Efficacy of Concentric Rehabilitation for HTLV-1 Associated Myelopathy (HAM) Patients on ADL

Abstract

We evaluated the clinical efficacy of concentric inpatient hospital rehabilitation (CIHR) for HTLV-1 associated myelopathy (HAM). We estimated the change of activity of daily living (ADL) using objective clinical parameters before and after rehabilitation. [Subjects] Fifteen HAM patients (male 3, female 12, mean age 51.9) at the chronic stable stage participated in this study. [Methods] These HAM patients were hospitalized for rehabilitation for six weeks periods at our hospital. We assessed the usefulness of CIHR therapy by the Functional Independence Measure (FIM) ratings and Osame's Motor Disability Score (OMDS) before and after rehabilitation. We also evaluated the changes of each FIM subcategory, especially focusing on gait ability. [Results] FIM ratings showed statistically significant increases after CIHR. Especially, the walking ratings in FIM and OMDS showed statistically significant improvements after CIHR. FIM subcategories related to lower limb movement improved remarkably whereas subcategories related to bladder and bowel management were without significant changes. [Conclusion] The improvement of ADL by CIHR was confirmed, mainly as a remarkable improvement in the gait ability. Concentric rehabilitation for HAM patients may be a promising therapy for improvement of ADL.