Physical Deficits Among People Living With Hiv: A Review Of The Literature And Implications For Rehabilitation

Background: Life expectancy has improved significantly among people living with HIV (PLWH). However, there is evidence of an accelerated aging process among PLWH, which includes physical impairments. Relative to the other consequences of aging among PLWH, physical impairments have not received much attention in the literature. There is an emerging need to study physical deficits in this population. Objectives: The main purposes of this review are to explore factors contributing to physical dysfunction in this population, describe common physical impairments, discuss physical performance measures, and make recommendations for rehabilitation professionals regarding exercise prescription for PLWH. Major Findings: Factors contributing to physical impairments include HIV severity, comorbidities, inflammation, and oxidative stress. Problems with muscle strength and mass, gait, static and dynamic balance, aerobic capacity, and frailty are common among PLWH and can have a negative impact on fall risk and functional performance. Several physical performance measures can be used for screening and assessment purposes, including the Short Physical Performance Battery, Six-Minute Walk Test, 5-times sit-to-stand, Community Mobility and Balance Scale, and gait speed tests. Conclusions: Physical impairments are prevalent among PLWH. Rehabilitation providers should identify PLWH who are at risk of developing physical impairments. Exercise interventions including aerobic, resistance, and balance training appear to benefit PLWH. More research is warranted to investigate outcome measures that should be routinely used in clinical practice and the efficacy of exercise in this population.