It is well documented that “exercise is a strategy used to reduce the disabling effects from the chronic problems brought on by the HIV infection”. Therefore, it is important that every HIV/AIDS patient become involved in treatment provided by a physical therapist. According to the 2014 World Health Conference for Physical Therapy, it is vitally important for individuals living with HIV/AIDS to maintain and/or improve their level of physical activity. Due to the expertise of physical therapists in movement and exercise and the understanding of the effects of pathologies on bodily systems, it is important that therapists design, prescribe, and manage the exercise for HIV/AIDS patients.
Although the physical therapist is not involved in treating the disease of the HIV patient, the therapist plays an important role in treating the conditions brought on by HIV and AIDS that limit movement and help the HIV/AIDS patient maintain a better quality of life. Patients with HIV develop many of the functional limitations that other patients may have, such as arthritis or sports related type injuries. HIV patients have an abnormally low functional capacity which manifests itself in a decreased capacity to perform work. In 2014 in an article in MovingForward PT, the goal of the physical therapist in working with HIV/AIDS patients was stated to be to “improve the quality of life of the HIV/AIDS patient and keep them active at home, work and in the community”.
A 2014 article in physio-pedia.com relates that a PT should develop a plan of care which will help improve ability for daily activities, improve heart health, improve balance, reduce pain, and help to maintain a healthy weight. The physical therapist should also prescribe a home exercise program with goals for the patient to achieve. Within the plan of care, the physical therapist must address the following:
- Quality of Life.
- Work Hardening.
- Community Management (accessing transportation, socialization opportunities, ability to access and negotiate health care and insurance systems).
Other sources also believe that the plan of care should:
- Tailor treatments that take HIV disease into account
- Provide customized exercise and pain management programs, and
- Help people with advanced HIV disease to prevent, reduce, and delay movement and function problems.
The overall benefits of exercise for HIV/AIDS patients include:
- Pain relief
- Reduces muscle atrophy
- Regularity of bowels
- Enhances immune function (by increasing T helpers and induce CD4 cells and activating CD8 cells)
- Improves cardiovascular function
- Improves pulmonary function
- Improves endurance
- Helps prevent pneumonia and other respiratory infections, and
- Reduces anxiety and improves the patient’s mood
It is important for physical therapists to work with HIV patients on the following activities in addition to progressive resistance and aerobic exercise:
- Soft tissue and joint mobilization
- Gait and balance training
- Functional electrical stimulation/neuromuscular electrical stimulation
- Proprioceptive neuromuscular facilitation, and
- Desensitization techniques
In 2014, the World Confederation for Physical Therapy worked with colleagues from McMaster University and the University of Toronto, Canada to develop a resource for information to assist physical therapists in learning more about the condition of HIV/AIDS and the benefits of physical therapy. The link to these numerous resources can be found at http://www.wcpt.org/node/33479#pt