Sonill Sooknunan Maharaj
University of KwaZulu-Natal, Republic of South Africa
Maharaj is a physiotherapist and obtained a Masters degree in Sports Medicine (Natal) and completed my PhD (UKZN) in the management of HIV/AIDS in public hospitals of Kwa Zulu-Natal in 2004. I am currently the head of Physiotherapy at the University of KwaZulu-Natal (RSA) and the chairman of the education committee of the Physiotherapy. Podiatry and Biokinetics committee of the Health Professions Council of South Africa. I have published in local and international Journals and serve as the reviewer for the Spinal Cord Journal and the Nelson R Mandela School of Medicine (UKZN) in aspects related to rehabilitation.
The introduction of highly active antiretroviral therapy (HAART) to human immuno-deficiency virus (HIV) infected individuals has changed the course of acquired immuno-deficiency syndrome (AIDS) from an acute to chronic condition. Patients on HAART spend less time on vigorous activities resulting in poor quality of life (QoL). The overall aim of rehabilitation is to restore, maintain and enhance the QoL. A study using a rehabilitation program of moderate intensity cycling and treadmill exercises followed by a home program improved the QoL for these individuals. Following the program days taken for sick leave also decreased. In another study conducted on mild to moderate symptomatic HIV children we found that rebound exercise and cycle ergometry were safe with no significant difference in heart, respiratory rates, blood pressure and oxygen saturation between the two modes of exercises. However sputum volumes produced during rebounding was significantly higher and expectorated in a shorter time than cycle ergometer exercises. A further study comparing rebound exercises to conventional chest physiotherapy in adult patients infected with tuberculosis bacilli (TB) on HAART also produced an increase in sputum expectorated following rebound exercises. This suggests that rebounding exercise can be used by physiotherapists as a safe adjunct with chest physiotherapy for the removal of excess secretions in children and adults. The researcher noted in spite of strategies to minimize ethical issues related to HIV/AIDS in South Africa, challenges still exist in particular to aspects of disclosure, confidentiality and stigmatization of infected individuals. This also has an impact on the rehabilitation process.