Journal Article

Examining the impact of a community-based exercise intervention on cardiorespiratory fitness, cardiovascular health, strength, flexibility and physical activity among adults living with HIV: A three-phased intervention study

Chan Carusone, Soo, O’Brien, Kelly K., Ilic, Ivan, Tang, Ada, Solomon, Patricia, Aubry, Rachel, Avery, Lisa, Davis, Aileen M., Zobeiry, Mehdi, Pandovski, Zoran, Bayoumi, Ahmed M.

2021

Overview

Our aim was to examine the impact of a community-based exercise (CBE) intervention on cardiorespiratory fitness, cardiovascular health, strength, flexibility, and physical activity outcomes among adults living with HIV. We conducted a longitudinal intervention study with community-dwelling adults living with HIV in Toronto, Canada. We measured cardiopulmonary fitness (V̇O2peak (primary outcome), heart rate, blood pressure), strength (grip strength, vertical jump, back extension, push-ups, curl ups), flexibility (sit and reach test), and self-reported physical activity bimonthly across three phases. Phase 1 included baseline monitoring (8 months); Phase 2 included the CBE Intervention (6 months): participants were asked to exercise (aerobic, strength, balance and flexibility training) for 90 minutes, 3 times/week, with weekly supervised coaching at a community-based fitness centre; and Phase 3 included follow-up (8 months) where participants were expected to continue with thrice weekly exercise independently. We used segmented regression (adjusted for baseline age and sex) to assess the change in trend (slope) among phases. Our main estimates of effect were the estimated change in slope, relative to baseline values, over the 6 month CBE intervention. Of the 108 participants who initiated Phase 1, 80 (74%) started and 67/80 (84%) completed the intervention and 52/67 (77%) completed the study. Most participants were males (87%), with median age of 51 years (interquartile range (IQR): 45, 59). Participants reported a median of 4 concurrent health conditions in addition to HIV (IQR: 2,7). Participants attended a median of 18/25 (72%) weekly supervised sessions. Change in V̇O2peak attributed to the six-month Phase 2 CBE intervention was 0.56 ml/kg/min (95% Confidence Interval (CI): -1.27, 2.39). Significant effects of the intervention were observed for systolic blood pressure (-5.18 mmHg; 95% CI: -9.66, -0.71), push-ups (2.30 additional push-ups; 95% CI: 0.69, 3.91), curl ups (2.89 additional curl ups; 95% CI: 0.61, 5.17), and sit and reach test (1.74 cm; 95% CI: 0.21, 3.28). More participants engaged in self-reported strength (p<0.001) and flexibility (p = 0.02) physical activity at the end of intervention. During Phase 3 follow-up, there was a significant reduction in trend of benefits observed during the intervention phase for systolic blood pressure (1.52 mmHg/month; 95% CI: 0.67, 2.37) and sit and reach test (-0.42 cm/month; 95% CI: -0.68, -0.16). Adults living with HIV who engaged in this six-month CBE intervention demonstrated inconclusive results in relation to V̇O2peak, and potential improvements in other outcomes of cardiovascular health, strength, flexibility and self-reported physical activity. Future research should consider features tailored to promote uptake and sustained engagement in independent exercise among adults living with HIV. NCT02794415. https://clinicaltrials.gov/ct2/show/record/NCT02794415.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Acquired immune deficiency syndrome / Adult / Adults / Aging / AIDS / Biology and Life Sciences / Blood pressure / Blood Pressure - physiology / Cardiorespiratory fitness / Cardiorespiratory Fitness - physiology / Cardiovascular health / Chronic illnesses / Complications and side effects / Confidence intervals / Diabetes / Exercise / Exercise - physiology / Exercise therapy / Exercise Therapy - methods / Female / Flexibility / Grip strength / Health aspects / Health care networks / Health sciences / Heart rate / Heart Rate - physiology / HIV / HIV Infections - physiopathology / HIV patients / Human immunodeficiency virus / Humans / Intervention / Longitudinal Studies / Male / Medicine and Health Sciences / Middle Aged / Muscle Strength - physiology / Patient outcomes / Physical activity / Physical fitness / Physical therapy / Physical training / Rehabilitation / Research and Analysis Methods / Sexually transmitted diseases / Slopes / Statistical analysis / STD / Systematic review / Training