The use of both aerobic and resistance exercise has been shown to improve physiologic parameters such as strength, endurance, time to fatigue, and body composition in the HIV-infected population. Exercise has also been used successfully to treat psychologic conditions such as depression and anxiety that are common in HIV-infected individuals. However, the effects of exercise on immune function in these individuals are uncertain because of conflicting results found among studies. Additionally, many ventures into this area have been attempted with poor research design, resulting in inconclusive evidence or poor generalizability. The focus of this paper is to review the research that has been performed using exercise as an intervention for HIV-infected persons and to determine what needs to be done next to further our understanding of how the HIV-infected body and mind respond to exercise training.
During post-occlusive reactive hyperemia (PORH) there is a temporary increase in the total hemoglobin + myoglobin (T[Hb+Mb]) signal as measured by near-infrared spectroscopy (NIRS). This transient increase predicts differences in the kinetic responses of deoxy[Hb+Mb] and oxy[Hb+Mb] during PORH. The purpose of this study was to determine whether sigmoidal (Gompertz or logistic) or exponential functions better describe these response curves during PORH. The fit of the three functions (exponential, Gompertz and logistic) to the NIRS responses, as determined from residual sum of squares, was compared using repeated measures ANOVA on Ranks. The Gompertz function provided a better fit to the oxy[Hb+Mb] response curve than did either the exponential or logistic function (χ (2) = 21.7, df = 2, p < 0.001). The logistic function provided a better fit for the deoxy[Hb+Mb] response (χ (2) = 22.9, df = 2, p < 0.001) than did either the Gompertz or exponential functions. For both NIRS signals, the better fitting sigmoidal functions fit the data well, with an average r value of 0.99 or greater. Adipose tissue thickness was correlated with parameters related to signal strength (amplitude, r = 0.86-0.89; baseline, r = 0.67-0.75; all p < 0.001) but was not related to kinetic parameters (time constant and inflection point; p > 0.05 for all comparisons). These results suggest that during PORH distinct sigmoidal mathematical functions best describe the responses of the oxy[Hb+Mb] (Gompertz) and deoxy[Hb+Mb] (logistic) as measured by NIRS. Further, differences in both the kinetic and amplitude aspects for the responses of oxy[Hb+Mb] and deoxy[Hb+Mb] predict the observed transient change in T[Hb+Mb]. Our methods provide a technique to evaluate and quantify NIRS responses during PORH, which may have clinical utility.
A growing body of evidence demonstrates a significant relationship between spirituality and health. HIV-infected individuals often find new meaning and purpose for their lives while establishing new connections and strengthening old ones. This descriptive, correlational study examined the relationships among spiritual well-being, sleep quality, and health status in 107 HIV-infected men and women. Spiritual well-being was found to be a significant factor related to both sleep quality and mental and physical health status. Every study participant reported sleep disturbance. The findings suggest that spiritual well-being and sleep quality need to be assessed so appropriate interventions can be implemented to improve health outcomes in this population.
Historically, wrestling is a sport dependent on weight. Three tragic deaths in late 1997 prompted the National Collegiate Athletic Association (NCAA) to make a Wrestling Weight Certification Program (WWCP) mandatory to foster a safe competitive environment. One institution examined the impact of this program on weight cutting. Thirty-two NCAA Division I wrestlers completed the WWCP in the 1998-1999 season and 29 in 1999-2000. Eighteen (56%) of 32 wrestlers in 1998-1999 weighed in 10 or more pounds above the previous year's competition weight. Whereas, 28% weighed in 20 or more pounds above the previous year's competition weight. Weekly weight loss for the wrestlers in 1998-1999 revealed a substantial loss during the first week, possibly demonstrating the use of time-tested techniques for weight loss. However, in 1999-2000, the first week weight loss was less pronounced, with 65.8% of the weight being lost during the second half of the WWCP. Therefore, these wrestlers may be breaking the sport historic cycle of weight fluctuations through the WWCP.
The purpose of this study was to determine what relationship exists among physical activity levels and viral load and CD4+ cell count in HIV-infected individuals. Increased viral load is associated with disease progression and symptom severity. A convenience sample of 66 male and female subjects between the ages of 18 and 64 years of age (mean 39 +/- 8) was recruited from a hospital-based HIV/AIDS clinic. Components of PA were assessed for three continuous days using a mini-motion logger wrist actigraph. These components included mean PA level, and PA index and acceleration index. Pearson's correlational analysis was used to test the strength of association between PA components and viral load or CD4+ cell count. A significant inverse relationship was found between mean PA level and viral load (p=0.047). An inverse relationship was also observed between PA index and viral load (p=0.0061). Neither mean PA nor PA index scores correlated with CD4+ cell counts. Acceleration index, a measure of PA intensity, showed no correlation to viral load or CD4+ cell counts. These findings suggest that increasing levels of physical activity might have beneficial effects on viral load in HIV-infected individuals.
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