Evaluation of a physiotherapy-led group rehabilitation intervention for adults living with HIV: referrals, adherence and outcomes

Brown, Darren; Claffey, Austin; Harding, Richard

doi:10.1080/09540121.2016.1191611

Cited by 33 publications

(40 citation statements)

References 53 publications

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“…Despite the medical advances in HIV management with antiretroviral therapy, older PLWH appear to experience age-associated comorbidities at a higher rate and at a younger age than the general population 2 35. The physical barriers attributed by our participants to HIV and medication, generalised fatigue, and chronic pain are consistently identified as barriers to exercise among PLWH 28 31–33 36. To engage older PLWH, exercise interventions must acknowledge and address these physical barriers.…”

Section: Discussionmentioning

confidence: 94%

A qualitative focus group study of perceived barriers and benefits to exercise by self-described exercise status among older adults living with HIV

et al. 2019

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ObjectivesAlthough exercise interventions have been shown to improve health outcomes among older people with HIV (PLWH), this population remains highly sedentary. The purpose of this study was to examine the differences in perceived barriers and benefits of exercise among older PLWH by self-identified exercise status.DesignFive focus groups were formed among PLWH: two groups of exercising men, two groups of non-exercising men and one group of women (mixed exercisers and non-exercisers). Themes were analysed in relation to the social-ecological model, utilising the constant comparative approach.SettingPatients were recruited from an academic medical centre, HIV clinic and community locations.ParticipantsPLWH aged 50 or older, diagnosed with HIV for at least 2 years, with no other health conditions that would preclude exercise.Primary and secondary outcome measuresDetermine facilitators, barriers and the ideal environment for exercise or physical activity and determine whether these differ between older PLWH who self-identify as exercisers or non-exercisers.ResultsAmong 25 men (11 exercisers and 14 non-exercisers) and four women (three non-exercisers and one exerciser), non-exercisers mentioned fewer benefits of exercise (n=46) than exercisers (n=75). Exercisers emphasised positive reinforcement, positive mood change and increased energy as benefits of exercise; interpersonal benefits of exercise were also discussed twice as often by exercisers than by non-exercisers. Non-exercisers emphasised barriers to exercise including lack of motivation, lack of self-efficacy and a negative perception of gym culture. Non-exercisers identified the need for age-appropriate activities as a feature of an ideal exercise environment. Both groups identified time, cost and health-related challenges as barriers to exercise.ConclusionsUnique exercise barriers and benefits by self-identified exercise status provide important insights into the design of future interventions to initiate and maintain exercise.Trial registration numberNCT02404792; Results.

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Section: Discussionmentioning

confidence: 94%

A qualitative focus group study of perceived barriers and benefits to exercise by self-described exercise status among older adults living with HIV

et al. 2019

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“…The HIV CBE intervention is a 24-week exercise programme at the Central Toronto YMCA. The intervention is derived from high-quality research evidence on the effectiveness of exercise with PLWH, recommendations from the American College of Sports Medicine, 21 qualitative consultation with community (PLWH and fitness instructors), 36 pilot work 37 and existing HIV rehabilitation services in the UK, 46 collectively adapted for the Canadian context. We chose a 6-month CBE duration because it aligns with transtheoretical model evidence on the stages of behaviour change whereby the ‘action’ of practicing a new behaviour (exercise) lasts up to 24 weeks followed by the ‘maintenance’ stage during which commitment to sustaining the new behaviour (self-monitored exercise) is solidified.…”

Section: Methodsmentioning

confidence: 99%

“…Participants will also attend monthly group educational sessions co-led by a health or fitness professional and/or PLWH focused on topics related to self-management and healthy living with HIV. 46 A variety of topics will be covered in six sessions, including stress management and relaxation, pain management, nutrition, fatigue management, smoking cessation, goal setting, confidence to self-manage, community services and supports and rehabilitation in the context of HIV. 46 Throughout the intervention, participants will be asked to complete a weekly online exercise log to document their physical activity.…”

Section: Methodsmentioning

confidence: 99%

Evaluating a community-based exercise intervention with adults living with HIV: protocol for an interrupted time series study

et al. 2016

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IntroductionOur aim was to evaluate a community-based exercise (CBE) intervention with the goal of reducing disability and enhancing health for community-dwelling people living with HIV (PLWH).Methods and analysisWe will use a mixed-methods implementation science study design, including a prospective longitudinal interrupted time series study, to evaluate a CBE intervention with PLWH in Toronto, Canada. We will recruit PLWH who consider themselves medically stable and safe to participate in exercise. In the baseline phase (0–8 months), participants will be monitored bimonthly. In the intervention phase (8–14 months), participants will take part in a 24-week CBE intervention that includes aerobic, resistance, balance and flexibility exercise at the YMCA 3 times per week, with weekly supervision by a fitness instructor, and monthly educational sessions. In the follow-up phase (14–22 months), participants will be encouraged to continue to engage in unsupervised exercise 3 times per week. Quantitative assessment: We will assess cardiopulmonary fitness, strength, weight, body composition and flexibility outcomes followed by the administration of self-reported questionnaires to assess disability and contextual factor outcomes (coping, mastery, stigma, social support) bimonthly. We will use time series regression analysis to determine the level and trend of outcomes across each phase in relation to the intervention. Qualitative assessment: We will conduct a series of face-to-face interviews with a subsample of participants and recreation providers at initiation, midpoint and completion of the 24-week CBE intervention. We will explore experiences and anticipated benefits with exercise, perceived impact of CBE for PLWH and the strengths and challenges of implementing a CBE intervention. Interviews will be audio recorded and analysed thematically.Ethics and disseminationProtocol approved by the University of Toronto HIV/AIDS Research Ethics Board. Knowledge translation will occur with stakeholders in the form of presentations and publications in open access peer-reviewed journals.Trial registration numberNCT02794415; Pre-results.

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“…They found that this exercise schedule was effective in providing improved cardiovascular fitness and higher endurance performance. Similarly, Brown et al [42] assessed the efficacy of a physiotherapy-led. Group-rehabilitation intervention program involving physical exercise to implement function in HIV patients with regard to referrals, adherence and outcomes; they obtained improvements in the six-minute walk test, strength in triceps and biceps, lattisimus dorsi, shoulder-press, chest-press and leg-press, and the physical, emotional and functional subscales, with higher levels of valid expectancies.…”

Section: Editorialmentioning

confidence: 99%

Physical Exercise Improves Health Domains in HIV Patients: ’Lifting a Burden’

Archer¹

2016

HIV Curr Res

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Evaluation of a physiotherapy-led group rehabilitation intervention for adults living with HIV: referrals, adherence and outcomes

Cited by 33 publications

References 53 publications

A qualitative focus group study of perceived barriers and benefits to exercise by self-described exercise status among older adults living with HIV

A qualitative focus group study of perceived barriers and benefits to exercise by self-described exercise status among older adults living with HIV

Evaluating a community-based exercise intervention with adults living with HIV: protocol for an interrupted time series study

Physical Exercise Improves Health Domains in HIV Patients: ’Lifting a Burden’

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