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Abstract
Lower extremity splinting to reduce pain and dysfunction associated with Peripheral Neuropathy in the HIV/AIDS population
R Sandoval, A J Waguespack
Harris-Thomas Street Clinic, Rehabilitation Services, Houston, TX, United States
ISSUES: Among the most common reasons for physical therapy referral of persons with Human Immunodeficiency Virus (HIV) are pain and disability caused by peripheral neuropathy (PN). The HIV virus has been associated with the destruction of large myelinated fibers leading to PN. More recently, PN has emerged as a neurotoxic side effect to anti-retroviral drugs (e.g. DDI, DDC, and D4T) in 30 – 40% of those taking them. The purpose of this project is to present our experience in treating lower extremity PN pain/disability at a major urban HIV clinic.
DESCRIPTION: PN in the HIV+ population is reported to vary between 30 and 60% of all PLWA’s with increased reports in the later stages of AIDS. Of these, a majority are likely associated with drug neurotoxicity. Clinical findings in PN include pain on plantar aspect of foot, poor tolerance of weight bearing activities, night cramping of the intrinsic muscles of the feet and calves, shortening/reduced pliability of the plantar fascia, and mild edema of the lower leg and foot. Our approach emphasizes self stretching and deep tissue massage of the plantar fascia, and use of a night splint.
LESSONS LEARNED: Two recent case studies are represented. Pre-treatment pain levels averaged 8.5 on a 0 –10 self-reporting scale. Post-treatment pain levels reported averaged 3.0, a 65% reduction after one week use of night splint protocol. Timed functional tasks including sit to stand, 50’ walk, unloaded forward reach, showed improvements in these two studied cases.
RECOMMENDATIONS: The incidence of PN, a debilitating syndrome, may continue to increase as the life-span of the HIV population is extended. Tailored to address plantar fascia dysfunction and edema. Physical Therapy reduces pain ad promotes mobility. Further studies are planned to examine effective treatment strategies and outcomes, and to promote a more evidence-based practice for this significant clinical challenge.
The XIV International AIDS Conference
Abstract no.
WePeF6659
Suggested Citation
" R Sandoval, et al.
Lower extremity splinting to reduce pain and dysfunction associated with Peripheral Neuropathy in the HIV/AIDS population
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Poster Exhibition:
The XIV International AIDS Conference:
Abstract no.
WePeF6659"
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