The effects of a physiotherapist-led exercise intervention on peripheral neuropathy among people living with HIV on antiretroviral therapy in Kigali, Rwanda
Background: HIV-associated peripheral neuropathy (PN) is common in people living with HIV. Its management is mostly symptomatic utilising pharmacological approaches. Objectives: This study determined the effects of an exercise intervention on PN among Rwandan people living with HIV receiving antire...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
AOSIS
2019-08-01
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| Series: | South African Journal of Physiotherapy |
| Subjects: | |
| Online Access: | https://sajp.co.za/index.php/sajp/article/view/1328 |
| Summary: | Background: HIV-associated peripheral neuropathy (PN) is common in people living with HIV. Its management is mostly symptomatic utilising pharmacological approaches.
Objectives: This study determined the effects of an exercise intervention on PN among Rwandan people living with HIV receiving antiretroviral therapy (ART).
Methods: A 12-week single-blinded randomised controlled trial using the Brief Peripheral Neuropathy Screen (BPNS) as the assessment tool tested the effects of an exercise intervention on PN, followed by a 12-week non-intervention period. A total of 120 people with HIV- associated PN on ART were randomised to an exercise or no exercise group. Both groups continued receiving routine care. A bivariate analysis using Pearson’s chi-square test for significant differences in PN symptoms and signs, between groups, at baseline, after the 12 weeks intervention and 12 weeks post-intervention using generalised linear regression models to determine predictors of treatment outcomes was undertaken, utilising an intention-to-treat analysis (alpha p ≤ 0.05).
Results: At 12 weeks, the intervention group compared to the control: neuropathic pain 70% versus 94% (p 0.005), PN symptoms severity – mild and/or none in 85% versus 60% (p 0.001) and radiation of PN symptoms reduced, 80% versus 37% (p 0.001). There were no differences in PN signs at 12 weeks intervention and at 12 weeks post-intervention. Having changed the antiretroviral (ARV) and having developed PN symptoms after the start on ARVs predicted treatment improvement, while demographic factors did not predict any treatment outcome.
Conclusion: A physiotherapist-led exercise intervention improved PN symptoms, but with non-significant improvement in PN signs. Factors related to early diagnosis and treatment of PN were facilitators for the improvement of PN symptoms.
Clinical implications: Physiotherapist-led exercises should be integrated into the routine management of people living with HIV on ART with PN symptoms. |
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| ISSN: | 0379-6175 2410-8219 |