RESUMO
Introduction: The findings of previous studies are inconclusive in terms of psychological abnormalities and sexual function in asymptomatic human lymphotropic virus type 1 (HTLV-1) carriers. Aim: This study aimed to evaluate the prevalence of sexual dysfunction and its relationship with psychological abnormalities in asymptomatic HTLV-1 carriers. Materials and Methods: This cross-sectional study was conducted on asymptomatic HTLV-1 patients who were referred to the Neurology Clinic of a tertiary hospital in Mashhad, Iran. Patients with spastic paraparesis, leukemia, and uveitis, and those with an expanded disability status scale (EDSS) score higher than 2 were excluded. Sexual function in male and female subjects was evaluated using the brief male sexual function inventory (BMSFI) and female sexual dysfunction index (FSFI) questionnaires, respectively. The severity of psychological symptoms was evaluated in all patients using the symptom checklist-90-revised (SCL-90-R) questionnaire. Results: A total of 117 patients (61 males and 56 females) with a mean age of 35.3 ± 6.3 years were evaluated. Overall, 50.9% of males had a high and 39.3% of females had a good sexual function. Both male and female patients with poor sexual function were older and had more children compared to those with good sexual function (P < 0.05). There was no significant difference in the distribution pattern of SCL-90 domains between patients with high and low to moderate sexual function among male patients (P > 0.05). Depression, hostility, interpersonal sensitivity, paranoid ideation, and psychological abnormality were significantly more prevalent in female patients with poor sexual function compared to those with good sexual function (P < 0.05). Conclusion: The prevalence of psychological abnormalities was high in female with sexual dysfunction and these disorders might have a negative effect on various dimensions of sexual function.
RESUMO
INTRODUÇÃO: A marcha de pessoas com Mielopatia Associada ao HTLV-1 ou Paraparesia Espástica Tropical (HAM/TSP) é pouco conhecida. OBJETIVO: Avaliar o perfil cinemático da marcha em pessoas com HAM/TSP. MÉTODOS: Estudo transversal com 25 pessoas com HAM/TSP e 25 participantes saudáveis. Os dados espaço-temporais e angulares das filmagens da marcha foram submetidos à análise cinemática utilizando o software CVMob®. A marcha dos participantes com HAM/TSP foi analisada quantitativamente através do teste t-student (alfa de 5% e poder de 80%). O projeto foi aprovado pelo comitê de ética da Escola Bahiana de Medicina e Saúde Pública sob o CAAE 13568213.8.0000.5544. RESULTADOS: O grupo HAM/TSP apresentou alterações significativas em dois domínios distintos da análise biomecânica da marcha quando comparados aos controles saudáveis. As variáveis angulares apresentaram maior inclinação, flexão e extensão do tronco (p <0,05); aumento da flexão do quadril e diminuição da extensão do quadril (p <0,05); diminuição da flexão e extensão do joelho (p <0,05); diminuição da flexão dorsal e plantar do tornozelo (p <0,05). A amplitude de movimento também foi reduzida em todas essas articulações. As variáveis espaço-temporais mostraram diminuição do comprimento da passada, aumento do tempo da passada e velocidade do ciclo da marcha (p <0,001). Essas mudanças apontam para redução nas amplitudes articulares do quadril, joelho e tornozelo, mudanças na base de apoio e assimetria do tempo do duplo apoio entre os lados direito e esquerdo, redução do tempo do pré-balanço, elevação do quadril no balanço médio e queda do pé ao longo do balanço. CONCLUSÃO: As pessoas com HAM/TSP apresentam marcha caracterizada por redução nas amplitudes articulares do quadril, joelho e tornozelo, assimetria do tempo de suporte duplo entre os lados direito e esquerdo, redução do tempo do pré-balanço, elevação do quadril no balanço médio e queda do pé ao longo do balanço.
INTRODUCTION: The gait in people with HTLV-1 Associated Myelopathy or Tropical Spastic Paraparesis (HAM / TSP) is little known. OBJECTIVE: To evaluate the kinematic profile of gait in people with HAM/ TSP. METHODS: A cross-sectional study with 25 people with HAM/TSP and 25 healthy participants. Spatiotemporal and angular data from filming of gait were submitted to kinematic analysis using CVMob® software. The gait of partipants with HAM/TSP was analized quantitatively through t Student test (alpha 5% and Power of 80%). The project was approved by Ethical Committee of the Bahiana School of Medicine and Public Health with CAAE 13568213.8.0000.5544. RESULTS: The HAM/TSP group showed significant changes in two different domains of biomechanical gait analysis when compared to healthy controls. The angular variables showed increased trunk inclination, flexion and extension (p<0.05); increased hip flexion and decreased hip extension (p<0.05); decreased knee flexion and extension (p<0.05); decreased ankle dorsi and plantar flexion (p<0.05). Range of Motion was also reduced in all those joints. The spatiotemporal variables showed decreased stride length, increased stride time and speed gait cycle (p<0.001). Those changes point out to reduction in joint amplitudes of hip, knee and ankle, changes in support base and double support time asymmetry between right and left sides, reduction of pre-swing time, hip lift in the mid-swing, and foot drop throughout the swing. CONCLUSION: People with HAM/TSP have gait characterized by reduction in joint amplitudes of hip, knee and ankle, asymmetry between right and left sides and reduction of pre-swing time, hip lift in the mid-swing, and foot drop throughout the swing.