title: HIV and exercise: A pilot study of strength training effects on HIV+ patients and a survey of exercise behaviour in the HIV+population
Creators: name: Siafakas, Menelaos G.
Publisher: name: University of Glasgow
Year: 1999
Subjects: subject: Public health, kinesiology.

description: HIV infection is a disease that attacks the immune system. Associated conditions include muscle wasting (occurring at more advanced stages of the disease), and mood disturbances due to stressors like the diagnosis itself, treatment, and social stigma. Exercise has been associated with improved muscle function, more favourable psychological function, and improved immunity, in normal populations. The same has also been postulated for HIV+ populations making exercise an ideal candidate for a complementary therapy for HIV+ patients. This study was undertaken in order to investigate the effects of moderate intensity strength training on various parameters in HIV+ patients. Six subjects were recruited (5 male, 1 female) and randomly assigned to an exercise or control group. At stage 1, the exercise group received 12 weeks of a moderate strength training programme 3 times each week, while the control group went about their normal routines. Changes in variables were compared between the exercise and control group (2 sample-t-test). In stage 2 the control group received the exercise programme, and their changes were compared to their changes in stage 1 (paired-t-test). Results showed that in stage 1 the exercise programme tended to increase muscle function, and this was significant for quadriceps isometric strength when comparing the exercise group to the control group t(3)=3.94, p=0.029. Psychological function also tended to improve, with the strongest evidence coming from the profile of mood states (POMS). Changes reached significant levels for comparison of experimental with control group, for the total POMS scores t(4)=3.83, p=0.019, and two subscales of the POMS, energetic-tired t(4)=2.83, p=0.047, clearheaded-confused t(4)=3.60, p=0.023. The trend of improved mood with exercise in stage 1, was followed by similar changes in stage 2 for the control group. The immunological data did not show any trends of changes with exercise. Because of the low numbers of subjects results from this study are only indicative and by no means strong. In conclusion, it seems that exercise is associated with improved strength and mood. The low recruitment for this pilot study indicated a possible motivational issue with exercise and HIV+ people. Exercise adoption and maintenance is a problem for the general population, but it seems clinical populations are especially problematic. As there were no studies on exercise levels and attitudes towards exercise concerning HIV in the literature, it was deemed worthy of investigating those for the Glasgow HIV+ population. Fifty seven (57) subjects were recruited from the Brownlee outpatients clinic (46 men and 11 women). They were asked to complete a questionnaire on the stages of exercise behaviour, which included the current recommendations for regular physical activity and motivations and barriers to exercise. Medical data (like weight and CD4 cell count) were also collected. The subject population was representative of the whole HIV+ clinic population, in terms of the proportion of subjects who were homosexual, drug users, and "others"(e.g. heterosexuals, haemophiliacs). Results showed that the activity levels of HIV+ patients were similar to those of the general population with 38% regularly active, 62% not meeting the current recommendations. However, under closer examination by method of contraction it seemed that the drug users group and 'others' were less active (74% and 80% respectively not meeting the current recommendations for regular physical activity). It was also seen that of the subjects now inactive, 82% were active before diagnosis. In terms of motivations to exercise the HIV+ subjects did not seem to differ from the general population. In terms of barriers the HIV+ subjects seemed to rate time much lower than the general population and perceive "obstacles" to be higher (e.g. lack of facilities, bad weather), also limiting health reasons were a perceived as higher. In conclusion, there seems to be a large number of HIV+ patients not meeting the current recommendations of regular physical activity, and this is pronounced for non-homosexual HIV+ patients. Given that exercise is safe and has the potential to be beneficial for HIV+ people, promoting exercise would be appropriate. Results from this study suggest that when designing a health promotion strategy for HIV+ patients, the health benefits of exercise and the fact that exercise is a safe practice for HIV+ people should be emphasised.