HIV/AIDS management: the roles of physiotherapy

Abstract

BACKGROUND: HIV/AIDS is a major health problem that has affected many people globally and it is the primary cause of death in Sub-Saharan Africa. Approximately 68% of the global total i.e. 22.5 million people living with HIV/AIDS (PLWHA) are in Sub-Saharan Africa. With antiretroviral therapy, PLWHA now live longer and present with various opportunistic neuro-musculo-skeletal and cardio-pulmonary conditions. PURPOSE: To explore the global, regional and local existing literature concerning knowledge, attitude and roles of physiotherapy in the management of PLWHA. METHOD: A retrospective search of articles published between January 1990 and March 2008. Outcome measures: Documented information concerning physiotherapy management of PLWHA, including physiotherapists' knowledge and attitudes, based on inclusion criteria. RESULTS: The search yielded 17 reviews of good or reasonable quality. Physiotherapy rehabilitation can address impairment and activity limitation. There is some evidence that aerobic training with a progressive exercise component is effective in improving the cardio-vascular system, distribution of adipose tissue and on quality of life. There is evidence that ice or dry-towel massage has a positive effect on neuropathic pain. Evidence from case studies suggests that joint mobilization, soft tissue mobilization, stretching, and the use of micro-current, pressure garments and orthotics may be effective. There was no evidence of the effect of other physiotherapy roles mentioned including chest physiotherapy, counseling and health education. CONCLUSION: There is some evidence that exercise is safe and beneficial to PLWHA. Further studies are needed to determine if other physiotherapy techniques are effective for treating PLWHA.