Effects of Physiotherapy in the Treatment of Neurogenic Bladder in Patients Infected With Human T-Lymphotropic Virus 1

Abstract

Objective To evaluate the efficacy of physiotherapy for urinary manifestations in patients with HTLV-1-associated lower urinary tract dysfunction. Methods Open clinical trial with 21 patients attending the physiotherapy clinic of the Hospital Universitário, Bahia, Brazil. Combinations of behavioral therapy, perineal exercises and intravaginal/intra-anal electrical stimulation were used. Results The mean age was 54±12 years and 67% were female. After treatment, there was an improvement in symptoms of urinary urgency, frequency, incontinence, nocturia and in the sensation of incomplete emptying (p<0.001). There was also a reduction in the overactive bladder symptom score from 10±4 to 6±3 (p<0.001) and an increasing in the perineal muscle strength (p<0.001). The urodynamic parameters improved, with reduction in the frequency of patients with detrusor hyperactivity from 57.9% to 42.1%; detrusor-sphincter dyssynergia (DSD) from 31.6% to 5.3%; detrusor hypocontractility from 15.8% to 0% and detrusor areflexia from 10.5% to 0%, with positive repercussions in the quality of life in all patients. Conclusion Physiotherapy was effective in cases of HTLV-1-associated neurogenic bladder, reducing symptoms, increasing perineal muscle strength, improving urodynamic parameters and quality of life.

Effects of Different Types of Exercise on Kidney Diseases

“…The movement therapy program included the electrical stimulation of the pelvic floor muscles. The results showed that physiotherapy was effective in reducing symptoms, increasing perineal muscle strength, and improving urodynamic parameters and quality of life [ 83 ].…”

Research scenario in physiotherapy for people with human t-cell lymphotropic virus (HTLV): scientometric study / Cenário das pesquisas em Fisioterapia para pessoas com Human T-Cell Lymphotropic Virus (HTLV): estudo cientométrico

“…As for the physical therapy resources used in the treatment, the use of individual outpatient kinesiotherapy was identified through functional exercises 36,37,38,39, home exercises 40 , proprioceptive neuromuscular facilitation 41,42 , Pilates 43,44 , virtual reality 45,46 , respiratory training 47 , electrical stimulation 48,39 , neuromodulation with tDCS 49 and rTMS 29 . Most of these resources have no side effects, are low cost, help to delay the evolution of dysfunctions and have a positive impact on quality of life.…”

Treinamento do assoalho pélvico com ou sem eletroterapia no tratamento dos sintomas da hiperatividade do detrusor em mulheres com esclerose múltipla e mielopatia associada ao HTLV-I (HAM/TSP): um ensaio clí­nico randomizado

“…Demonstrou que a eletroterapia no miôtomo de S4 com parâmetro de 12 Hz foi eficiente para promoção da redução dos sintomas de hiperatividade detrusora avaliados pelo OABv8 e incremento dos parâmetros de contratilidade e força do assoalho pélvico pelo esquema PERFECT, além de melhora dos parâmetros urodinâmicos. O que proporcionou redução de urge incontinência e melhora qualidade de vida das participantes [30].…”