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Aerobic exercise: effects on parameters related to fatigue, dyspnea, weight and body composition in HIV-infected adults

Smith, Barbara A.a; Neidig, Judith L.b,d; Nickel, Jennie T.e; Mitchell, Gladys L.c; Para, Michael F.b; Fass, Robert J.b

Basic Science

Objectives: The purpose of the study was to examine the effects of aerobic exercise on physiological fatigue (time on treadmill), dyspnea [rate of perceived exertion (RPE) and forced expiratory volume at 1 s (FEV1)], weight, and body composition in HIV-1-infected adults (200–499 × 106 CD4+ cells/l).

Design: The study was a randomized, wait-listed, controlled clinical trial of aerobic exercise in HIV-1-infected adults on signs and symptoms associated with HIV-1 infection or its treatment.

Methods: Sixty subjects were recruited and randomized to two groups. Experimental subjects completed a 12-week supervised exercise program. Control subjects continued usual activity from baseline to week 12 and were then were enrolled in the exercise program.

Results: At baseline, the groups were similar in age, weight, body mass index [mean body mass index (BMI) > 27], time since diagnosis, number of symptoms, CD4+ cell count, and number on protease inhibitor therapy (n = 7). Despite disproportionate attrition from the exercise group (38%), exercise subjects were able to remain on the treadmill longer, lost weight, decreased BMI, subcutaneous fat, and abdominal girth when compared to controls. The improvement in weight and body composition occurred without a decrease in kilocalories consumed. Exercise did not seem to have an effect on RPE, a surrogate for dyspnea, and FEV1. There was no significant difference in either the change in CD4+ cell count, percentage or copies of plasma HIV-1 RNA between groups.

Conclusions: We conclude that supervised aerobic exercise training safely decreases fatigue, weight, BMI, subcutaneous fat and abdominal girth (central fat) in HIV-1-infected individuals. It did not appear to have an effect on dyspnea.

From the aUniversity of Alabama at Birmingham School of Nursing, Birmingham, Alabama, the bDepartment of Internal Medicine, Division of Infectious Diseases, College of Medicine and Public Health, the cDivision of Epidemiology and Biostatistics, College of Medicine and Public Health, the dDepartment of Adult Health and Illness, College of Nursing, The Ohio State University, Columbus and the eOhio Department of Human Services, Columbus, Ohio, USA.

Received: 3 May 2000;

revised: 6 December 2000; accepted: 18 January 2001.

Sponsorship: This study was funded by National Institutes of Health (NIH), National Institute of Nursing Research (NR 03974) and the National Institute of Allergy and Infectious Diseases (AI 25924), Adult ACTG.

Correspondence to Professor Barbara A. Smith, The University of Alabama at Birmingham School of Nursing, 1530 3rd Ave. South Birmingham, AL 35294-1210, USA. Tel: +1 205 934 0582; fax: +1 205 975 6194; e-mail: Smithb@son.uab.edu

© 2001 Lippincott Williams & Wilkins, Inc.