Feasibility of testing the effect of individualised home-based exercises on function, quality of life and BMD in patients with and without HIV managed for femoral shaft fractures

Human Immunodeficiency Virus (HIV) infection remains a common comorbidity among patients with fractures, yet a few studies have examined whether exercise can prevent bone demineralisation in this group. It is unclear whether people living with HIV who sustain fractures may experience improvements in bone mineral density (BMD), function or quality of life (QoL) following structured exercise. This study assessed the feasibility of a home-based exercise programme aimed at improving BMD, functional capacity and QoL, and explored whether densitometry can detect exercise-related changes in South African patients with femoral shaft fractures. A randomised controlled trial was conducted at the Chris Hani Baragwanath Orthopaedic Clinic. Participants with femoral shaft fractures were randomly allocated to an intervention or control group and assessed for gait, function, BMD, physical activity, and QoL at baseline and at 6 and 12 weeks post-surgery. Of the 22 participants (mean age 34.64 ± 8.09 years), 63.6% were male, and 27.3% were HIV positive. By week 12, the intervention group showed higher BMD at the right toe, right thumb and greater trochanter but decreased at fracture sites. Mobility scores improved in the intervention group. Exercise enhanced BMD at weight-bearing sites and supported faster recovery of mobility, although gains were limited at fracture locations.