Key words: Peripheral neuropathy, HIV/AIDS, Progressive resisted exercise, Performance oriented mobility, Quality of life.
Background: Distal symmetrical poly-neuropathy (DSP) has emerged as one of the major neurological complication associated with HIV/AIDS and antiretroviral therapy. People with DSP commonly have problems with pain, mobility, altered gait and balance all which affect their quality of life. While therapeutic strengthening exercise has been reported to attenuate these impairments in other co-morbid conditions like diabetes mellitus and in HIV/AIDS, there is no evidence available on the effects of exercise on DSP in people living with HIV/AIDS (PLWHA).The purpose of this study was to determine the effects of progressive resisted exercises (PRE) on performance oriented mobility and health related quality of life in (PLWHA) related DSP. Objectives of this study were to determine the effects of PRE on gait, balance and pain levels and establish if there is a relationship between performance-oriented mobility and health-related quality of life in PLWHA related DSP. Methods: In order to fulfil the objectives, an assessor-blinded randomized controlled trial was conducted over two studies, with a combined sample of 160 participants sourced from two family care clinics at two central hospitals and ten anti-retroviral therapy dispensing municipal clinics in Harare, Zimbabwe. While the experimental group with 80 participants had an intervention program of PRE sessions of one hour for the lower limbs, done twice per week over 12 weeks, the control group of 80 participants was given advice to walk unsupervised at home. Loss to follow up in this study was at 60% (n=97) and the data was analysed using an intention to treat analysis approach. Results: Participants of an average age of 42.2 years (SD=8.5) constituted of 70.6% (n=113) female participants. Combination antiretroviral therapy containing stavudine, was used by 59% (n=94) of the participants and 59% (n=94) of the participants had moderate to severe neuropathy. Proximal muscles exhibited weakness (hamstring muscles strength = 3.43 kg force (SD=1.5)) when compared to leg muscles (gastrocnemius muscles strength = 12.8 kg force (SD=2.0)). Gait and balance scores did not show differences in effect between the intervention and the control group (95%CI 0.00-0.02, p = 0.8). Similarly there were no differences of effect for muscle strength (95%CI 0.00-0.08, p=0.13-0.8) and pain (95%CI 0.0-0.06, p>0.13). However the effect on quality of life changes were significantly different between the two groups (95%CI 0.00-0.12 p= 0.04). Quality of life was positively associated with gait, odds ratio 1.01 (95%CI 1.00 – 1.04), moderately associated with balance odds ratio 0.68, (95%CI 0.52 – 0.93) negatively associated with pain odds ratio 0.98 (95%CI 0.97 – 0.99). Conclusion: This research study established that progressive resisted exercises have positive effects on the health related quality of life in PLWHA related DSP. However this study did not show a difference of the effects of progressive resisted exercises on performance oriented mobility in PLWHA related DSP when compared to advice to exercise at home. The study findings may not be generalized to all individuals living with HIV/AIDS who have DSP as the participants were from a particular demographic setting. This project may be continued at the participating family care clinics as a roll on of the perceived benefits of exercise for people with HIV related DSP.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/12569 |
| Date | 19 March 2013 |
| Creators | Mkandla, Khumbula |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | application/pdf |
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