Original Research

Investigation of physical and functional impairments experienced by people with active tuberculosis infection: A feasibility pilot study

Heleen van Aswegen, Ronel Roos, Melanie McCree, Samantha Quinn, Mervyn Mer
African Journal of Disability | Vol 8 | a515 | DOI: https://doi.org/10.4102/ajod.v8i0.515 | © 2019 Heleen van Aswegen, Ronel Roos, Melanie McCree, Samantha Quinn, Mervyn Mer | This work is licensed under CC Attribution 4.0
Submitted: 09 March 2018 | Published: 13 August 2019

About the author(s)

Heleen van Aswegen, Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; and, Wits-University of Queensland Critical Care Infection Collaboration Group, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Ronel Roos, Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; and, Wits-University of Queensland Critical Care Infection Collaboration Group, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Melanie McCree, Wits-University of Queensland Critical Care Infection Collaboration Group, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Samantha Quinn, Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Mervyn Mer, Wits-University of Queensland Critical Care Infection Collaboration Group, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; and, Department of Medicine, Divisions of Critical Care and Pulmonology, Charlotte Maxeke Johannesburg Academic Hospital, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa


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Abstract

Background: Tuberculosis (TB) remains a significant healthcare problem. Understanding physical and functional impairments that patients with active TB present with at the time of diagnosis and how these impairments change over time while they receive anti-TB therapy is important in developing appropriate rehabilitation programmes to optimise patients’ recovery.

Objectives: The aim of this study was to assess the acceptability, implementation and practicality of conducting a prospective, observational and longitudinal trial to describe physical and functional impairments of patients with active TB.

Method: A feasibility pilot study was performed. Patients with acute pulmonary TB admitted to an urban quaternary-level hospital were recruited. Physical (muscle architecture, mass and power, balance, and breathlessness) and functional (exercise capacity) outcomes were assessed in hospital, and at 6 weeks and 6 months post-discharge. Descriptive statistics were used to analyse the data.

Results: High dropout (n = 5; 41.7%) and mortality (n = 4; 33.3%) rates were observed. Limitations identified regarding study feasibility included participant recruitment rate, equipment availability and suitability of outcome measures. Participants’ mean age was 31.5 (9.1) years and the majority were human immunodeficiency virus (HIV) positive (n = 9; 75%). Non-significant changes in muscle architecture and power were observed over 6 months. Balance impairment was highlighted when vision was removed during testing. Some improvements in 6-minute walk test distance were observed between hospitalisation and 6 months.

Conclusion: Success of a longitudinal observational trial is dependent on securing adequate funding to address limitations observed related to equipment availability, staffing levels, participant recruitment from additional study sites and participant follow-up at community level. Participants’ physical and functional recovery during anti-TB therapy seems to be limited by neuromusculoskeletal factors.


Keywords

tuberculosis; physical function; muscle cross-sectional area; HIV; muscle mass

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