Rehabilitation for Patients with HIV and AIDS Flashcards
How HIV causes AIDS
- CD4 cell depletion or “Low T-Cell counts” results in immunodeficiency
- AIDS is defined as CD4 count < 200 per ml accompanied by opportunistic infections
AIDS is defined as CD4 count < _____ per ml
200 per ml
HAART =
Highly Active Antiretroviral Treatment
Stages of HIV and AIDS
- Asymptomatic (HIV)
- Early symptomatic (HIV or AIDS)
- Advanced (AIDS)
Lymphodystrophy
- “AIDS Wasting Syndrome”
- Caused by HAART
- Significant wasting of extremities and face
- Increased girth of abdomen, upper back, thorax
Lymphodystrophy
“AIDS Wasting Syndrome”
Complication of lymphodystrophy
Heart disease, stroke
Patients with Lymphodystrophy may benefit from
- Aerobic conditioning
- Nutritional support
- Strength training and PREs
- Growth hormones vs. Progressive resistive training – both seem to be equally effective
General abnormality of disease of the muscle caused by deletion of the mitochondria
Myopathy
25% of AIDS patients
The Role of Exercise in Acute Myopathy
Exercise is contraindicated
The Role of Exercise in Chronic Myopathy
Can benefit from exercise
Chronic Myopathy Presentation:
Difficulty with:
Can benefit from:
- 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
treatment of myopathy
- 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
Most common complication of HIV
Peripheral Neuropathy
Peripheral Neuropathy Pathogenesis:
is largely unknown:
- HAART
- HgB or albumin levels
- Poor nutrition
Peripheral Neuropathy, predictors of poor outcomes
- Increased age
- Weight loss
- Lower CD4 count
most common type of peripheral neuropathy
Distal Symmetric Polyneuropathy
- Burning and parasthesia
- Motor: None
- Stocking, glove
- Onset: Late in disease progression
- Burning and paresthesia
- Stocking, glove
Distal Symmetric Polyneuropathy
The Role of Rehabilitation in Peripheral Neuropathy:
- Specific attention to feet: skin checks!
- Monitor pain, sensory distribution, mmt
- Exercise may be beneficial
Advanced Disease
- Remain physically active, frequent exercise
- Exercise training on symptom limited basis
- Avoid strenuous training
- Careful monitoring of health status
