Mildmay’s Lead Physiotherapist Selected to Present at International Symposium

Asterios Lotsios, Lead Physiotherapist at Mildmay Hospital, has been selected to present his research at the Symposium on Digital Technology, Rehabilitation and Healthy Ageing at the University of Manchester on 3 October 2025.

His poster, “Digital Health–Enabled Neuro-rehabilitation to Support Recovery and Healthy Ageing in VZV-Associated Myelitis,” highlights Mildmay’s innovative approach to supporting patients with rare and complex neurological conditions.

Understanding VZV-Associated Myelitis

VZV-associated myelitis is a rare inflammation of the spinal cord caused by the Varicella-Zoster virus, the same virus responsible for chickenpox and shingles. Fewer than 0.3% of people with shingles develop this condition. Symptoms may include sudden weakness or paralysis in the lower limbs, sensory loss, and bladder or bowel dysfunction, often following a distinctive skin rash. Diagnosis can be complex and usually requires a combination of clinical assessment, MRI imaging, and analysis of cerebrospinal fluid. Early treatment with antivirals and tailored neuro-rehabilitation is vital to support recovery.

• The Varicella-Zoster virus (VZV), which causes chickenpox and shingles, can reactivate in people with weakened immune systems.

• People living with HIV are at higher risk of shingles, and the complications of shingles - such as VZV-associated myelitis - occur more frequently and can be more severe.

• Although VZV myelitis is rare in the general population (less than 0.3% of shingles cases), the risk is significantly increased in immunocompromised patients, including those with HIV.

Why Mildmay Treats This Condition

• Mildmay is a specialist hospital for HIV-related complex conditions and neurocognitive disorders.

• VZV-associated myelitis fits into Mildmay’s expertise because it is both a neurological complication and one that occurs more often in patients with HIV or other immunosuppressive conditions.

• Treatment requires specialist neuro-rehabilitation, which is one of Mildmay’s strengths, combining physiotherapy, occupational therapy, and digital health interventions.

• Mildmay’s holistic and multidisciplinary approach is especially important for rare conditions like this, where standard rehabilitation services may lack experience.

By developing digital health–enabled rehabilitation programmes, Asterios is helping patients regain function, maintain independence, and improve quality of life. His research demonstrates how technology can be harnessed to enhance rehabilitation, support remote monitoring, and improve long-term outcomes.

International Collaboration and Knowledge Exchange

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The symposium is supported by a trilateral partnership between the University of Manchester, the University of Melbourne, and the University of Toronto, in collaboration with the Canada-International HIV and Rehabilitation Research Collaborative (CIHRRC). CIHRRC brings together people living with HIV, researchers, clinicians, community organisations, and policymakers from around the world to advance rehabilitation and care for those living with disability and chronic illness.

We are delighted that Asterios will be representing Mildmay at this prestigious event. His contribution reflects both his personal commitment to advancing neuro-rehabilitation and Mildmay’s mission to provide innovative, specialist care for people with complex health needs.