Foot function and HIV related DSPN (Version 2.2) 08.07.2015
Research type
Research Study
Full title
Limited joint mobility and plantar skin hardness in relation to measures of Distal Sensory Peripheral Neuropathy (DSPN)- vibration perception threshold (VPT), painDETECT questionnaire and the Neuropad device, in subjects with HIV-infection: A case controlled observational study
IRAS ID
180666
Contact name
Paul Blanchard
Contact email
Duration of Study in the UK
0 years, 8 months, 20 days
Research summary
Distal sensory peripheral neuropathy (DSPN) is a condition affecting the small nerve fibres leading to pain, numbness andsensations such as "pins and needles" and burning, principally in the feet but also in the hands in some individuals. DSPN is
a feature of HIV−infection due to direct nerve damage by the virus itself, nerve damage as a result of the bodies immunesystem reactions to the virus and also due to a number of drugs used in the treatment of HIV−infection being toxic to the
nerves.
DSPN in individuals with HIV−infection is extremely common. It is estimated that DSPN causes symptoms in about a third of
all patients with advanced HIV disease or AIDS. Nerve damage which is apparent on examination but may not be causing
symptoms probably affects almost all individuals with chronic HIV−infection.The author completed a non-comparative observational study in subjects with HIV-infection intended to determine if changes in tissues, articular joint range of movement, balance and plantar pressure are related to the degree of peripheral nerve damage in HIV-infection as measured by vibration perception threshold.
As a simple correlational study this work was designed as a first step in establishing if measurable changes in structural and functional biomechanics exist in the setting of HIV-infection. From this initial study they do appear to exist and are related to the severity of peripheral neuropathy as measured by vibration perception threshold (VPT).
Non-comparative observational study: Summary of statistically significant findings
• Negative correlation between VPT and plantar flexion (rho= -0.393, p=0.009) but no correlation between VPT and dorsiflexion.
• Negative correlation between VPT and ankle inversion (rho -0.393, p=<0.05) but no correlation between VPT and ankle eversion.
• No correlation between VPT and “prayer sign”
• Negative correlation between VPT and 1st metacarpophalangeal extension (rho -.414, p=<0.05)
• Positive correlation between VPT and skin hardness at the heel (rho=0.448, p=0.02) but not at the lateral mid-foot, medial mid-foot or 1st metatarsal head.
• Positive correlation between area of sway with eyes closed (rho=0.436, p=0.024) and VPT. No correlation on either measure with eyes open.
• Positive correlation between pressure-time interval on walking gait cycle and VPT (rho=0.37, p=0.05). No correlation between VPT and peak plantar pressure.
These results, in addition to the literature on LJM in diabetics informed the study design and choice of biomechanical measures for the current case controlled observational study.
REC name
North of Scotland Research Ethics Committee 1
REC reference
15/NS/0066
Date of REC Opinion
15 Jul 2015
REC opinion
Further Information Favourable Opinion