Original Research

The relationship between lower limb muscle strength and lower extremity function in HIV disease

Peter C. Mhariwa, Hellen Myezwa, Mary L. Galantino, Douglas Maleka
South African Journal of Physiotherapy | Vol 73, No 1 | a360 | DOI: https://doi.org/10.4102/sajp.v73i1.360 | © 2017 Peter C. Mhariwa, Hellen Myezwa, Mary L. Galantino, Douglas Maleka | This work is licensed under CC Attribution 4.0
Submitted: 14 October 2016 | Published: 26 September 2017

About the author(s)

Peter C. Mhariwa, Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, South Africa
Hellen Myezwa, Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, South Africa
Mary L. Galantino, Stockton University Physical Therapy Program, Galloway, New Jersey, United States; School of Medicine – CCEB, University of Pennsylvania, United States
Douglas Maleka, Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, South Africa


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Abstract

Background: Human immunodeficiency virus (HIV) negatively impacts muscle strength and function. This study aimed to establish the relationship between lower limb muscle strength and lower extremity function in HIV disease.
Method: A cross-sectional study was undertaken with a sample of 113 HIV-positive participants. Lower limb muscle strength and self-reported function were established using dynamometry and the Lower Extremity Functional Scale (LEFS), respectively. Muscle strength and functional status were established in a subset of 30 HIV-negative participants to determine normative values.
Results: Muscle strength for participants with HIV ranged from an ankle dorsiflexion mean of 9.33 kg/m2 to 15.79 kg/m2 in hip extensors. In the HIV-negative group, ankle dorsiflexors recorded 11.17 kg/m2, whereas hip extensors were the strongest, generating 17.68 kg/m2. In the HIV-positive group, linear regression showed a positive relationship between lower limb muscle strength and lower extremity function (r = 0.71, p = 0.00). Fifty per cent of the changes in lower extremity function were attributable to lower limb muscle strength. A simple linear regression model showed that lower limb ankle plantar flexors contributed the most to lower extremity function in this cohort, contrary to the literature which states that hip and trunk muscles are the most active in lower limb functional activities.
Conclusion: Lower extremity strength impacts perceived function in individuals stabilised on antiretroviral therapy for HIV disease. These findings demonstrate that ankle plantar flexors produce more force over hip flexors. Careful attention should be paid to the implications for strength training in this population.

Keywords

HIV; Lower limb function; muscle strength

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