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Benjamin-Damons N1, Potterton J1, Kamerman P1
1University of the Witwatersrand, Physiotherapy, Johannesburg, South Africa
Background: The profile of HIV has changed since the advent of ART which revolutionised the treatment of HIV. South Africa has the largest ART programme in the world.
Sensory neuropathy is directly related to infection and often compounded by anti-retroviral therapy. In phase one of this study a total of 25.9% (n=36) children presented with HIV-SN.
Purpose: The aim of this study was to determine the outcome of an intervention programme on the gross motor function of CLWHIV that develop HIV-SN.
Methods: Children attending the Rahima Moosa Mother and Child Hospital were screened for signs and symptoms of PN using the Brief Peripheral Neuropathy Screen and gross motor function was assessed using the Movement ABC-2. Twenty-eight CLWHIV agreed to participate in the exercise intervention. The intervention was designed using a Delphi survey completed by experts in the field of managing paediatric conditions and was supported by literature.The intervention consisted of:
Education of the parents/caregivers and children on HIV-SN; Exercises starting with a warm-up, stretching-; aerobic -;strength - and balance exercises followed by a cool down walk Massage using a hand-held vibrating massager.
Data analysis of mean and standard deviation was used. Linear logistic regression was used to determine differences in MABC zones.
Results: Of the total number of participants n=28, 14 were female. The mean age of the children was 8.6 years (SD = 1.7). The intervention started with 11 participants (45.8%) being classified as being 'at risk' to only three (15.8%) on completion.
A stepwise linear regression model was used to determine differences at each point of assessment. The results were statistically significant, p = .023, where baseline scores were the lowest, indicating an improvement during the intervention period.
When looking at the zoning of Green, Amber and Red, there was an overall improvement of 30% in motor ability. The overall test score showed a statistically significance between period one and two (p ˂ 0.001) as well as between period one and three (p = 0.023).
There was an overall decrease in the reporting of symptoms such as: pain, hot, cold and pins and needles.There was a significant decrease in the presence of decreased vibration sense on the right between periods one and three where p = 0.021. When looking at the components of the M-ABC test:
There was a statistically significant change in the balance score between periods one and two where p = 0.044.
Conclusion(s): When testing the programme, it was found that the most change was seen in the first six weeks of the intervention with participants then reaching a plateau. The participants showed improvement in their overall gross motor function, with most moving over to the 'Green' category of the M-ABC-2® traffic light system. We thus deduce that the programme was successful, but that six weeks will be sufficient to see positive change.
Implications: The intervention programme yielded positive results with balance as well as aiming and catching scores showing statistical significance. A more rigorous clinical trial is recommended.
Keywords: Paediatrics, HIV, sensory neuropathy
Funding acknowledgements: South African Society of Physiotherapy Research Foundation
National Research Foundation Thuthuka Grant
National Research Foundation Sabbatical Grant
Sensory neuropathy is directly related to infection and often compounded by anti-retroviral therapy. In phase one of this study a total of 25.9% (n=36) children presented with HIV-SN.
Purpose: The aim of this study was to determine the outcome of an intervention programme on the gross motor function of CLWHIV that develop HIV-SN.
Methods: Children attending the Rahima Moosa Mother and Child Hospital were screened for signs and symptoms of PN using the Brief Peripheral Neuropathy Screen and gross motor function was assessed using the Movement ABC-2. Twenty-eight CLWHIV agreed to participate in the exercise intervention. The intervention was designed using a Delphi survey completed by experts in the field of managing paediatric conditions and was supported by literature.The intervention consisted of:
Education of the parents/caregivers and children on HIV-SN; Exercises starting with a warm-up, stretching-; aerobic -;strength - and balance exercises followed by a cool down walk Massage using a hand-held vibrating massager.
Data analysis of mean and standard deviation was used. Linear logistic regression was used to determine differences in MABC zones.
Results: Of the total number of participants n=28, 14 were female. The mean age of the children was 8.6 years (SD = 1.7). The intervention started with 11 participants (45.8%) being classified as being 'at risk' to only three (15.8%) on completion.
A stepwise linear regression model was used to determine differences at each point of assessment. The results were statistically significant, p = .023, where baseline scores were the lowest, indicating an improvement during the intervention period.
When looking at the zoning of Green, Amber and Red, there was an overall improvement of 30% in motor ability. The overall test score showed a statistically significance between period one and two (p ˂ 0.001) as well as between period one and three (p = 0.023).
There was an overall decrease in the reporting of symptoms such as: pain, hot, cold and pins and needles.There was a significant decrease in the presence of decreased vibration sense on the right between periods one and three where p = 0.021. When looking at the components of the M-ABC test:
There was a statistically significant change in the balance score between periods one and two where p = 0.044.
Conclusion(s): When testing the programme, it was found that the most change was seen in the first six weeks of the intervention with participants then reaching a plateau. The participants showed improvement in their overall gross motor function, with most moving over to the 'Green' category of the M-ABC-2® traffic light system. We thus deduce that the programme was successful, but that six weeks will be sufficient to see positive change.
Implications: The intervention programme yielded positive results with balance as well as aiming and catching scores showing statistical significance. A more rigorous clinical trial is recommended.
Keywords: Paediatrics, HIV, sensory neuropathy
Funding acknowledgements: South African Society of Physiotherapy Research Foundation
National Research Foundation Thuthuka Grant
National Research Foundation Sabbatical Grant
Topic: Paediatrics; Oncology, HIV & palliative care
Ethics approval required: Yes
Institution: University of the Witwatersrand
Ethics committee: University of the Witwatersrand Human Research Ethics Committee
Ethics number: M 120767
All authors, affiliations and abstracts have been published as submitted.
