Physiotherapy Interventions in HIV
Original Editor - Niha Mulla
Top Contributors - Niha Mulla
Introduction[edit | edit source]
Physiotherapeutic interventions with exercises and manual therapy for people living with HIV is highly beneficial as physiotherapy plays a vital role in optimization of life. As HIV lead to AIDS, defense mechanism of the body fails step-by-step.
HIV patients have been living longer since past three decades as 50% of HIV patients have access to Antiretroviral Therapy. This means people with HIV are aging, leading to increased number of co-morbidities. As Antiretroviral Therapy adds valuable years to the life of these patients, it is vital to add life to these years via physical therapy and rehabilitation. Physical rehabilitation plays a major role in maintaining physical, mental and social health. 
Due to multi system pathology of the disease, most HIV/AIDS patients have prolonged hospital stays that raise the chances of complications like muscle wasting, joint stiffness, contractures, reduced lung capacities, pressure sores, early cardiopulmonary disorders along with diabetes, etc. which show beyond doubt that physiotherapy interventions are much needed. 
Rehabilitation with older/Aging HIV positive patients[edit | edit source]
Aging in itself is not easy. Join aging with HIV and the difficulties faced by the individual will multiply by ten folds. Physical, social and psychological consequences of the disease, long term treatment and comorbidities along with an uncertain future, is not easy to deal with, but rehabilitations makes it easy to deal with it as a whole.
Some common day to day difficulties of patients with HIV/ aging HIV patients are as follows:[edit | edit source]
- Health uncertainty
- Difficulties with daily living activities/ home chores
- Difficulty being part of social life/ maintaining a job
- Stress, Depression and anxiety leading from worrying about future life.
- Early onset of cardiovascular disorders, diabetes, musculoskeletal and neurocognitive disorders.
Everything together is a perfect recipe for disability especially when added together with aging. 
Physiotherapy and rehabilitation assist in managing patients in long term care due to HIV, which can be provided as in patient care or out patient care at clinic or at home rehabilitation intervention. It helps prevent, delay or cure complications and lead an independent, pain free life. Each patient with HIV/AIDS needs to be assessed separately using HIV Disability Questionnaire as each patients can show different level of morbidities and comorbidities. 
Physiotherapy in acute stage[edit | edit source]
- Clear chest secretions
- Eliminate shortness of breadth 
- Maintain and improve cardiopulmonary fitness 
- Maintain normal Joint range of motion
- Postural correction to avoid pain and deformities
- Aerobic and resistive exercises to maintain functional health (medium to high intensity)
Physiotherapy in chronic stage[edit | edit source]
- Strengthening and resistive exercises to prevent/cure muscle weakness and wasting
- Improve neurological balance 
- Maintain circulation to the limbs with active and passive exercises and mobility training
- Stretch to prevent contractures. 
- Pain Management
- Independence of daily living activities
- Improve pulmonary function
- Aerobic training to maintain functional health at least 3 times each week (low intensity for longer duration) 
- Cognitive behavioral therapy to improve memory and functional status
Benefits of physiotherapy, rehabilitation & exercise in patients with HIV[edit | edit source]
- Improved Body Mass Index/ BMI 
- Improves measure of blood lipids 
- Improved muscle strength
- Improved cardiopulmonary fitness 
- Reduced depression and anxiety 
- Improved quality of life 
References[edit | edit source]
- Brown D. HIV – what has physiotherapy and rehabilitation got to do with it? Physiospot. 2017 Available from: https://www.physiospot.com/opinion/hiv-what-has-physiotherapy-and-rehabilitation-got-to-do-with-it/#author
- Pullen SD, Chigbo NN, Nwigwe EC, Chukwuka CJ, Amah CC, Idu SC. Physiotherapy intervention as a complementary treatment for people living with HIV/AIDS. Hiv/aids (Auckland, NZ). 2014;6:99.
- Simfukwe P. The role of physiotherapy in people living with HIV/AIDS. Health Department, Republic of South Africa. Available from: https://www.kznhealth.gov.za/physio_hivaids.pdf
- O'Brien KK, Solomon P, Trentham B, MacLachlan D, MacDermid J, Tynan AM, Baxter L, Casey A, Chegwidden W, Robinson G, Tran T. Evidence-informed recommendations for rehabilitation with older adults living with HIV: a knowledge synthesis. BMJ open. 2014 May 1;4(5):e004692.
- Cobbing S, Hanass-Hancock J, Myezwa H. A home-based rehabilitation intervention for adults living with HIV: A randomized controlled trial. Journal of the Association of Nurses in AIDS Care. 2017 Jan 1;28(1):105-17.
- O’Brien KK, Solomon P, Bergin C, O’Dea S, Stratford P, Iku N, Bayoumi AM. Reliability and validity of a new HIV-specific questionnaire with adults living with HIV in Canada and Ireland: the HIV Disability Questionnaire (HDQ). Health and quality of life outcomes. 2015 Dec;13(1):1-1.
- Jaggers JR, Hand GA. Health benefits of exercise for people living with HIV: A review of the literature. American journal of lifestyle medicine. 2016 May;10(3):184-92.