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Objective. The purpose of this study was to compare disability in people with HIV and peripheral neuropathy with those without neuropathy and explore how neuropathy and other relevant factors are associated with disability. Methods. In this cross-sectional study, participants completed the Brief pain inventory, Beck Depression Inventory II, World Health Organization Disability Assessment Schedule (WHODAS 2.0), and a health and demographic questionnaire. Additional data were extracted from the medical record. A raw score of [greater than or equal to]1 on the Subjective Peripheral Neuropathy Screen questions about lower extremity numbness or paresthesia was used to identify peripheral neuropathy. Predictors of disability (as determined by association with World Health Organization Disability Assessment Schedule 2.0 scores) were evaluated bivariately and in a multivariable model. Path modeling was used to identify a parsimonious model to elucidate the mediated effects of peripheral neuropathy on disability. Results. Participants with peripheral neuropathy had more depression symptoms, more pain (severity and interference), and higher disability scores compared with participants without neuropathy. The relationship between neuropathy and disability was mediated by pain interference and depression (standardized root mean residual = .056). Conclusion. In this sample of people with HIV, those with lower extremity peripheral neuropathy reported more severe disability, worse pain, and more depression symptoms than those without neuropathy. The relationship between peripheral neuropathy and disability may be mediated though pain interference and depression. Impact. Distal sensory polyneuropathy is a common comorbidity experienced by people living with HIV and frequently causes pain. This study can help providers direct care toward lessening disability experienced among people with HIV and peripheral neuropathy by targeting interventions for treatment of pain and depression. Lay Summary. People living with HIV may experience disabling painful neuropathy. Treatment for pain and depression may help reduce the disability associated with painful neuropathy., Anti-retroviral therapy has greatly increased the longevity of many persons living with HIV (PLWH). However, comorbidities, multimorbidity, and disability may emerge over time (1-3) Disability is defined as physical, cognitive, [...]

Novel coronavirus disease 2019 (COVID-19) is a pandemic comparable with human immunodeficiency virus (HIV) in many ways. It is an infection with no known vaccine or cure and no licensed [...]

Background. Distal sensory polyneuropathy (DSP) is a common complication of HIV disease. Its effects on quality of life (QOL) and function have not been well described. Objective. The study objectives were: (1) to compare QOL and lower extremity function in people with HIV-related DSP and people with HIV disease who do not have DSP, (2) to determine the extent to which function predicts QOL, (3) to evaluate the agreement of 2 function scales, and (4) to describe the use of pain management resources. Design. This was a cross-sectional survey study with predictive modeling and measurement tool concordant validation. Methods. A demographic questionnaire, the Medical Outcomes Study HIV Health Survey, the Lower Extremity Functional Scale (LEFS), the Lower Limb Functional Index (LLFI), and a review of medical records were used. General linear modeling was used to assess group differences in QOL and the relationship between function and QOL. Bland-Altman procedures were used to assess the agreement of the LEFS and the LLFI. Results. Usable data for analyses were available for 82 of the 94 participants enrolled. The 67% of participants who reported DSP symptoms tended to be older, had HFV disease longer, and were more likely to receive disability benefits. Participants without DSP had better LLFI, LEFS, and physical health summary scores. In multivariate models, lower limb function predicted physical and mental health summary scores. The LLFI identified participants with a lower level of function more often than the LEFS. Participants with DSP were more likely to use medical treatment, physical therapy, and complementary or alternative treatments. Limitations. A sample of convenience was used; the sample size resulted in a low power for the mental health summary score of the Medical Outcomes Study HIV Health Survey. Conclusions. Quality of life and function were more impaired in participants with HIV disease and DSP. The LLFI was more likely to capture limitations in function than the LEFS. Participants with DSP reported more frequent use of pain management resources., More than 1.1 million people in the United States have HIV disease. (1) Although life expectancies have dramatically increased since the introduction of antiretroviral therapy (ART), numerous comorbidities, including peripheral [...]

highlights the findings and application of Cochrane reviews and other evidence pertinent to the practice of physical therapy. The Cochrane Library is a respected source of reliable evidence related to health care. Cochrane systematic reviews explore the evidence for and against the effectiveness and appropriateness of interventions--medications, surgery, education, nutrition, exercise--and the evidence for and against the use of diagnostic tests for specific conditions. Cochrane reviews are designed to facilitate the decisions of clinicians, patients, and others in health care by providing a careful review and interpretation of research studies published in the scientific literature) Each article in this PTJ series summarizes a Cochrane review or other scientific evidence on a single topic and presents clinical scenarios based on real patients or programs to illustrate how the results of the review can be used to directly inform clinical decisions. This article focuses on an adult patient with human immunodeficiency virus (HIV) disease. Could a physical therapist-guided progressive resistive exercise (PRE) program improve body weight, body composition, and strength in an individual with HIV disease?, Human immunodeficiency virus (HIV) disease is caused by infection with the HIV retrovirus. If untreated, HW infection results in progressive immune suppression and subsequent opportunistic infections that are the cause [...]

Background and Purpose. The purpose of this study was to determine the effect of change in video display terminal (VDT) height from desktop height (96.5 cm [38 in]) to an elevated position (109.2 cm [43 in]) on postural angles of the head and neck and the effect on cervical spine flexion moments. Subjects. Twenty-seven persons (3 male, 24 female) who spent at least 3 hours per day using a computer while seated were the subjects. The subjects had a mean age of 36.7 years (SD=6.0, range=25-47). Methods. Subjects were photographed over two 10-minute periods while seated using a computer with the VDT at two different heights. Later, a goniometer was used over images to record angles. Results. There was no difference in cervical flexion moment between the two screen positions. Several postural angles of the head and neck showed changes, but the clinical relevance of these changes is questionable. Conclusion and Discussion. Changing the VDT height from 96.5 to 109.9 cm (floor to midscreen) has no effect on flexion moment on the cervical spine during short periods of VDT operation. If flexion moment is considered a biomechanical indicator of postural stress, it does not appear that the elevated screen position reduces postural stress on the cervical spine during short periods of VDT operation. [Kietrys DM, McClure PW, Fitzgerald GK. The relationship between head and neck posture and VDT screen height in keyboard operators. Phys Ther. 1998;78:395-403.], Key Words: Cervical, Computer, Ergonomics, Posture. The use of computers has become commonplace over the past two decades. Computer operators have experienced an increased incidence of musculoskeletal disorders.[1-4] A high [...]

AbstractThe U.S. opioid crisis necessitates that health care providers of all types work collaboratively to manage patients taking prescription opioid medications and manage those who may be misusing prescription opioids. Musculoskeletal conditions are the most common diagnoses associated with an opioid prescription. Physical therapists commonly manage patients with musculoskeletal conditions and chronic pain. Some patients who attend physical therapy for pain management take prescription opioid medications for pain and some of these patients may be misusing prescription opioids. Physical therapists who manage patients with musculoskeletal conditions are well-positioned to help address the opioid crisis. Historically, physical therapists have not been adequately engaged in efforts to manage persons with co-occurring musculoskeletal pain and opioid misuse or OUD. The American Physical Therapy Association (APTA) has emphasized physical therapy over the use of prescription opioids for the management of painful conditions. The APTA, however, does not highlight the important role that physical therapists could play in monitoring opioid use among patients receiving treatment for pain, nor the role that physical therapists should play in screening for opioid misuse. Such screening could facilitate referral of patients suspected misuse to an appropriate provider for formal assessment and treatment. This commentary presents simulated musculoskeletal patient presentations depicting 2 common opioid use states; chronic opioid use and opioid misuse. The cases highlight and interactions that physical therapists could have with these patients and actions that the physical therapist could take when working inter-disciplinarily. Recommendations are provided that aim to increase physical therapists’ knowledge and skills related to managing patients taking prescription opioid medications for pain.

To Ms. Gleason and others who share her point of view: Please allow me to bring you into the 21st century regarding LGBT issues in health care. Many issues related [...]