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03 Mar2015

03 March 2015.

Written by Liesbeth Raymakers
Posted in Aging

03-03-2015 08:03:43
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Recommendations for rehab for adults living with HIV

As adults age with HIV, more individuals are living with the physical, social and psychological consequences of the disease, long-term treatment and comorbidities associated with ageing. Since the introduction of anti-retroviral drugs (in the 1990’s in Europe and US, in 2000’s in Africa and India) HIV is now experienced as a chronic illness with specific challenges such as premature onset of cardiovascular disease (CVD), diabetes, bone and joint disorders, neurocognitive disorders and non-AIDS-defining cancers.

Rehabilitation has become an increasingly important strategy to address disability in patients, but few professionals work specifically with people living with HIV (PLHIV) highlighting a gap in service provision and need for further HIV knowledge, training and clinical guidance. No guidelines specific to HIV rehabilitation exist; and high level evidence is absent. This article aims to fill that gap.

The authors established 8 overarching and 52 specific evidence-informed recommendations from a combination of the research. PLHIV and rehab clinicians were integral in developing the recommendations.

Synaps of recommendations (see article for full list):

  • education of health care professionals in HIV and ageing is paramount
  • individual and multidisciplinary rehab plans with a focus on neurocognitive and mental health impairments are necessary
  • rehab is recommended across the continuum of care (acute, recovery and community-based care)
  • contextual factors such as stigma and social support should be addressed in the programme.
  • intrinsic factors such as self-management and spirituality play a major role in outcome success
  • cognitive rehabilitation interventions (cognitive training, stimulation, rehabilitation) may be recommended for adults with mild cognitive impairment and stroke.
  • a combination of aerobic and resistive exercise may be recommended for older adults living with HIV who are medically stable and living with comorbidities.

These evidence-informed recommendations provide a guide for rehabilitation with older adults living with HIV.

> From: O'Brien et al., BMJ Open 4 (2015) e004692(Epub ahead of print). All rights reserved to The Author(s). Click here for the Pubmed summary.

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Tags: Rehabilitation, aging, HIV, Recommendations

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About the Author
Liesbeth Raymakers
Liesbeth Raymakers
Liesbeth Raymakers has been working as a Physiotherapist since 1998, mainly in hospital based care, ICU and intensive rehab. Originally from the Nethe...

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  • Articles
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        • Shoulder
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      • Lower extremity
        • Hip
        • Knee
        • Ankle
        • Foot
      • Spine
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        • Lumbar
        • Thoracic
        • Rib cage
        • Cervical
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