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 pro. le in a group of tropical spastic paraparesis/ HTLV-I-associated myelopathy patients, identifying the requirements for community ambulation. Setting: Terciary 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 modi. able factors that affect disability level. Conclusion: It was possible to describe the pro. le of disability in this group of patients, identifying the requirements to the community ambulation.