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Sensorimotor
Dysfunction: A Result of HIV Infection or an Effect of Antiretroviral
Treatment and Comorbid Psychiatric Disorders?
Balance
and gait problems have repeatedly been mentioned in case descriptions
of patients infected with HIV-1. Objective evidence of these problems
has rarely been reported, however. Furthermore, the extent to which
balance and gait are influenced by antiretroviral medications or
co-morbid psychiatric disorders has rarely been examined.
The
current study compared 78 HIV-1 seronegative volunteers to 28 HIV/AIDS
patients receiving no antiretroviral therapy, 25 patients receiving
only nucleoside analogue therapy, and 37 patients receiving HAART.
The
dependent measures included Equilibrium Quotient scores recorded
during 3 subtests of the Sensory Organization Test (SOT), the number
of falls during each subtest, the functional base of support, gait
speed and cadence, single leg balance time, proximal strength, and
vibrotactile threshold of the foot. The analysis employed the number
of alcohol and drug abuse problems, depression severity, and body
mass index as covariates.
Results
ANCOVAs
revealed significant decrements in the 3 HIV-1 seropositive groups
relative to the control group on Equilibrium Quotient scores during
the most difficult of the SOT subtests (sway-referenced support
surface with eyes-closed).
HIV/AIDS
patients also exhibited a smaller functional base of support and
greater vibrotactile thresholds.
Antiretroviral
treatment did not affect balance; but, it did alter sensory threshold
in a complex manner.
Conclusions
HIV/AIDS
is associated with reliable decrements in balance and peripheral
sensory function which are variably sensitive to antiretroviral
treatment. The implications of these findings for mobility, and
workplace or operator safety, should be explored further.
03/23/05
Reference
L O Bauer and others. Sensorimotor Dysfunction
in HIV/AIDS: Effects of Antiretroviral Treatment and Comorbid Psychiatric
Disorders. AIDS
19(5): 495-502, March 25, 2005.
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