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

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.