As people with HIV/AIDS live longer because of the life prolonging antiretroviral drugs, many of them struggle with activity limiting symptoms and subsequent disability. Limitations in the performance of basic activities of daily living among people living with HIV/AIDS have become a major concern for both the patients and their relatives. Although Home based care is a cost effective approach to managing HIV/AIDS through community care givers, services such as physiotherapy that add meaning to life have not been incorporated in most home based care packages. In Zambia both interventions and research have focused on prevention, dug and psychosocial management of HIV/AIDS and its related complications and symptoms. Rehabilitation services and specifically physiotherapy has not been incorporated in the care even though HIV/AIDS symptoms and impairments amenable to physiotherapy have been acknowledged.

METHODS

A comparative, cross sectional study was undertaken to compare the performance of basic activities of living between participants from Physiotherapy in Palliative Care Programme where physiotherapy was incorporated and typical home based care under the Lusaka Archdiocese. Two equal random independent samples of 215 participants were selected. The International Classification of Functioning Disease and Health was used to measure the severity of symptoms and functional capacities. The main outcome measures were prevalence and severity of activity limiting symptoms, mobility capacity, performance of self care activities and overall performance of basic activities of living. The independent sample t test was used to determine whether there were significant differences in the outcome measures between the two groups of participants drawn from the two types of home based care programmes.

RESULTS

It was found that there was no significant difference in the performance of basic activities of living between the two groups although participants from the physiotherapy incorporated programme were generally better than the typical home based care programme. Participants from Physiotherapy in Palliative care programme had significantly severe activity limiting symptoms were significantly older and had been on home based care for significantly shorter period. They were significantly better at performance of self care activities but did not significantly differ with Archdioceses of Lusaka participants in mobility capacity.

CONCLUSION

There is some suggestion that physiotherapy could help in enhancing basic activities of living among people living with HIV/AIDS. This is suggested by the better performance of self care activities among PPCP participants who on the other hand had significantly worse symptoms, were much older and yet were on HBC for a shorter period. The recruitment process and criteria were suspected to have influenced the outcomes measures. The Physiotherapy in Palliative Care Programme may have targeted patients with severe impairments and activity limitations.  Incorporating physiotherapy in HIV/AIDS home based care programmes and the training of service providers could improve the performance of BADLs among people living with HIV/AIDS. There is however need to research further using matched samples or randomized clinical trials.

Key words; activity limiting symptoms, basic activities of daily living, ICF, home based care, physiotherapy, rehabilitation, HIV/AIDS