IMPACT OF POSTURAL DEVIATION ON QUALITY OF LIFE AMONG PATIENTS WITH HAM/TSP

Résumé

Background and Purpose. HTLV-1 associated myelopathy or Tropical Spastic Paraparesis (HAM/TSP) causes,beyond other disturbances,postural alterations.It is necessary to evaluate the impact of postural misalignment on quality of life. Subjects and Methods. In this cross-sectional study the 38 selected individuals underwent a postural evaluation using Software for Postural Assessment(SAPO®) with their functional level established by the SF-36. Results. The postural pattern of this type of patient is characterized by adopting the anteriorized position of head and trunk, hip and knee flexion, and reduced ankle angle.The more pronounced the deviation,the larger the impact in quality of life,in terms of Functional Capacity and Physical Appearance.The postural impairments that most influenced the functional capacity were the anteriorization of trunk (Pearson Linear Correlation;r=-0.63,p=0.04) and hip flexion(Pearson Linear Correlation;r=- 0.60,p=0.03).Weaker correlations were found with the knee flexion (Spearman Linear Correlation;r=- 0.41,p=0.04),anteriorization of head (Pearson Linear Correlation;r=- 0.42,p=0.02), and reduced ankle angle(Pearson Linear Correlation;r=0.30,p=0.03).Concerning the physical aspect,correlation reverse have been identified on the anteriorization of trunk(Pearson Linear Correlation;r=- 0.59,p=0.03).These features denote an anteriorized position in relation to vertical alignment. Discussion and Conclusion. This study demonstrates that there is a typical pattern of posture of the patient with HAM/TSP,which is characterized by an anterior shift of the center of mass, with a flexor pattern of hip and knee.These changes affect the functional capacity of patients,leading to a decreased quality of life.It is suggested the inclusion of a rehabilitation program involving postural approaches for these patients,in order to improve their activities of daily living.