Single Limb Support Instability combined with Vestibular and Proprioceptive Alteration in Hispanic Latinx Living with HIV

Authors

  • Martín G. Rosario Texas Woman’s University, Physical Therapy Program, Dallas Campus; Texas.
  • Kaelah Corrigan Texas Woman’s University, Physical Therapy Program, Dallas Campus; Texas.
  • Elizabeth Orozco Texas Woman’s University, Physical Therapy Program, Dallas Campus; Texas.
  • Carley Bowman Texas Woman’s University, Physical Therapy Program, Dallas Campus; Texas.

DOI:

https://doi.org/10.15621/ijphy/2022/v9i1/1143

Keywords:

Standing Deviations, Motor control, Dynamic Balance, HIV complications, Single Limb Balance.

Abstract

Abstract: Healthy individuals can maintain static and dynamic balance via appropriate allocation among proprioceptive (Pro), vestibular (Ve), and visual sensory systems, established as the dynamic systems theory (DST). However, people living with the human immunodeficiency virus (PLHIV) underperform one or more of these systems, altering their ability to control balance. The issue is to determine specific balance system deficits in PLHIV during many challenging standing tasks to understand better where these deficiencies are located. The study aims to distinguish balance deficits in PLHIV using challenging activities with a reduced base of support.
Methods: Thirty adults living with HIV from La Perla Gran de Precio Community Center took part in this examination. We collected balance kinematics with accelerometers and gyroscopes during five balancing tasks. The five tasks included balancing on a firm surface with double limb support (DLS) and single limb support (SLS) and balancing tasks on an unstable surface (foam) with vertical head movements at 60 bpm set by a metronome.
Results: The balancing tasks requiring shifts from SL to DL on firm and foam surfaces with visual input alterations (eyes closed and open) and head movements showed significant increases in sway (p<0.001). The medial-lateral (ML) and anterior-posterior (AP) sway velocities displayed substantial increases (p<0.001) in AP sway among all five tasks and a considerable decrease in ML among the five tasks.
Conclusion: People living with HIV have balance instability, with increased difficulty during conditions requiring to bear weight on a single limb with Ve and Pro adaptations. The mechanism creating these deficits in the Ve and Pro systems is yet unsettled. Future studies should focus on 1) early assessment of Ve and Pro, 2) the mechanisms affecting said balance systems, and 3) the correlation of ART medications with balance and fall risk in this population.

References

Global HIV & AIDS statistics — 2018 fact sheet http://www.unaids.org/en/resources/fact-sheet Accessed [January 2022].

Rojas-Celis, V., Valiente-Echeverría, F., Soto-Rifo, R., & Toro-Ascuy, D. (2019). New Challenges of HIV-1 Infection: How HIV-1 Attacks and Resides in the Central Nervous System. Cells, 8(10), 1245. https://doi.org/10.3390/cells8101245.

Rosario, M.G., Marshall, J., Herkert, A., Binoy, B., Windham, H., & Orozco, E. (2020a). Lower Limb Neuromuscular Modification and Standing Postural Control Alteration in Apparent Asymptomatic People Living with HIV. J Rehab Pract Res 1(1):102. https://doi.org/10.33790/jrpr1100102.

Pollock, A. S., Durward, B. R., Rowe, P. J., & Paul, J. P. (2000). What is balance? Clinical Rehabilitation, 14(4), 402-6. doi:http://dx.doi.org.ezp.twu.edu/10.1191/0269215500cr342oa.

Shumway-Cook A & Woollacott MH. (2007). Motor control: Translating research into clinical practice. (6th ed.) Philadelphia: Lippincott Williams & Wilkins. APA

Shumway-Cook A, Woollacott M. (2012). Normal Postural Control. In: Motor Control Translating Research into Clinical Practice. 4th ed. Baltimore, MD: Lippincott Williams & Wilkins: 162-166.

Heinze, B. M., Vinck, B. M., Hofmeyr, L. M., & Swanepoel, d. (2014a). Vestibular involvement in adults with HIV/AIDS. Auris, nasus, larynx, 41(2), 160–168. https://doi.org/10.1016/j.anl.2013.08.003

Heinze, B. M., Vinck, B. M., & Swanepoel, D. W. (2014b). Does the human immunodeficiency virus influence the vestibulocollic reflex pathways? A comparative study. The Journal of laryngology and otology, 128(9), 772–779. https://doi.org/10.1017/S0022215114001996

Rosario, M. (2020). Gastrocnemius and tibialis anterior neuromuscular modification recruitment during postural standing in people living with HIV. HIV & AIDS Review. International Journal of HIV-Related Problems, 19(4), 260-266. https://doi.org/10.5114/hivar.2020.101633

Trenkwalder, C., Straube, A., Paulus, W., Krafczyk, S., Schielke, E., & Einhäupl, K. M. (1992). Postural imbalance: an early sign in HIV-1 infected patients. European archives of psychiatry and clinical neuroscience, 241(5), 267–272. https://doi.org/10.1007/BF0219597

Bauer, L. O., Wu, Z., & Wolfson, L. I. (2011). An obese body mass increases the adverse effects of HIV/AIDS on balance and gait. Physical therapy, 91(7), 1063-1071.

Bauer, L. O., Ceballos, N. A., Shanley, J. D., & Wolfson, L. I. (2005). Sensorimotor dysfunction in HIV/AIDS: effects of antiretroviral treatment and comorbid psychiatric disorders. AIDS (London, England), 19(5), 495–502. https://doi.org/10.1097/01.aids.0000162338.66180. 0b.

Rosario, M. G., Jamison, L., & Gines, G. (2020c). The Role of HIV Antiretroviral Medication on Motor-Cognitive and Neurological Alterations in Hispanic People Living with HIV. J Pub Health Issue Pract 4(1):160. doi: https://doi.org/10.33790/jphip1100160.

Bjerk, M., Brovold, T., Skelton, D. A., & Bergland, A. (2017). A falls prevention programme to improve quality of life, physical function and falls efficacy in older people receiving home help services: study protocol for a randomised controlled trial. BMC health services research, 17(1), 559. https://doi.org/10.1186/s12913-017-2516-5

National HIV Curriculum. (2021). International HIV dementia scale (IHDS). Tools & calculators. https://www.hiv.uw.edu/page/mental-health-screening/ihds

Shirley Ryan Ability Lab. (2013). Fukuda stepping test (Unterberger step test). Rehabilitation Measures Database. https://www.sralab.org/rehabilitation-measures/fukuda-stepping-test- Unterberger-step-test

Zhang, Y. B., & Wang, W. Q. (2011). Reliability of the Fukuda stepping test to determine the side of vestibular dysfunction. The Journal of international medical research, 39(4), 1432–1437. https://doi.org/10.1177/147323001103900431

Shirley Ryan Ability Lab. (2013). Five times sit to stand. Rehabilitation Measures Database. https://www.sralab.org/rehabilitation-measures/five-times-sit-stand-test

Bohannon RW. (2006) Reference values for the five‐repetition sit‐to‐stand test: a descriptive metaanalysis of data from elders. Percept Mot Skills; 103(1):215‐222.

Whitney SL, Wrisley DM, Marchetti GF, Gee MA, Redfern MS, Furman JM. (2005) Clinical measurement of sit-to-stand performance in people with balance disorders: validity of data for the Five-Times- Sit-to-Stand Test. Phys Ther.;85(10):1034-1045.

Tiedemann, A., Shimada, H., et al. (2008). "The comparative ability of eight functional mobility tests for predicting falls in community-dwelling older people." Age and Ageing 37(4): 430-435.

Martín G. Rosario, Abigail Schacherl, Gayle Bevers, Kendra Longoria, & Abigail Versemann. (2021b). Ankle Complex Neuromuscular Coordination Variation in People Living with HIV. International Journal of Physiotherapy, 8(1), 52-58. https://doi.org/10.15621/ijphy/2021/v8i1/907

Saccomanno, M. F., & Ammassari, A. (2011). Bone disease in HIV infection. Clinical cases in mineral and bone metabolism: the official journal of the Italian Society of Osteoporosis,Mineral Metabolism, and Skeletal Diseases, 8(1), 33–36.

Published

2022-03-09

How to Cite

Martín G. Rosario, Kaelah Corrigan, Elizabeth Orozco, & Carley Bowman. (2022). Single Limb Support Instability combined with Vestibular and Proprioceptive Alteration in Hispanic Latinx Living with HIV. International Journal of Physiotherapy, 9(1), 01–08. https://doi.org/10.15621/ijphy/2022/v9i1/1143

Issue

Section

Original Articles