Dynamic and static postural alterations in HIV-related progressive multifocal leukoencephalopathy in a Latino-Hispanic male: a case study

Abstract

Introduction: Human immunodeficiency virus (HIV) affects millions of people worldwide. Because of an impaired immune system, HIV-positive people are at a higher risk of contracting HIV-related complications, including progressive multifocal leukoencephalopathy (PML). PML is a progressive disease involving degeneration of the white matter in the central nervous system, causing profound adverse effects on gait and posture. This case report presents gait and posture deficiencies in a physically active 52-year-old Latino-Hispanic male with HIV-related PML. Case description: System examinations were conducted to evaluate confidence in balance, balance deficits, and fall risk, given the clinical presentation of HIV-related PML. The patient presented a profound balance and gait motor control impairments, with alterations in posture stability, particularly in mediolateral sway, and velocity were increased when adding vestibular input challenge and dual-tasks (counting backward) components. During gait assessment, the patient compensated by reducing speed during the turn and walk back to the sitting position. Conclusions: This case study strives to provide specific evidence for static and dynamic motor control in PML HIV-related case. Strengthening exercises focusing on posture musculature are highly recommended. Additionally, we encourage to focus on dynamic balance interventions to improve PML-related alterations such the ones presented in this case report. HIV AIDS Rev 2020; 19, 2: 139-145 DOI: https://doi.org/10.5114/hivar.2020.96326