The effect of exercise training on aerobic fitness, immune indices, and quality of life in HIV+ patients

Stringer, William W.; Berezovskaya, Marina; O’Brien, William A.; Beck, Christopher; Casaburi, Richard

doi:10.1097/00005768-199801000-00003

Cited by 116 publications

(159 citation statements)

References 27 publications

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“…Lower cardiorespiratory fitness has been reported in HIVinfected subjects irrespective of HAART use, 41 but improves with exercise training. 25,42,43 This may further indicate inadequate aerobic capacity in HIV + people, possibly due to the effects of HIV disease or HAART on tissue oxygen extraction and utilization. Low cardiorespiratory fitness has been associated with elevated cardiovascular disease morbidity and mortality, as a result central obesity and other risk factors in non-HIV-positive populations.…”

Section: Discussionmentioning

confidence: 99%

Exercise Training Reduces Central Adiposity and Improves Metabolic Indices in HAART-Treated HIV-Positive Subjects in Rwanda: A Randomized Controlled Trial

Mutimura

Crowther

Cade

et al. 2008

AIDS Research and Human Retroviruses

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As HAART becomes more accessible in sub-Saharan Africa, metabolic syndromes, body fat redistribution (BFR), and cardiovascular disease may become more prevalent. We conducted a 6-month, randomized controlled trial to test whether cardiorespiratory exercise training (CET), improves metabolic, body composition and cardiorespiratory fitness parameters in HAARTtreated HIV + African subjects with BFR. Six months of CET reduced waist circumference (−7.13 ± 4.4 cm, p < 0.0001), WHR (−0.10 ± 0.1, p < 0.0001), sum skinfold thickness (−6.15 ± 8.2 mm, p < 0.0001) and % body fat mass (−1.5 ± 3.3, p < 0.0001) in HIV + BFR + EXS. Hip circumference was unchanged in non-exercise control groups. CET reduced fasting total cholesterol (−0.03 ± 1.11 mM, p < 0.05), triglycerides (−0.22 ± 0.48 mM, p < 0.05) and glucose levels (−0.21 ± 0.71 mM, p < 0.05) (p < 0.0001). HDL-, LDL-cholesterol and HOMA values were unchanged after CET. Interestingly, HIV + subjects randomized to non-exercising groups experienced increases in fasting plasma glucose levels, whereas HIV seronegative controls did not (p < 0.001). Predicted VO 2 peak increased more in the HIV + BFR + EXS than in all other groups (4.7 ± 3.9 ml/kg/min, p < 0.0001). Exercise training positively modulated body composition and metabolic profiles, and improved cardiorespiratory fitness in HAART-treated HIV + Africans. These beneficial adaptations imply that exercise training is a safe, inexpensive, practical, and effective treatment for evolving metabolic and cardiovascular syndromes associated with HIV and HAART exposure in resource-limited sub-Saharan countries, where treatment is improving, morbidity and mortality rates are declining, but where minimal resources are available to manage HIV-and HAARTassociated cardiovascular and metabolic syndromes.

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Section: Discussionmentioning

confidence: 99%

Exercise Training Reduces Central Adiposity and Improves Metabolic Indices in HAART-Treated HIV-Positive Subjects in Rwanda: A Randomized Controlled Trial

Mutimura

Crowther

Cade

et al. 2008

AIDS Research and Human Retroviruses

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“…The 20mMST assessment tool for cardiorespiratory fitness has been employed in health and fitness settings [20]. Each subject's cardiorespiratory fitness was assessed individually during the 20mMST to minimise possible sources of error, and their rating of perceived exertion was measured with the Borg Perceived Exertion Scale [14]. Two BFR + EXS subjects were lost from the study: one died following surgery, and another moved to a distant location.…”

Section: Exercise Protocolmentioning

confidence: 99%

“…However, there remains a paucity of information on the effects of interventions such as exercise training (EXS) on QoL in HAART-treated HIV+ patients with BFR in sub-Saharan Africa where the prevalence of HIV is highest in the world and access to HIV treatment is improving. EXS has been reported to improve psychological well-being, physical functioning and promote independence in an HIV population [13,14]. EXS has also been reported to alleviate negative psychological states and promote positive mood, vigour and well-being in both healthy individuals and other patient populations [15,16].…”

Section: Introductionmentioning

confidence: 99%

The effects of exercise training on quality of life in HAART-treated HIV-positive Rwandan subjects with body fat redistribution

et al. 2008

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Objective-Our objective was to examine the effects of exercise training (EXS) on quality of life (QoL) in highly active antiretroviral therapy (HAART)-treated HIV-positive (HIV+) subjects with body fat redistribution (BFR) in Rwanda.Methods-The effects of a randomised controlled trial of EXS on QoL were measured using World Health Organisation Quality of Life (WHOQOL)-BREF in HIV+ subjects with BFR randomised to EXS (n = 50; BFR + EXS) or no exercise training (n = 50; BFR + noEXS). Conclusions-Exercise training improved several components of QoL in HAART-treated HIV+ African subjects with BFR. Exercise training is an inexpensive and efficacious strategy for Results-At

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“…Table 1 Efficacy of stress management interventions for HIV-seropositive adults at first measurement occasion. .91 0% a Extreme outliers were excluded for the anxiety , depression [aerobic exercise]), distress (Caddick, 1995;, quality of life (Stringer et al, 1998 [moderate exercise and heavy exercise]), CD4+ count (Stout-Shaffer, 1999), and fatigue [Tai Chi]) dependent variables. The direction and significance of the weighted mean effect sizes and homogeneity tests including outliers were consistent with the results excluding outliers.…”

Section: Depressionmentioning

confidence: 99%

Stress management interventions for HIV+ adults: A meta-analysis of randomized controlled trials, 1989 to 2006.

Scott-Sheldon¹,

Kalichman²,

Carey³

et al. 2008

Health Psychology

198

155

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Objective: Numerous studies document that stress accelerates disease processes in a variety of diseases including HIV. As a result, investigators have developed and evaluated interventions to reduce stress as a means to improve health among persons living with HIV. Therefore, the current meta-analysis examines the impact of stress-management interventions at improving psychological, immunological, hormonal, and other behavioral health outcomes among HIV+ adults.Design-This meta-analytic review integrated the results of 35 randomized controlled trials examining the efficacy of 46 separate stress-management interventions for HIV+ adults (N = 3,077).Main Outcome Measures-Effect sizes were calculated for stress processes (coping and social support), psychological/psychosocial (anxiety, depression, distress, and quality of life), immunological (CD4+ counts and viral load), hormonal (cortisol, dehydroepiandrosterone sulfate [DHEA-S], cortisol/DHEA-S ratio, and testosterone) and other behavioral health outcomes (fatigue).Results-Compared to controls, stress-management interventions reduce anxiety, depression, distress, and fatigue and improve quality of life (d + s = 0.16 to 0.38). Stress-management interventions do not appear to improve CD4+ counts, viral load, or hormonal outcomes compared with controls.Conclusion-Overall, stress-management interventions for HIV+ adults significantly improve mental health and quality of life but do not alter immunological or hormonal processes. The absence of immunological or hormonal benefits may reflect the studies' limited assessment period (measured typically within 1-week post-intervention), participants' advanced stage of HIV (HIV+ status known for an average of 5 years), and/or sample characteristics (predominately male and Caucasian participants). Future research might test these hypotheses and refine our understanding of stress processes and their amelioration. Coping with a chronic, life-threatening disease, however, is not without consequence as disease progression often involves a series of psychological and physical stressors that may impair daily functioning and quality of life. These stressors may involve a variety of physical symptoms, pain, concerns over disclosure of and stigma associated with HIV, and distress regarding one's own mortality (Derlega, Winstead, Greene, Serovich, & Elwood, 2002;Kalichman & Catz, 2000). NIH Public AccessResearch has demonstrated that such psychological and physical stressors can alter physiological processes and undermine health (see Kemeny, 2003;McEwen, 1998;Tosevski & Milovancevic, 2006;Vanable, Carey, Blair, & Littlewood, 2006). Although acute activation of these physiological processes is adaptive, chronic activation may lead to negative health effects including impaired immune functioning (see Segerstrom and Miller, 2004). Indeed, increased stress associated with chronic medical diseases such as HIV/AIDS appears to accelerate immune impairment, including reduced lymphocyte circulation and increased cortisol levels and a m...

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The effect of exercise training on aerobic fitness, immune indices, and quality of life in HIV+ patients

Abstract: Exercise training resulted in a substantial improvement in aerobic function while immune indices were essentially unchanged. Quality of life markers improved significantly with exercise. Exercise training is safe and effective in this patient group and should be promoted for HIV+ patients.

Cited by 116 publications

References 27 publications

Exercise Training Reduces Central Adiposity and Improves Metabolic Indices in HAART-Treated HIV-Positive Subjects in Rwanda: A Randomized Controlled Trial

Exercise Training Reduces Central Adiposity and Improves Metabolic Indices in HAART-Treated HIV-Positive Subjects in Rwanda: A Randomized Controlled Trial

The effects of exercise training on quality of life in HAART-treated HIV-positive Rwandan subjects with body fat redistribution

Stress management interventions for HIV+ adults: A meta-analysis of randomized controlled trials, 1989 to 2006.

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