Progressive Resistance Training in Elderly HIV-Positive Patients: Does it Work?

Abstract

BACKGROUND: Elderly people present alterations in body composition and physical fitness, compromising their quality of life. Chronic diseases, including HIV/AIDS, worsen this situation. Resistance exercises are prescribed to improve fitness and promote healthier and independent aging. Recovery of strength and physical fitness is the goal of exercise in AIDS wasting syndrome. OBJECTIVE: This study describes a case series of HIV-positive elderly patients who participated in a progressive resistance training program and evaluates their body composition, muscular strength, physical fitness and the evolution of CD4 + and CD8 + cell counts. METHODS: Subjects were prospectively recruited for nine months. The training program consisted of three sets of 8-12 repetitions of leg press, seated row, lumbar extension and chest press, performed with free weight machines hts, twice/week for one year. Infectious disease physicians followed patients and reported all relevant clinical data. Body composition was assessed by anthropometric measures and dual-energy x-ray absorptiometry before and after the training program. RESULTS: Fourteen patients, aged 62-71 years old, of both genders, without regular physical activity who had an average of nine years of HIV/AIDS history were enrolled. The strengths of major muscle groups increased (74%-122%, p=0.003-0.021) with a corresponding improvement in sit-standing and walking 2.4 m tests (p=0.003). There were no changes in clinical conditions and body composition measures, but triceps and thigh skinfolds were significantly reduced (p=0.037). In addition, there were significant increases in the CD4 + counts (N=151 cells; p=0.008) and the CD4 + /CD8 + ratio (0.63 to 0.81, p=0.009). CONCLUSION: Resistance training increased strength, improved physical fitness, reduced upper and lower limb skinfolds, and were associated with an improvement in the CD4 + and CD4 + /CD8 + counts in HIV positive elderly patients without significant side effects.

Nível De Atividade Física E Síndrome Lipodistrófica Em Pacientes Com Hiv/Aids

“…Como meio de atenuar esses efeitos destacar-se a prática da atividade física, em que a mesma pode contribuir na melhora da autoestima 6,7 , da força muscular 8,9 , do sistema imune 10 , dos marcadores bioquímicos, da massa muscular 8,11,12 , do sistema cardiorrespiratório 13 e do perfil antropométrico 14,15 .…”

Efeito do exercício físico na percepção de satisfação de vida e função imunológica em pacientes infectados pelo HIV: Ensaio clínico não randomizado

“…Moreover, these patients do not always want to have disclosed their condition. For this reason, most of the available studies on the relationship between AIDS and exercise were performed with small samples, such as de Souza et al 5 (14 patients in the experimental group, without CG), Dolan et al 19 (40 patients in the experimental group, homebased program, without GC), Driscoll et al 20 (11 patients in the experimental group and 14 controls), and Roubenoff and Wilson 21 (6 patients in the experimental group and 19 controls), MacArthur, Levine and Birk 22 (3 patients in the experimental group and 3 controls), Rigsby et al 23 (19 patients in the experimental group, without GC) or Spence et al 24 (24 patients in the experimental group and 12 controls). This study, therefore, has a sample consistent with those other similar studies in which the CG has a smaller number of participants in relation to the EG, and many did not even have a CG.…”

“…Since then, the Acquired Immunodeficiency Syndrome (AIDS) has become a chronic disease, enabling the use of non-pharmacological approaches such as physical exercises 3,4 which maintains functionality and quality of life for several years. Therefore, maintaining the physical and functional fitness of patients with HIV/AIDS has become one of the most important therapeutic targets, particularly in the case of "wasting syndrome", which is an important loss of muscle mass 5 . On the other hand, HIV-infected patients suffer with multiple social stressors that may accelerate the progression of this disease.…”

Impacto do treinamento resistido na força e hipertrofia muscular em HIV-soropositivos

“…Uma vez que a HAART per se não resulta em hipertrofia muscular (CADE et al, 2007), novos estudos devem ser realizados com o propósito de elucidar acuradas prescrições de exercícios resistidos, visando a efeitos positivos do treinamento na constituição de massa muscular magra e ganho de força em pacientes soropositivos (SATTLER et al, 2002;SOUZA et al, 2008). Ademais, revisão de literatura tem sugerido limitações como ausência de grupocontrole (ROBINSON et al, 2007;SOUZA et al, 2008), amostras pequenas (RØGE et al, 2002;ROBINSON et al, 2007;SOUZA et al, 2008) e reduzido período de intervenção (LINDEGAARD et al, 2008;SAKKAS et al, 2009).…”

“…Uma vez que a HAART per se não resulta em hipertrofia muscular (CADE et al, 2007), novos estudos devem ser realizados com o propósito de elucidar acuradas prescrições de exercícios resistidos, visando a efeitos positivos do treinamento na constituição de massa muscular magra e ganho de força em pacientes soropositivos (SATTLER et al, 2002;SOUZA et al, 2008). Ademais, revisão de literatura tem sugerido limitações como ausência de grupocontrole (ROBINSON et al, 2007;SOUZA et al, 2008), amostras pequenas (RØGE et al, 2002;ROBINSON et al, 2007;SOUZA et al, 2008) e reduzido período de intervenção (LINDEGAARD et al, 2008;SAKKAS et al, 2009). O TR, por sua vez, pode ser usado para evitar a perda da massa magra e a perda funcional do músculo, uma vez que um dos efeitos crônicos clássicos do TR, importante para esta população, é o aumento da força (MENDES et al, 2011), oriundo tanto pelo aumento da área transversa muscular (DOLAN et al, 2006), quanto pela melhora da eficiência muscular (DOLAN et al, 2006;MENDES et al, 2011;SOUZA et al, 2011).…”