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Effects of progressive training in HIV/AIDS infected adults with muscle wasting

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Effects of progressive training in HIV/AIDS infected adults with muscle wasting

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Background: Human immunodeficiency virus (HIV)/ acquired immunodeficiency syndrome(AIDS) wasting is a condition associated with HIV infection and is defined as an involuntary loss of more than 10% baseline of body weight in combination with diarrhea, weakness or fever (O'Brien 2007). Treatment with highly active antiretroviral therapy (HAART) has increased the life span in HIV infected individuals. However both before and after the introduction of HAART, muscle wasting remains a complication of HIV and is associated with negative outcomes which include reduction in physical function (ACSM 2003). Thus strategies to develop weight and especially the metabolically active body cell mass (BCM), which is comprised primarily of muscle and viscera, remains an important goal for the management of persons infected with HIV (Sattler 1999). Moderate intensity exercise training has been shown not only to be safe but also beneficial for increasing lean muscle mass, decreasing fat mass and improving muscular strength (Dudgeon W. et.al 2006). Progressive resistance training (PRT) is a non pharmacological intervention which has been know to increase lean body mass, muscle mass and strength (Roubenhoff 1999). A better insight in the effects of PRT on muscle wasting in HIV infected individuals will enable improvement in quality of life in the HIV population, reduce pharmacological costs as well as understanding and management of PRT in HIV persons by healthcare workers. Objectives: To review the effect and safety of PRT on body weight, body composition, strength and CD4 count in adults living with HIV-infection Hypothesis: PRT will increase strength and improve quality of life in HIV-infected adults. Methods: Search strategy To identify studies to be included in this review a search was conducted in the following databases: MEDLINE, COCHRANE, EMBASE, SCIENCE DIRECT and GOOGLE SCHOLAR. The keywords used in the search were: HIV/AIDS, exercise, Progressive resistance training, Muscle wasting, strength, AIDS wasting and lean body mass. Selection criteria The included studies were randomized clinical trials comparing progressive resistance exercise alone or in combination with aerobic exercise to a control group or another treatment modality, performed at least three times a week and lasting for at least twelve weeks among adults (18 years or older) living with HIV/AIDS. Main results: Five articles met the inclusion criteria. The meta-analyses in this study were limited due to a variety of characteristics included in the studies which were: type of exercise intervention, exercise intensity, exercise progression, length of study, outcomes assessed, measurement tool regarding outcomes, gender and differences in baseline regarding AIDS wasting.Main results indicated that performing PRT alone or in combination with aerobic exercise at least three times a week lasting for twelve weeks appears to be safe and may lead to significant increases in body weight, body composition and strength. These outcomes further increased when PRT was combined with pharmacological therapy. Authors conclusions: This systematic review suggests that progressive resistance exercise is beneficial for HIV adults with wasting conditions who can and will comply with a proper progressive resistive exercise program. Meta-analysis suggests that performing progressive resistance exercise three times a week for at least twelve weeks may lead to statistically significant improvements in body weight for adults living with HIV/AIDS. Evidence concerning effectiveness and safety of progressive resistive exercise for adults living with HIV is limited due to the small number of studies included and sample size. Further studies should aim to assess the effect of progressive resistance exercise on different stages of the HIV-infection. Keywords: HIV/AIDS, exercise, progressive resistance training, muscle wasting, strength, AIDS wasting, lean body mass

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OrganisatieHogeschool van Amsterdam
InstituutGezondheid
Gepubliceerd in
Jaar2008
TypeBachelorscriptie
TaalEngels

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