Mhariwa Peter C, Myezwa Hellen, Galantino Mary L, Maleka Douglas
Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, South Africa.
Stockton University Physical Therapy Program, Galloway, New Jersey, United States.
S Afr J Physiother. 2017 Sep 26;73(1):360. doi: 10.4102/sajp.v73i1.360. eCollection 2017.
Human immunodeficiency virus (HIV) negatively impacts muscle strength and function. This study aimed to establish the relationship between lower limb muscle strength and lower extremity function in HIV disease.
A cross-sectional study was undertaken with a sample of 113 HIV-positive participants. Lower limb muscle strength and self-reported function were established using dynamometry and the Lower Extremity Functional Scale (LEFS), respectively. Muscle strength and functional status were established in a subset of 30 HIV-negative participants to determine normative values.
Muscle strength for participants with HIV ranged from an ankle dorsiflexion mean of 9.33 kg/m to 15.79 kg/m in hip extensors. In the HIV-negative group, ankle dorsiflexors recorded 11.17 kg/m, whereas hip extensors were the strongest, generating 17.68 kg/m. In the HIV-positive group, linear regression showed a positive relationship between lower limb muscle strength and lower extremity function ( = 0.71, = 0.00). Fifty per cent of the changes in lower extremity function were attributable to lower limb muscle strength. A simple linear regression model showed that lower limb ankle plantar flexors contributed the most to lower extremity function in this cohort, contrary to the literature which states that hip and trunk muscles are the most active in lower limb functional activities.
Lower extremity strength impacts perceived function in individuals stabilised on antiretroviral therapy for HIV disease. These findings demonstrate that ankle plantar flexors produce more force over hip flexors. Careful attention should be paid to the implications for strength training in this population.
人类免疫缺陷病毒(HIV)对肌肉力量和功能产生负面影响。本研究旨在确定HIV疾病患者下肢肌肉力量与下肢功能之间的关系。
对113名HIV阳性参与者进行了一项横断面研究。分别使用测力计和下肢功能量表(LEFS)来确定下肢肌肉力量和自我报告的功能。对30名HIV阴性参与者的一个子集进行了肌肉力量和功能状态评估,以确定正常值。
HIV阳性参与者的肌肉力量范围从踝背屈平均9.33千克/米到髋伸肌的15.79千克/米。在HIV阴性组中,踝背屈肌为11.17千克/米,而髋伸肌最强,为17.68千克/米。在HIV阳性组中,线性回归显示下肢肌肉力量与下肢功能之间存在正相关关系(=0.71,=0.00)。下肢功能变化的50%可归因于下肢肌肉力量。一个简单的线性回归模型显示,在该队列中,下肢踝跖屈肌对下肢功能的贡献最大,这与文献中所述的髋部和躯干肌肉在下肢功能活动中最为活跃的观点相反。
下肢力量会影响接受抗逆转录病毒治疗的HIV疾病稳定患者的感知功能。这些发现表明,踝跖屈肌比髋屈肌产生的力量更大。应仔细关注这一人群力量训练的影响。