Electromiography Study in the Respiratory Muscle Training in Human Lymphotropic Virus Type 1

Human T-lymphotropic viruses, HTLV (Human Lymphotrophic Virus T), are retroviruses, which stand out as type 1 (HTLV-1) and type 2 (HTLV-2), the former being the etiologic agent of serious organ diseases such as leukemia adult T-cell lymphoma (ATLL), a neurological disorder, Tropical Spastic Paraparesis / HTLV-I-associated myelopathy (PET / HAM) and other non-malignant ophthalmologic, dermatological, rheumatic and osteomyelitis non-malignant disorders. For HTLV-2 it has not yet separated with some disease.

The highest prevalence of virus is found in countries of the Caribbean, South America, Melanesia Islands, West Africa and Japan. Brazil is an endemic country for infection and prevalence varies from state to state, being highest in Bahia, Pernambuco and Pará. The form of sexual transmission, hematologic for blood transfusions or accompanied by contaminated needles, mother-to-child verticalization, the passage of the lymphocyte infected by breast milk and also in the perinatal period.

The mechanism of the disease comes from the infection of several types of cells, such as T and B lymphocytes, monocytes and fibroblasts. However, its tropism is by TCD4 + cells. The form of contamination is cell-cell, thus being transferred from infected material to uninfected cells, modifying the immune system, as well as cell cells.

The main characteristic of HTLV infection is that in most cases the virus persists asymptomatic and undetectable by the immune system per year or until death in about 98% of the patients, while the hosts are able to transmit the virus. There are still no basic surveys on how severe forms of symptoms of graves occur in those infected.

In this context, when the individual becomes symptomatic, he is affected by chronic infection that may be associated with disabling diseases that compromise quality of life, such as the neurological disease PET-MAH. The onset is insidious with frequent changes in gait and urinary symptoms, mainly affecting the lower limbs such as spasticity, hyperreflexia, sensory-motor dysfunctions such as neuropathic or nociceptive pain, paresis, paralysis and paresthesia, urinary bladder disorders, muscle weakness and low back pain. The early diagnosis of motor complications in the face of the onset of neurological disease also contributes to the prevention of the installation of motor sensory sequelae if the physiotherapeutic treatment is established early. According to this reference, one of the aspects of preventive care refers to the functional autonomy correlated with physical conditioning in order to increase the strength and / or endurance of the skeletal muscles.

In this way, the possibility of morphological and functional changes in the respiratory system is also highlighted. With preventive therapeutic possibilities, the respiratory muscle training (TMR) appears to this indicator with reference to the maximum inspiratory and expiratory pressures (PiMáx and PeMáx). This procedure directly reflects on the patient's functionality, having as guideline the conduction of training protocols. The protocol should be conducted at least three days weekly frequently twice daily.

One tool to evaluate muscular behavior during TMR is surface electromyography (EMGs), which consists of a non-invasive detection of the muscular electrical activity by which it is presented graphically. It is constituted by the transcription of the sum of the electrical activity of all the active muscle fibers, through the positioning of electrodes on the skin. Thus, in order to verify the muscular activity of the respiratory dynamics related to inspiration, the main groups are the diaphragm, parasternal intercostal, sternocleidomastoid, abdominal rectus.

Therefore, the training requires time, availability and greater displacement of the patient to the outpatient treatment units, thus causing difficulties in adherence to the proposed therapy. To that end, it has been proposed ways that facilitate such conduction, such as home treatments, which, in most cases, the patient is supervised by the physiotherapist at least once a week presently followed by distance monitoring.