. Conclusion: Home exercises oriented by a guidebook may benefit posture, functional mobility and gait parameters in people with TSP, and physiotherapist supervision can ensure better results.

Resumo

Introdução: A fisioterapia apresenta resultados positivos em pessoas com paraparesia espástica tropical (PET). Entretanto, a dificuldade de locomoção e a distância dos centros de reabilitação limitam a participação em programas ambulatoriais. Objetivo: Avaliar o impacto de um programa de exercícios domiciliares na postura e mobilidade funcional de pessoas com PET. Métodos: Um ensaio clínico randomizado comparou três grupos de pessoas que realizaram exercícios guiados por cartilha: com supervisão (GS), sem supervisão (GN) e controle (GC) durante seis meses. Desfechos primários: ângulos posturais (SAPO®) e mobilidade funcional (TUG). Desfechos secundários: parâmetros da marcha (CVMob®). Resultados: O protocolo descrito na cartilha melhorou os ângulos posturais e a mobilidade funcional. Os resultados também foram positivos para os parâmetros da marcha (p<0,05). O GS apresentou melhores respostas que o GN, porém ambos foram preferíveis ao GC. Conclusão: Exercícios domiciliares orientados por cartilha podem ser úteis para beneficiar a postura, mobilidade funcional e parâmetros de marcha em pessoas com PET, e a supervisão do fisioterapeuta possibilita garantir melhores resultados.

Keywords:

tropical spastic paraparesis - home exercise - posture - functional mobility - gait

Palavras-chave:

paraparesia espástica tropical - exercício domiciliar - postura - mobilidade funcional - marcha


Publication History

Received: 31 August 2019

Accepted: 18 October 2019

Article published online:
02 June 2023

© 2020. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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