Effects of an Education and Home-Based Pedometer Walking Program on Ischemic Heart Disease Risk Factors in People Infected with HIV: A Randomized Trial

Roos, Ronel MSc*; Myezwa, Hellen PhD*; van Aswegen, Helena PhD*; Musenge, Eustasius PhD

JAIDS Journal of Acquired Immune Deficiency Syndromes: 1 November 2014 - Volume 67 - Issue 3 - p 268–276
doi: 10.1097/QAI.0000000000000299
Clinical Science

Objective: People infected with the human immunodeficiency virus are at an increased risk of developing ischemic heart disease (IHD); however, the effects of an education and home-based pedometer walking program on risk factors of IHD are not known.

Methods: We conducted a 12-month randomized study of an education and home-based pedometer walking program in 84 human immunodeficiency virus–infected individuals with risk factors of IHD.

Results: Pedometer step count of the control and intervention groups improved significantly (P = 0.03 for both groups) at 6 months but was not significant at 12 months (P = 0.33 and 0.21, respectively). Significant between-group effects were observed in 6-minute walk test distance (P = 0.01), waist to hip ratio (P = 0.00), glucose (P = 0.00), and high-density lipoprotein (P = 0.01) over the 12-month period. The program did not result in change in high-sensitivity C-reactive protein as it was associated with perceived stress (r = 0.23; P = 0.03), weight (r = 0.28; P = 0.01), body mass index (r = 0.35; P < 0.00), waist (r = 0.28; P = 0.01) and hip circumference (r = 0.28; P = 0.01). Multivariate generalized estimation equation analysis demonstrated an inverse association between interaction and perceived stress (logB = −0.01; 95% confidence interval: −0.02 to −0.01; P <0.00) and body mass index (logB = −0.02; 95% confidence interval: −0.03 to −0.002; P = 0.02) at group level.

Conclusion: An education and home-based pedometer walking program improves physical activity levels, and beneficial changes in other IHD risk factors were noted.

*Department of Physiotherapy, Faculty of Health Sciences, School of Therapeutic Sciences, University of the Witwatersrand, Johannesburg, South Africa; and

Division of Epidemiology and Biostatistics, Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.

Correspondence to: Ronel Roos, MSc, Department of Physiotherapy, Faculty of Health Sciences, School of Therapeutic Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa (e-mail: ronel.roos@wits.ac.za).

This study was possible because of the support from Themba Lethu HIV clinic, Clinical HIV Research Unit, Right to Care and the Department of Medicine at Helen Joseph Hospital in Gauteng, South Africa. This study was supported by grants received from the University of the Witwatersrand (Faculty Research Committee grants), South African Society of Physiotherapy (Research Foundation grant), National Research Foundation Thuthuka grant, National Research Foundation Sabbatical Grant to Complete Doctoral Degrees and Medical Research Council.

The authors have no conflicts of interest to disclose.

Any opinion, findings, and conclusions or recommendations expressed in this material are those of the authors, and therefore the NRF does not accept any liability in regard thereto. The views and opinions expressed are not those of the MRC but of the authors of the material produced or publicized.

Received March 25, 2014

Accepted July 07, 2014

© 2014 by Lippincott Williams & Wilkins