Rehabilitation for Patients with HIV and AIDS

Question 1

How HIV causes AIDS

Answer 1

• CD4 cell depletion or “Low T-Cell counts” results in immunodeficiency
• AIDS is defined as CD4 count < 200 per ml accompanied by opportunistic infections

Question 2

AIDS is defined as CD4 count < ​_____ per ml

Answer 2

200 per ml ​

Question 3

HAART =

Answer 3

Highly Active Antiretroviral Treatment

Question 4

Stages of HIV and AIDS

Answer 4

• Asymptomatic (HIV)
• Early symptomatic (HIV or AIDS)
• Advanced (AIDS)

Question 5

Lymphodystrophy
​

Answer 5

• “AIDS Wasting Syndrome”
• Caused by HAART

Question 6

• Significant wasting of extremities and face
• Increased girth of abdomen, upper back, thorax

Answer 6

Lymphodystrophy

“AIDS Wasting Syndrome”

Question 7

Complication of lymphodystrophy

Answer 7

Heart disease, stroke

Question 8

Patients with Lymphodystrophy may benefit from

Answer 8

• Aerobic conditioning
• Nutritional support
• Strength training and PREs
• Growth hormones vs. Progressive resistive training – both seem to be equally effective

Question 9

General abnormality of disease of the muscle caused by deletion of the mitochondria

Answer 9

Myopathy

25% of AIDS patients

Question 10

The Role of Exercise in Acute Myopathy

Answer 10

Exercise is contraindicated

Question 11

The Role of Exercise in Chronic Myopathy

Answer 11

Can benefit from exercise

Question 12

Chronic Myopathy Presentation:

Difficulty with:
Can benefit from:

Answer 12

• Weakness of proximal muscle groups
• Difficulty with:
  
  • transitioning from sit to stand
  • Climbing stairs
  • Arms overhead long periods
  • Rising from squat

Can benefit from exercise

Question 13

treatment of myopathy

Answer 13

• May be responsive to anabolic steroids
• Massage, yoga, relaxation and meditation
• Discontinue use of antiretroviral agents causing myopathy
• Monitor pain ratings: Calves, thighs, upper arms

Question 14

Most common complication of HIV

Answer 14

Peripheral Neuropathy

Question 15

Peripheral Neuropathy Pathogenesis:

Answer 15

is largely unknown:

• HAART
• HgB or albumin levels
• Poor nutrition

Question 16

Peripheral Neuropathy, predictors of poor outcomes

Answer 16

• Increased age
• Weight loss
• Lower CD4 count

Question 17

most common type of peripheral neuropathy

Answer 17

Distal Symmetric Polyneuropathy

• Burning and parasthesia
• Motor: None
• Stocking, glove
• Onset: Late in disease progression

Question 18

• Burning and paresthesia
• Stocking, glove

Answer 18

Distal Symmetric Polyneuropathy

Question 19

The Role of Rehabilitation in Peripheral Neuropathy:

Answer 19

• Specific attention to feet: skin checks!
• Monitor pain, sensory distribution, mmt
• Exercise may be beneficial

Question 20

Advanced Disease

Answer 20

• Remain physically active, frequent exercise
• Exercise training on symptom limited basis
• Avoid strenuous training
• Careful monitoring of health status