Moderate strength training can help with peripheral neuropathy in PLHIV

Many people living with HIV, at some point, will experience chronic pain due to peripheral neuropathy. New research indicates that moderate strength training of the leg muscles may significantly improve the situation. The results of the study ‘Strength exercise for balance and gait in HIV-associated distal symmetrical polyneuropathy: A randomised controlled trial’ were published in HIV Medicine 

Peripheral neuropathy (PN) is a common neurological condition associated with HIV. It often begins in the hands and feet, and can progress further. Symptoms can be mild, presenting as numbness and tingling, but PN can also cause severe pain and cause problems with walking.

Scientists from the University of KwaZulu-Natal in South Africa recruited 102 participants with PN and HIV to participate in the study. The average age of the participant was 36, 55% were women, 91% reported “poor” or “very poor” health, all participants were taking HIV treatment. Most neuropathy developed only after the start of HIV treatment, often after a year of treatment. 61% of participants began treatment between 4 to 6 years ago.

At the start of the study, the participants were examined and tested before being divided into two groups:

• Group 1 - performed exercises for 12 weeks to strengthen the quadriceps, gluteal, hamstrings, tibialis anterior and calf muscles. Over the 12 week period coaches slowly increased the intensity of the training.
• Group 2 - proceeded as normal, with no added exercise or training.

At the end of the study period, both groups were retested.

Group 1, who performed the strength training showed significant improvements:

• Balance indicators increased, on average, from 10 to 15 points on the Tinetti Performance-Oriented Mobility Assessment scale.
• Gait scores increased, on average, from 7 to 11 points.

Group 2, who did no additional training, saw balance indicators fall from 10 to 9 points, and the gait score remained at 8 points throughout the study.

The team consider these differences statistically significant. They also noted that this study did not assess pain indicators and their impact on test results.

"This study confirms the safety of moderate intensive exercises to improve balance and walking disorders in people living with HIV-associated peripheral neuropathy," said the lead study author, Abdulsalam Yakasai.