Mkandla Khumbula, Myezwa Hellen, Musenge Eustasius
a Physiotherapy Department , University of Zimbabwe , Harare , Zimbabwe.
b Physiotherapy Department, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa.
AIDS Care. 2016;28(5):639-43. doi: 10.1080/09540121.2015.1125418. Epub 2016 Jan 5.
Distal symmetrical poly-neuropathy (DSP) is a neurological complication associated with HIV/AIDS and stavudine (d4T) containing antiretroviral therapy. People with DSP experience pain, numbness and muscle weakness, which affect their quality of life (QOL). The purpose of this study was to establish the effect of a progressive-resisted exercise (PRE) intervention on health-related quality of life (HR-QOL) in people living with HIV/AIDS-related DSP. An assessor-blinded randomised controlled trial was conducted, with participants sourced from 10 clinics with HIV services, the family care clinic at Wilkins Hospital and 2 large hospitals in Harare, Zimbabwe. A 12-week PRE intervention was conducted twice weekly for 80 participants, while the control group with 80 participants continued with usual daily activities. The main outcome variable was HR-QOL for which we controlled for demographic and clinical measures in generalised estimating equation population-averaged models. Data were summarised and analysed using an intention to treat analysis approach using the Stata v10 program. Mean age of participants was 42.2 years (SD = 8.5). While d4T was used by 59% (n = 94), an equal proportion of the participants also had moderate to severe neuropathy. PRE was found to significantly improve HR-QOL in the intervention group based on the mean difference between the intervention group mean change and the mean change in the control group (F ratio 4.24; p = .04). This study established that PREs have positive effects on HR-QOL for people living with HIV/AIDS-related DSP.
远端对称性多发性神经病(DSP)是一种与人类免疫缺陷病毒/获得性免疫综合征(HIV/AIDS)以及含司他夫定(d4T)的抗逆转录病毒疗法相关的神经并发症。患有DSP的人会经历疼痛、麻木和肌肉无力,这些会影响他们的生活质量(QOL)。本研究的目的是确定渐进性抗阻运动(PRE)干预对感染HIV/AIDS相关DSP的人群健康相关生活质量(HR-QOL)的影响。开展了一项评估者盲法随机对照试验,参与者来自津巴布韦哈拉雷的10家提供HIV服务的诊所、威尔金斯医院的家庭护理诊所和2家大型医院。对80名参与者进行了为期12周的PRE干预,每周两次,而80名参与者的对照组继续进行日常活动。主要结局变量是HR-QOL,我们在广义估计方程总体平均模型中对人口统计学和临床指标进行了控制。使用Stata v10程序,采用意向性分析方法对数据进行总结和分析。参与者的平均年龄为42.2岁(标准差=8.5)。虽然59%(n=94)的人使用了d4T,但相同比例的参与者也患有中度至重度神经病。基于干预组平均变化与对照组平均变化之间的平均差异,发现PRE能显著改善干预组的HR-QOL(F值4.24;p=0.04)。本研究证实,PRE对感染HIV/AIDS相关DSP的人群的HR-QOL有积极影响。