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. 2021 Aug 17;8(9):ofab425.
doi: 10.1093/ofid/ofab425. eCollection 2021 Sep.

Mobility Deviations in Adults With Human Immunodeficiency Virus: A Cross-Sectional Assessment Using Gait Analysis, Functional Performance, and Self-Report

Karina Berner  1 , Arnaud Gouelle  2   3 , Hans Strijdom  4 , M Faadiel Essop  5 , Ingrid Webster  4 , Quinette Louw  1
Affiliations

Mobility Deviations in Adults With Human Immunodeficiency Virus: A Cross-Sectional Assessment Using Gait Analysis, Functional Performance, and Self-Report

Karina Berner et al. Open Forum Infect Dis. .

Abstract

Background: Little is known about how human immunodeficiency virus (HIV) affects walking biomechanics, or about associations between HIV-related gait deviations, functional performance, and self-reported outcomes. This paper reports on (1) gait biomechanics and variability in people with HIV (PWH) and (2) associations with clinical tests, self-reported function, and falls.

Methods: A cross-sectional study tested consecutively sampled PWH (n = 50) and HIV-seronegative participants ([SNP] n = 50). Participants underwent 3-dimensional gait analysis, performed clinical tests (short walk and single leg stance tests with and without dual tasking, chair-rise tests, and a physical performance battery), and completed questionnaires about function and falls. Between-group comparisons were done using analysis of covariance. Linear correlations between gait variability, clinical tests, and patient-reported outcomes were established.

Results: People with HIV and SNP had comparable median ages (PWH = 36.6, interquartile range [IQR] = 32.0-45.6]; SNP = 31.1, IQR = 23.2-45.1). Compared with SNP, PWH walked slower (adjusted mean difference [MD] = -0.2 meters per second [m/s], 95% confidence interval [CI] = -0.3 to -0.1) with greater variability (adjusted MD = 14.7 variability score points, 95% CI = 9.9-19.5). Moreover, PWH were slower in five-times sit-to-stand (5STS) performance (adjusted MD = 1.9 seconds, 95% CI = 1.00-2.9). Significant deviations in hip kinematics (increased flexion; adjusted MDs = 2.4°-2.8°, P = .012-.016) and knee kinematics (reduced flexion; adjusted MDs = 2.3°-3.7°, P = .007-.027) were found in PWH during dual-task (DT) walking. The PWH's 5STS moderately correlated with larger gait variability (usual pace r = -0.5; dual task r = -0.6), poorer self-reported mobility (r = 0.4) and self-care function (r = 0.5), and fear of falling (P = .003).

Conclusions: People with HIV presented with biomechanical deviations suggestive of a slowed and variable gait, especially under cognitive challenges. Five-times STS may be useful to screen for gait deviations in PWH.

Keywords: HIV infection; chair rise time; gait variability; kinematics; physical function.

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Figures

Figure 1.
Figure 1.
Enhanced Gait Variability Index (EGVI) scores in human immunodeficiency virus (HIV)-negative participants (SNP) and people with HIV (PWH) for usual-paced (UP) and dual-task (DT) walking. Plots show mean scores (labeled diamonds) with 95% confidence intervals (capped vertical error bars) as well as median scores (horizontal lines), score range (uncapped vertical error bars), and interquartile range (boxes).
See this image and copyright information in PMC

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