Common impairments and functional limitations of HIV sequelae that require physiotherapy rehabilitation in the medical wards at Queen Elizabeth Central Hospital, Malawi: A cross sectional study

Introduction
The progression of human immunodeficiency virus (HIV) to acquired immune deficiency syndrome (AIDS) and the use of antiretroviral therapy (ART) have resulted in a range of complications, which affect different body systems and result in functional limitations and disabling impairments.
Objective
To investigate HIV-related impairments and functional limitations that require physiotherapy rehabilitation in patients admitted to the medical wards at Queen Elizabeth Central Hospital in Blantyre, Malawi.
Methods
This was a descriptive quantitative cross-sectional study involving the participation of 32 female (59.3%) and 22 male (40.7%) adults living with HIV and admitted to the medical wards at Queen Elizabeth Central Hospital. We collected data using a questionnaire that consisted of the World Health Organization Disability Assessment Schedule 2 (WHODAS2.0) and some demographic questions. Results were analysed using the Statistical Package for the Social Sciences (SPSS).
Results
Participation in society was the most frequently reported functional complication; the least common limitation was getting along with people (70.3%, n = 38 participants) and interaction with others (24%; n=13). Shortness of breath (55%; n=30), muscle weakness (44.4%; n=24) and joint and muscle pain (37%; n=20) were the most commonly reported impairments. Participation restriction in the society affected both males (77.3%) and females (70.7%). The least common limitation that required physiotherapy for both males and females was getting along with people (26.6% and 25%, respectively). On average, male and female participants had a disability severity score of 48.5±4.6 and 42.2±22.8, respectively.
Conclusion
Our data showed that there is a clear need for early intervention to halt or delay the progression of complications to avoid severe disability; this is not only good for the patient but also for the socioeconomic state of the nation. Timely and full functional assessment, as well as referral of people living with HIV/AIDS for rehabilitation, is an important step forwards.

Keywords
HIV; disability; impairments; physiotherapy; functional limitations; functional complication