Journal articles: 'HIV-positive persons Exercise therapy'

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Ferez, Sylvain, Athanasios Pappous, and Sébastien Ruffié. "Activité physique et sportive des PVVIH: de l’intérêt de la pratique à l’accès à la pratique (revue de littérature) (La actividad física y deportiva de las PVVIH: Del interés por la práctica al acceso a la práctica (Revisión de la bibliografía))." Retos, no. 18 (March 9, 2015): 77–82. http://dx.doi.org/10.47197/retos.v0i18.34657.

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La cuestión de la calidad de vida de las Personas Vivas con el VIH (PVVIH) es un objetivo que se toma con cada vez más seriedad, y se puede observar una proliferación de trabajos en el ambito de ciencias de la vida que toman fundamento en la hipótesis de los efectos positivos de la actividad física y deportiva. La mayor parte de los estudios que se resumen en la presente revision de literatura han sido llevados a cabo desde el punto de vista de la fisiología del ejercicio y buscan identificar los tipos de prácticas seguras que proporcionen los mayores beneficios en términos de salud y de calidad de vida. No obstante hasta la fecha ningún estudio específico ha tratado ésta tematica desde el punto de vista sociologico. Los autores de ésta revision de literatura hacen una llamada para futuros estudios que enfoquen en el modo en el que el acceso a la práctica física y deportiva se ve afectada por la sepositividad. Se subraya la importancia que los paradigmas de la sociología de la salud y la sociología del ocio de la actividad física puedan tener para el estudio de la práctica deportiva de las personas seropositivas.Palabra clave: Personas seropositivas, actividad fisica, exclusion, sociología de la salud.Abstract: The scientific literature about AIDS and physical exercise has been traditionally dominated by biomedical approaches. The first studies which were published in the beginning of the nineties focused mainly on the transmission risks of the virus during sports. Later studies were concerned with the physiological logics of the exercise on HIV-positive persons. Since the end of the nineties the therapeutic progress contributed to envisage sport as a way to mediate the side effects of medical treatments. However the present review highlights a serious gap in the literature on Sport and HIV using a sociological point of view. The authors of this article argue that the time has come to consider sociological data linked to the experiences of HIV/AIDS in order to understand the difficulties and barriers that seropositive persons have to face when participating in sport.Key words: seropositive persons, physical activity, exclusion, sociology of health.

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MACARTHUR, RODGER D., SHELDON D. LEVINE, and THOMAS J. BIRK. "Supervised exercise training improves cardiopulmonary fitness in HIV-infected persons." Medicine & Science in Sports & Exercise 25, no. 6 (June 1993): 684???688. http://dx.doi.org/10.1249/00005768-199306000-00006.

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León, Julia, Aurelio Ureña, Manuel Jorge Bolaños, Alfonso Bilbao, and Antonio Oña. "A Combination of Physical and Cognitive Exercise Improves Reaction Time in Persons 61–84 Years Old." Journal of Aging and Physical Activity 23, no. 1 (January 2015): 72–77. http://dx.doi.org/10.1123/japa.2012-0313.

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We have compared the effects of different 12-week exercise programs on simple and choice reaction and movement times in persons 61 to 84 years old. One hundred thirty-eight volunteers were randomized to either a control group, a two-day exercise group (two 60-min sessions a week of aerobic exercises), or a two-day physical plus cognitive exercise group (two 60-min sessions a week of aerobic and cognitive exercises). At follow-up, the aerobic and cognitive exercise program was found to have resulted in significant positive effects. Improvements were found in the two-day physical plus cognitive exercise group in all of the reaction parameters, particularly improvement in choice reaction time, which is used in most daily activities. Our results suggest that to improve reaction time values, it is advisable to include cognitive features into a physical exercise routine.

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Dudgeon, Wesley D., Kenneth D. Phillips, Stephanie E. Burgess, J. Larry Durstine, and Gregory A. Hand. "Moderate-Intensity Exercise Affects Mental Health and Mood in HIV-Infected Persons." Medicine & Science in Sports & Exercise 38, Supplement (May 2006): S54. http://dx.doi.org/10.1249/00005768-200605001-01120.

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Malita, Florin M., Antony D. Karelis, Emil Toma, and Remi Rabasa-Lhoret. "Effects of Different Types of Exercise on Body Composition and Fat Distribution in HIV-Infected Patients: A Brief Review." Canadian Journal of Applied Physiology 30, no. 2 (April 1, 2005): 233–45. http://dx.doi.org/10.1139/h05-117.

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HIV infection and its treatment is associated with unfavourable metabolic and morphological abnormalities. These metabolic abnormalities, particularly alterations in body composition and fat distribution, may increase the risk for cardiovascular and metabolic complications, as well as reduce functional independence and lower self-esteem. Thus there is an urgent need to develop interventions intended to manage secondary side effects of HIV or antiretroviral therapy-related complications. In poly-treated patients, nonpharmacological interventions are a logical first step. Exercise training in particular may help alleviate some of the metabolic adverse effects associated with antiretroviral therapy by favourably altering body composition and patterns of body fat distribution. Studies have shown that exercise training, particularly aerobic training, can help reduce total body and visceral fat, as well as normalizing lipid profiles in HIV-infected patients. The results for resistance training, however, are less conclusive. Knowledge of the use of resistance and aerobic training and its attendant effects on insulin resistance and adipocytokines may represent an effective nonpharmacologic means for treating metabolic complications of HIV-infected persons who are receiving appropriate antiretroviral therapy. In this brief review we examine the effects of aerobic and resistance training on body composition, body fat distribution, and selected metabolic outcomes. Key words: lipodystrophy, highly active anti-retroviral therapy, aerobic training, resistance training

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Dudgeon, Wesley D., Kenneth D. Phillips, Stephanie E. Burgess, J. Larry Durstine, and Gregory A. Hand. "Lean Tissue Mass And Fat Mass Changes In HIV-infected Persons Following Moderate Intensity Exercise Training." Medicine & Science in Sports & Exercise 37, Supplement (May 2005): S127. http://dx.doi.org/10.1249/00005768-200505001-00664.

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Dudgeon, Wesley D., Kenneth D. Phillips, Stephanie E. Burgess, J. Larry Durstine, and Gregory A. Hand. "Lean Tissue Mass And Fat Mass Changes In HIV-infected Persons Following Moderate Intensity Exercise Training." Medicine & Science in Sports & Exercise 37, Supplement (May 2005): S127. http://dx.doi.org/10.1097/00005768-200505001-00664.

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Cutrono, Stacy E., John E. Lewis, Arlette Perry, Joseph Signorile, Eduard Tiozzo, and Kevin A. Jacobs. "Effect Of A Community-Based Exercise Program On Inflammation And Fitness Among Persons Living With HIV/AIDS." Medicine & Science in Sports & Exercise 47 (May 2015): 633. http://dx.doi.org/10.1249/01.mss.0000478443.55718.1e.

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Silveira, Stephanie L., Emma V. Richardson, and Robert W. Motl. "Social cognitive theory as a guide for exercise engagement in persons with multiple sclerosis who use wheelchairs for mobility." Health Education Research 35, no. 4 (June 14, 2020): 270–82. http://dx.doi.org/10.1093/her/cyaa013.

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Abstract Multiple sclerosis (MS) is an immune-mediated neurodegenerative disease of the brain, optic nerves and spinal cord. Among persons with MS, 30% experience significant mobility impairment that requires use of a wheelchair for mobility. Exercise is an evidence-based second-line therapy that can improve mobility; however, little research has focused on individuals that use wheelchairs for mobility. Framed by social cognitive theory (SCT), we conducted a formative qualitative study examining exercise status and perceptions among 20 persons with MS who use wheelchairs for mobility. Using deductive, semantic thematic analysis, we coded for SCT variables (i.e. self-efficacy, knowledge, outcome expectations, barriers and facilitators) and identified participants as regular or inconsistent exercisers. In total, 12 participants were classified as regular exercisers and 8 inconsistent exercisers. Regular exercisers more frequently reported high self-efficacy, consistent exercise knowledge and numerous facilitators. All participants reported some positive outcome expectations and several barriers and facilitators. These findings can inform future intervention studies supporting exercise behavior change through SCT. Strategies such as increasing self-efficacy, imparting instructional materials, shaping realistic outcome expectations and providing tools directed toward overcoming barriers and identifying facilitators may work to support the exercise endeavor of persons with MS who use wheelchairs for mobility.

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Lundy, Janice. "BUILDING AN AGE-FRIENDLY HEALTH CARE SYSTEM." Innovation in Aging 3, Supplement_1 (November 2019): S186. http://dx.doi.org/10.1093/geroni/igz038.666.

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Abstract Gateway GWEP has partnered with a rural Missouri critical access hospital to establish an age-friendly health system in their community. Program innovations include development and training of: 1) electronic health records integration of the Rapid Geriatric Assessment (RGA) for all patients 65+ years old; 2) RGA-based protocol for Medicare Annual Wellness Visits (MAWV); 3) Multidisciplinary health care assessment team 4) Evidence-based or Evidence Informed treatment interventions, including Cognitive Stimulation Therapy (CST), exercise and strengthening program for persons participating in CST, Care of Persons with Dementia in their Environments (COPE) and caregiver support. Since 2015, 1,200 RGAs, 338 MAWVs have been completed; 165 persons with dementia participated in CST; and 74 have participated in exercise and strengthening. Data supports positive outcomes in functional independence, cognitive status, and care-giver dementia management skills and well-being. Successes and lessons learned regarding strategies to develop an age-friendly health systems will be discussed.

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Kever, Anne, Katherine E. Nelson, Ines M. Aguerre, Claire S. Riley, Amelia Boehme, Nancy W. Lee, Rebecca Strauss Farber, Seth N. Levin, Joel Stein, and Victoria M. Leavitt. "ASPIRE trial: study protocol for a double-blind randomised controlled trial of aspirin for overheating during exercise in multiple sclerosis." BMJ Open 10, no. 11 (November 2020): e039691. http://dx.doi.org/10.1136/bmjopen-2020-039691.

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IntroductionThe many benefits of exercise for persons with multiple sclerosis (MS) are well established, yet patients often refrain from exercise due to overheating and exhaustion. The present randomised controlled trial tests aspirin (acetylsalicylic acid (ASA)) as a convenient method to prevent overheating and improve exercise performance in persons with MS. The effects of ASA are compared with those of acetaminophen (APAP) and placebo.Methods and analysisParticipants are seen for a laboratory maximal exercise test on 3 separate days separated by at least 1 week. At each session, body temperature is measured before oral administration of a standard adult dose (650 mg) of ASA, APAP or placebo. One hour after drug administration, participants perform a maximal ramp test on a cycle ergometer. Primary outcomes are (a) time to exhaustion (that is, time spent cycling to peak exertion) and (b) body temperature change. Crossover analyses will include tests for effects of treatment, period, treatment–period interaction (carryover effect) and sequence.Ethics and disseminationEthical approval was granted by the institutional review board at Columbia University Irving Medical Center (reference: AAAS2529). Results of the trial will be published in peer-reviewed scientific journals and presented at national and international conferences. Neurologists, physiatrists, primary care physicians and physiotherapists are important stakeholders and will be targeted during dissemination. Positive trial results have the potential to promote aspirin therapy, an inexpensive and readily available treatment, to reduce overheating and allow more persons with MS to benefit from exercise.Trial registration numberNCT03824938.

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McGrew, Christopher, Daisy-Scarlett MacCallum, Dustymarie Narducci, Rathna Nuti, Leonard Calabrese, Robert J. Dimeff, Stephen Paul, Sourav Poddar, Ashwin Rao, and Douglas McKeag. "AMSSM position statement update: blood-borne pathogens in the context of sports participation." British Journal of Sports Medicine 54, no. 4 (March 19, 2019): 200–207. http://dx.doi.org/10.1136/bjsports-2019-100650.

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This American Medical Society for Sports Medicine position statement update is directed towards healthcare providers of patients involved in sport and exercise. There have been significant advances in clinical and scientific research in the understanding of blood-borne pathogens (BBPs), and this update incorporates these advancements. This document is intended as a general guide to clinical practice based on the current state of the evidence, while acknowledging the need for modification as new knowledge becomes available. Confirmed transmission of BBPs during sport is exceedingly rare. There are no well-documented reports of HIV, HCV or HDV transmission during sport. There is also no evidence for universal testing for BBPs as a specific requirement for participation in sports. Competitive athletes and non-athletes should follow appropriate general public health agency recommendations for screening for BBPs, considering their individual risk factors and exposures. Standard (universal) precautions must be followed by those providing care to athletes. Exercise and athletic participation can help promote a healthy lifestyle for persons living with BBPs. Those with acute symptomatic BBP infection should limit exercise intensity based on their current health status. Education is the key tool for preventing BBP transmission. Research gaps include evaluation of the prevalence of BBP infections in competitive athletes, the effects of long-term, intense training on infected athletes and the effects of BBP treatment therapies on performance.

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Han, Shuyu, Yaolin Pei, Lina Wang, Yan Hu, Xiang Qi, Rui Zhao, Lin Zhang, Wenxiu Sun, Zheng Zhu, and Bei Wu. "The Development of a Personalized Symptom Management Mobile Health Application for Persons Living with HIV in China." Journal of Personalized Medicine 11, no. 5 (April 25, 2021): 346. http://dx.doi.org/10.3390/jpm11050346.

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Persons living with HIV (PLWH) continuously experience symptom burdens. Their symptom prevalence and severity are also quite different. Mobile health (mHealth) applications (apps) offer exceptional opportunities for using personalized interventions when and where PLWH are needed. This study aimed to demonstrate the development process of the symptom management (SM) app and the structure and content of it. Our research team systematically searched for evidence-based resources and summarized up-to-date evidence for symptom management and health education. Our multidisciplinary research team that included physicians, nurses, software engineers, and nursing professors, evaluated the structure and content of the drafted app. Both quantitative data and qualitative results were collected at a group discussion meeting. Quantitative data were scores of sufficient evidence, situational suitability, practicability, cost-effectiveness, and understandability (ranged from one to four) for 119 items of the app contents, including the health tracking module, the self-assessment module, coping strategies for 18 symptoms (80 items), medication management, complementary therapy, diet management, exercise, relaxation techniques, and the obtaining support module. The SM app was comprised of eight modules and provided several personalized symptom management functions, including assessing symptoms and receiving different symptom management strategies, tracking health indicators, and communicating with medical staff. The SM app was a promising and flexible tool for HIV symptom management. It provided PLWH with personalized symptom management strategies and facilitated the case management for medical staff. Future studies are needed to further test the app’s usability among PLWH users and its effects on symptom management.

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Rausch Osthoff, A. K., C. Horvath, and K. Niedermann. "POS0044-HPR FEASIBILITY OF FITNESS ASSESSMENTS IN GROUP EXERCISE THERAPY FOR INDIVIDUALS WITH AXIAL SPONDYLOARTHRITIS." Annals of the Rheumatic Diseases 81, Suppl 1 (May 23, 2022): 237.2–238. http://dx.doi.org/10.1136/annrheumdis-2022-eular.5134.

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BackgroundAssessments should be standard in individual as well as group physical therapy. The Ankylosing Spondylitis Association of Switzerland has translated the EULAR recommendations for physical activity (PA) in a concept for group exercise therapy, which, in addition to guidance on exercising in all four fitness dimensions (aerobic, strength, flexibility, neuromotor function), also includes PA counselling and regular fitness assessments for the planning and documentation of the individual therapy progress as well for quality monitoring of the exercise groups.ObjectivesTo evaluate the feasibility of the selected assessments across all four fitness dimensions, rating the acceptance, practicability, and integration by physiotherapists (PTs) and people with axSpA.MethodsA feasibility study was conducted in four pilot exercise therapy groups. PTs performed the assessment battery, consisting of a) the Chester Step Test (CST) for aerobic fitness; b) the modified Core Strength Test for core strength, c) the Bath Ankylosing Spondylitis Metrology Index (BASMI) for spinal mobility and d) the Single Leg Stance Test (SLST) for balance, with the participants of the exercise therapy groups. Subsequently, the PTs and the participants with axSpA rated the acceptance, practicability, and integration by means of questionnaires.Acceptance was operationalised as satisfaction and perceived applicability, practicability was operationalised as feasibility and comprehensibility, and integration was operationalised as usefulness and repeatability. An ordinal scale with four answer options (very good, good, moderate, bad) and a free text field for comments was used. The categories ‘very good’ and ‘good’ were interpreted as ‘positive evaluation’. The feasibility of the assessments was defined based on three levels (I-III): with a positive evaluation of >80% (level I) a specific assessment was considered suitable, with a positive evaluation of 50-80% (level II) adjustments were necessary, with a positive evaluation of <50% (level III) a specific assessment was not considered suitable for group exercise therapy and a new choice had to be made.ResultsThe BASMI was rated level I by people with axSpA and PTs, no adaptations were necessary. The CST was rated level I by people with axSpA and level II by PTs (too time consuming and failure-prone software), resulting in the adaptation that the test can now be performed without software, and a training will make the testing PTs more efficient. The modified Core Strength Test was rated level I by people with axSpA and level II by PTs (instructions unclear), leading to adaptations in the instruction manual. The SLST was rated level I by people with axSpA and level II by PTs (instruction “standing on one leg as long as possible” not useful for persons without balance deficit), leading to the adaptation that the test can be stopped after 60 seconds as the normal values are below that threshold.ConclusionFrom patient perspective, the feasibility of the tests was evaluated positive in terms of acceptance, practicability and integration (all level I). From PTs’ perspective some adaptations were necessary (level II, except BASMI). After the adaptations, the assessment battery can now be used in group exercise therapy for individuals with axSpA. In this way, the individual fitness status can be evaluated, and interventions can be adapted, and thus the quality of group exercise therapy can be continuously monitored and improved if necessary.AcknowledgementsWe thank all participants and the SVMB for their support.Disclosure of InterestsNone declared

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Gasper, Joseph M., Megan Lewis, Anne Kroeger, Ben Muz, Nicholas LaRocca, and Debra Frankel. "Multiple Sclerosis Adult Day Programs and Health-Related Quality of Life of Persons with Multiple Sclerosis and Informal Caregivers." International Journal of MS Care 22, no. 4 (January 9, 2020): 187–92. http://dx.doi.org/10.7224/1537-2073.2019-020.

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Abstract Background: Multiple sclerosis adult day programs (MSADPs) offer life-enhancing services for individuals and informal caregivers affected by multiple sclerosis (MS), including medical care, rehabilitation therapies, nutrition therapy, cognitive training, tailored education, exercise programs, and social interaction. The purpose of this study was to examine the effects of MSADPs on health-related quality of life (HRQOL) and health care utilization of persons with MS and HRQOL and well-being of informal caregivers. Methods: Using a quasi-experimental design, outcomes between baseline and 1-year follow-up in persons with MS and informal caregivers who used MSADP services and a comparison group of similar persons with MS and caregivers who did not use MSADP services were compared. For persons with MS, outcomes included standardized measures of physical and mental HRQOL and health care utilization. For caregivers, outcomes included physical and mental HRQOL and well-being. Changes in outcomes between baseline and follow-up were examined using propensity score–weighted difference-in-differences regression analysis. Results: For persons with MS, MSADP use had a significant positive effect on 12-Item Short Form Health Survey physical component scores, although the difference was not clinically meaningful. Use of MSADPs did not have effects on any other outcomes for persons with MS or caregivers. Conclusions: Use of MSADPs did not show a clinically meaningful effect on HRQOL for persons with MS or informal caregivers. The MSADPs do not seem to offer sustained benefits to persons with MS or caregivers, but the possibility of initial short-term benefits cannot be ruled out.

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Gehlhar, Andreas, Nikola Schmidt, Nina Eisenburger, Sven Feddern, Annelene Kossow, Johannes Nießen, Stefanie Wessely, Gerhard A. Wiesmüller, Barbara Grüne, and Christine Joisten. "Impact of physical activity on COVID-19-related symptoms and perception of physical performance, fatigue and exhaustion during stay-at-home orders." BMJ Open Sport & Exercise Medicine 8, no. 2 (May 2022): e001319. http://dx.doi.org/10.1136/bmjsem-2022-001319.

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ObjectivesThe measures used to contain the COVID-19 pandemic led to a significant reduction in physical activity. Due to the health benefits of exercise, recommendations were made for lockdown restrictions. Within the CoCo-Fakt study (Cologne-Corona counselling and support for index and contacts during the quarantine period), we aimed to determine how these recommendations were implemented, especially by individuals who were officially quarantined due to an infected persons (IPs) or as close contacts (CPs), and how this affected their physical and psychological condition.MethodsFrom 12 December 2020 to 6 January 2021, all IPs and CPs registered by Cologne’s public health department up to the survey period were surveyed online. Of 10 547 people in the CoCo-Fakt sample, 8102 were integrated into the current analysis. In addition to demographic data, information regarding COVID-19-specific and persistent symptoms or conditions and their association with the amount and type of exercise and screen time before and during the quarantine were collected.ResultsBefore quarantine, 66.9% of IPs and 69% of CPs were physically active; during quarantine, this decreased by 49.4% in IPs depending on the course of the disease and by 30.6% in CPs. Physically active IPs and CPs felt less exhausted and more fit during their quarantine periods than those who were inactive, with active IPs significantly less likely to report prolonged physical and psychological symptoms than their more sedentary counterparts.ConclusionGiven the acute and long-term positive effects of exercise on quarantined individuals, corresponding recommendations should be communicated to those affected, especially CPs. Recommendations for IPs depend on their health status.

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Son, Hyo-Jung, Dae-Sik Kim, and Sin-Ae Park. "Horticultural Therapy for Improving the Work Performance and Interpersonal Relationships of Persons with Intellectual Disabilities." International Journal of Environmental Research and Public Health 19, no. 21 (October 25, 2022): 13874. http://dx.doi.org/10.3390/ijerph192113874.

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For the occupational adaptation and social integration of the intellectually disabled, it is helpful to improve their work performance and interpersonal skills. The purpose of the study was to evaluate the effectiveness of horticultural therapy (HT) programs to improve work performance and interpersonal relationships of persons with intellectual disabilities. Based on observations and analyses of how people with intellectual disabilities work, we have developed a 12-session HT program that includes upper limb movements and physical activities to improve hand function. We recruited, with the consent of their legal guardians, 14 (6 males, 8 females) participants who had intellectual disabilities and were working at a sheltered workshop in K-gu, Seoul, South Korea. The program consisted of twelve sixty-minute sessions that were conducted twice a week at a rooftop garden. For pre- and post-evaluation of the program, the survey of functional adaptive behavior (SFAB), interpersonal negotiation strategies, a horticultural job evaluation (self), hand function tests (pegboard, pinch gauge, fingertips), and blood sample tests for physiological indicators of exercise were conducted. Interpersonal negotiation strategies, functional adaptive behaviors, and physical abilities for job behaviors, including agility and grasping of the hand, improved significantly from before to after the program (p < 0.05). A positive result of VEGF (vascular endothermic growth factor) in blood sample tests implies the need for further research on cognitive changes caused by horticultural activities. This study has limitations due to the small number of participants, but the results suggest that low- to medium-intensity horticultural treatment programs using the upper body and hands could be effective for vocational rehabilitation of the intellectually disabled.

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Sheets, Debra, Linda Clare, Saskia Sivananthan, Isabelle Vedel, Teresa Liu-Ambrose, Henry Brodaty, Jim Mann, and Carrie McAiney. "Canadian Consensus Conference on Psychological and Non-Pharmacological Interventions for Dementia." Innovation in Aging 4, Supplement_1 (December 1, 2020): 492–93. http://dx.doi.org/10.1093/geroni/igaa057.1592.

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Abstract Psychological and non-pharmacological interventions that could have a positive effect on outcomes important to persons living with dementia are essential to identify given the the limited efficacy of dementia medications and the diverse needs of persons living. In 2019, for the first time the Canadian Consensus Conference on the Diagnosis and Treatment of Dementia (CCCDTD) created a working group to develop recommendations related to a broad range of psychosocial and non-pharmacological interventions exist, typically aimed at improving cognition, symptoms, or well-being, as well as improving caregiver well-being and coping. The recommendations, primarily intended for primary care physicians, may also allow clinicians, organizations, and communities and help to better meet the needs of people living with dementia and their caregivers. A group of 11 experts, including persons living with dementia and informal caregivers, as well as clinicians and researchers from various organizations both nationally and internationally were invited to participate. A rapid review of meta-analyses and literature reviews on psychological and non-pharmacological interventions was conducted. The synthesized results were submitted for a consensus building approach using a Delphi method, involving a panel of more than 50 Canadian participants. Recommendations with a positive vote of 80% or more were considered to have reached consensus. All proposed recommendations reached consensus using the Delphi process. Details of the recommendations are presented. Five recommendations are made: group or individual physical exercise, group cognitive stimulation therapy, psychoeducational interventions for caregivers, dementia friendly organizations/communities, and case management.

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Kalva-Filho, Carlos A., Lucas Simieli, Murilo H. Faria, and Fabio A. Barbieri. "Infographic: Four training modalities to improve functional mobility in people with Parkinson’s disease." Brazilian Journal of Motor Behavior 16, no. 1 (March 1, 2022): 1–3. http://dx.doi.org/10.20338/bjmb.v16i1.284.

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Impairment of functional mobility is one of the most disabling symptoms in people with Parkinson’s disease (PwPD). Limitations in mobility lead to sedentarism, which may decrease the quality of life in PwPD. Several studies demonstrated that the combination of exercise with the traditional pharmacological treatment (i.e., levodopa) is effective to improve mobility in PwPD 1-5. Although the effects of traditional modalities (e.g., walking overground and cycling) are well documented, other stimuli may also induce positive responses on mobility in PwPD. However, such studies demonstrated trivial results or effectiveness in terms of functional mobility, indicating that the exercise – mainly using non-traditional stimuli – should be carefully prescribed. To avoid practical mistakes and ensure a high probability of success in mobility rehabilitation in PwPD, rehabilitation professionals must apply up-to-date and high-quality knowledge about mobility. Also, they must recognize the effects of different exercise modalities to improve functional mobility and the motivators and barriers to exercise in PwPD 1. This infographic aims to present (1) the motiving factors and barriers of training in PwPD, (2) the main effects of four exercise modalities on functional mobility (considering its underlining mechanisms), and (3) demonstrate the training evidence to improve the functional mobility. The exercise modalities were selected from the four recent meta-analyses (searched on PUBMED) that tested the exercise effects on functional mobility and presented data related to exercise prescription for PwPD. The encouragement of other persons is the most motivating factor for PwPD during exercise. The lacking of encouragement, fatigue and depression are related to exercise barriers in PwPD 1. Suárez-Iglesias et al. 2 demonstrated that Pilates was effective to improve functional mobility, improving Timed Up and Go (TUG) performances. Interventions using hydrotherapy, with or without land-based therapy, also showed positive effects on TUG values 3. Dance modality, associated with auditory cues, promoted positive effects on gait velocity, TUG, and freezing of gait 4. Finally, Robinson et al. 5 observed that treadmill training, when compared to no-exercise ones, improved the gait velocity and step length in PwPD regardless of use or not body weight support. Overall these results were observed in patients with early to moderate stages of disease (Hoehn and Yahr < 3). These main effects and the mechanism related to the positive responses were presented in the infographic. Despite the noteworthy positive effects of exercise using these modalities in PwPD, recommendations for training prescriptions are still debatable. The characteristics of the modalities were poorly described in most of the studies. For example, even with the availability of acceptable and practical tools, the exercise intensity or its increment throughout the training was not properly reported. Therefore, it is difficult to determine a specific guideline to improve functional mobility in PwPD. The discussion about prescriptions (hydrotherapy) and the program with the highest weight in the meta-analysis (dance, pilates and treadmill) were presented in the infographic. Future studies should detail, as many as, possible training characteristics, increasing the reproducibility and applicability of the results.

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Joseph, Conran, Breiffni Leavy, and Erika Franzén. "Predictors of improved balance performance in persons with Parkinson’s disease following a training intervention: analysis of data from an effectiveness-implementation trial." Clinical Rehabilitation 34, no. 6 (May 3, 2020): 837–44. http://dx.doi.org/10.1177/0269215520917199.

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Objective: (1) To determine associated factors of improved balance performance after a 10-week HiBalance intervention period, and (2) to determine effects of the programme on modifiable factors found above, considering both groups. Design: Pre-posttest substudy founded on the outcomes evaluation of an effectiveness-implementation trial. Participants: Sixty-one participants were allocated the HiBalance training, while 56 were controls. Intervention: Participants received a 10-week, two times weekly, progressive balance training, that is, HiBalance intervention, led by physical therapists. The intervention was group based and gradually incorporated dual-tasking over the training period. Participants also performed, unsupervised, a 1×/week home exercise programme. Main outcome: The Mini-Balance Evaluation Systems Test (Mini-BESTest) assessed balance performance, and those having improved by ⩾2 points were classified as positive responders. Balance confidence was the secondary outcome. Results: Fifty-three (87%) participants completed the intervention and 32 (60%) improved their balance scores by ⩾2 points in the intervention group, with 11 (24%) in the control group. The multivariable logistic regression analysis revealed two independently associated factors of improved balance, which included balance confidence (odds ratio (OR) = 0.95; 95% confidence interval (CI) = 0.90–0.99) and attendance of ⩾80% of training sessions (OR = 10.10; 95% CI = 1.71–59.60). The final model demonstrated good fit and acceptable discrimination (area under the curve = 0.84). Secondary analysis revealed a fair relationship (Rho = 0.30; P = 0.044) between improvements in balance confidence and balance performance in the intervention but not control group. Conclusion: Two personal factors were significantly associated with a higher likelihood of improvement in clinically measured balance performance. The HiBalance intervention appears to benefit those with lower balance confidence.

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Bel, Loïc, Michaël Duc, Mario Bizzini, Pierre-Etienne Fournier, and Lara Allet. "Context of injury prevention strategies in Swiss basketball: survey of athletes, medical staff and coaches." BMJ Open Sport & Exercise Medicine 8, no. 4 (December 2022): e001386. http://dx.doi.org/10.1136/bmjsem-2022-001386.

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ObjectivesThis project aims to assess opinions, attitudes, knowledge, beliefs, practices and perceived barriers and facilitators of injury prevention (IP) strategies in Swiss basketball teams.MethodsAn online survey was sent to athletes, coaches and medical staff of the three best basketball leagues in Switzerland. The survey was subdivided in four sections: (1) characteristic of participants, (2) knowledge, opinions, attitudes and beliefs, (3) practices and (4) barriers and facilitators.ResultsAmong 105 persons (n=45 female, n=60 male) who answered the survey, more than 60% (n=68) considered the risk of injury for basketball athletes as being high to very high. The ankle, knee and the hand were considered as being the most at risk. More than 80% of participants considered that recovery, training load and the warm-up quality were very important factors for IP. More than 90% of participants considered IP as either important or very important with 53 (50.5%) of the participants indicating using exercise-based IP in their clubs. Athletes and coaches’ motivation and compliance were judged as either important or very important for successful IP implementation by more than 80% of participants, with the coach being reported as the most influential person. Environmental barriers towards human or infrastructural resources were also reported as factors influencing IP strategies, namely by female participants.ConclusionGood knowledge and positive attitude towards IP were reported by participants, but exercise-based IP strategies lack implementation. The coach was considered as the most influential person and was reported with the athletes as playing an important role towards successful implementation.

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Holzapfel, Simon D., Pamela R. Bosch, Chong D. Lee, Patricia S. Pohl, Monica Szeto, Brittany Heyer, and Shannon D. Ringenbach. "Acute Effects of Assisted Cycling Therapy on Post-Stroke Motor Function: A Pilot Study." Rehabilitation Research and Practice 2019 (February 13, 2019): 1–10. http://dx.doi.org/10.1155/2019/9028714.

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Background. Stroke is the most common cause of long-term disability in the United States (US). Assisted Cycling Therapy (ACT) at cadences of about 80 rpm has been associated with improvements in motor and clinical function in other clinical populations. The acute effects of ACT on motor function of persons with stroke have not been investigated. Objectives. The primary purpose of this cross-over trial was to compare the effects of ACT, voluntary cycling (VC), and no cycling (NC) on upper (Box and Blocks Test) and lower extremity motor function (Lower Extremity Motor Coordination Test) in adults with chronic stroke (age: 60 ± 16 years; months since stroke: 96 ± 85). The secondary purpose was to examine average cycling cadence and ratings of perceived exertion as predictors of change in motor function following the exercise session. Methods. Twenty-two participants (female = 6, male = 16) completed one 20-min session each of ACT (mean cadence = 79.5 rpm, VC (mean cadence = 51.5 rpm), and NC on separate days in quasi-counterbalanced fashion). Results. Main effects of intervention did not differ between ACT and VC. Within-intervention analyses revealed significant (p < 0.05) pre- to posttest changes in all outcome measures for ACT but only in the Lower Extremity Motor Coordination Test on the non-paretic side for VC. Trend analyses revealed a positive relationship between average ACT cadences and improvements in upper and lower extremity motor function (p < 0.05). A positive relationship between average VC cadences and lower extremity function was also revealed (p < 0.05). Conclusion. ACT and VC produced similar acute improvements in paretic and non-paretic lower extremity motor function whereas changes in upper extremity motor function were more limited. Faster cycling cadences seem to be associated with greater acute effects.

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Thaller, Lisa, Anika Frühauf, Alexander Heimbeck, Ulrich Voderholzer, and Martin Kopp. "A Comparison of Acute Effects of Climbing Therapy with Nordic Walking for Inpatient Adults with Mental Health Disorder: A Clinical Pilot Trial." International Journal of Environmental Research and Public Health 19, no. 11 (June 1, 2022): 6767. http://dx.doi.org/10.3390/ijerph19116767.

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As climbing therapy is increasingly used for mental health disorders, the present study aimed to compare acute effects of a therapeutic climbing intervention (CT) on affective responses, anxiety, and self-efficacy with those of Nordic walking (NW) and a sedentary control condition (SC) in an inpatient setting with persons with depression, anxiety, or obsessive–compulsive disorders. A total of 21 inpatients (32 ± 12.2 years) participated in a clinical trial in all interventions using an experimental within-subject design. Anxiety and self-efficacy were assessed preintervention (t0) and postintervention (t2) using the State-Trait Anxiety Inventory and the General Self-Efficacy Scale, and affective responses were additionally evaluated during (t1) and 180 min after the intervention (t3) using the Feeling Scale, Felt Arousal Scale, and Positive and Negative Affect Schedule. Statistical evaluation was performed with a 3 × 2 or 3 × 4 repeated measures ANOVA. Significant interaction effects were found for affective responses regarding positive affect, affective valence, and perceived activation (p < 0.015) favoring CT over NW and SC. For anxiety, a significant interaction effect was found (F(2.40) = 6.603; p = 0.003; η2 = 0.248), and also perceived self-efficacy increased significantly (F(2.40) = 6.046; p = 0.005; η2 = 0.232). Single CT sessions may enhance affective responses and self-efficacy and reduce anxiety in inpatients with mental health disorders to a higher extent than NW. CT as part of an inpatient therapy program may help to improve key affective mechanisms and should be further studied in comparison with other exercise interventions with comparable intensity.

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Vasylieva, Nataliia O., Tetyana Koziy, Oksana Lavrykova, Yulia Karpukhina, and Tetiana Biriukova. "Effectiveness of Physical Therapy in Middle-Aged Women with Alimentary Form of Obesity of the First Degree." Acta Balneologica 64, no. 3 (2022): 230–34. http://dx.doi.org/10.36740/abal202203105.

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Aim: The objective of the article is to demonstrate the research on the effectiveness of physical therapy in renewal of health of women with alimentary-constitutional type of I degree obesity. The task was also to study the initial level of obesity of women, to develop the structure of the therapeutic rehabilitation complex, to implement the developed programme of physical therapy and evaluate its effectiveness. Materials and Methods: The study was conducted for six months on the basis of a sports and recreation complex, which includes a gym, aerobics and a swimming pool with professional equipment. It was attended by 40 people aged from 33 to 56, with overweight and obesity of I degree. They were divided into two groups: the main (20 people) and control (20 people). The main group used a set of strength physical exercises of aerobic and anaerobic types, diet therapy andconstant online psychological support. The women in the control group performed the standard set of physical exercises that are usually offered in sports facilities and ate at their own discretion. We also used elements of therapeutic exercise to increase energy expenditure, reduce excess weight and strengthen muscles, restore and maintain physical and professional performance. There wereno people with serious disorders of the cardiovascular, endocrine and other body systems among the participants of the study. Results: During the therapeutic programme, we performed monthly control measurements of body parameters and body weight in order to monitor their dynamics and compare it with that in the control group, which was engaged in the standard complex. At the beginning of the study, the results in both groups were quite positive, after some time the rate of weight loss began to slow down, and in the control group, among some participants it even worsened – the weight returned. 6 months after the initial control, a final control of both groups of women of second adulthood was performed. When comparing the data obtained before and after rehabilitation measures, we observed a significant decrease in body weight in individuals of the study group in contrast to the control, where there was a decrease in body weight, but it was statistically insignificant. Analysis of the dynamics of monthly weight loss for the entire rehabilitation period showed that in the control group there was a decrease in body weight in the first and second months of the rehabilitation complex, relative to the main group, then the dynamics was marked by significant weight loss in the 1st, 2nd, 3rd month. Conclusions: Based on the obtained results, we proved the high efficiency of the proposed therapeutic and rehabilitation complex (combination of diet therapy, exercises of aerobic and anaerobic directions) for the treatment of persons with I degree of obesity (significantly reduced body weight and reduced the size of body parts). Rehabilitation measures used in our study activate metabolic processes, increase energy expenditure, reduce excess body weight, strengthen the body. By following a healthy lifestyle, eating rationally, you can prevent a number of diseases, improve efficiency and general well-being, avoid premature aging. Physical therapy of obese patients requires a combination of dietary and physiotherapeutic methods (massage, physiotherapy, psychological training), which allows to achieve sustainable weight loss for a long period.

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Dupuis, Frédérique, Julien Déry, Fabio Carlos Lucas de Oliveira, Ana Tereza Pecora, Rose Gagnon, Katherine Harding, Chantal Camden, et al. "Strategies to reduce waiting times in outpatient rehabilitation services for adults with physical disabilities: A systematic literature review." Journal of Health Services Research & Policy 27, no. 2 (February 12, 2022): 157–67. http://dx.doi.org/10.1177/13558196211065707.

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Objective Identifying effective strategies to reduce waiting times is a crucial issue in many areas of health services. Long waiting times for rehabilitation services have been associated with numerous adverse effects in people with disabilities. The main objective of this study was to conduct a systematic literature review to assess the effectiveness of service redesign strategies to reduce waiting times in outpatient rehabilitation services for adults with physical disabilities. Methods We conducted a systematic review, searching three databases (MEDLINE, CINAHL and EMBASE) from their inception until May 2021. We identified studies with comparative data evaluating the effect of rehabilitation services redesign strategies on reducing waiting times. The Mixed Methods Appraisal Tool was used to assess the methodological quality of the studies. A narrative synthesis was conducted. Results Nineteen articles including various settings and populations met the selection criteria. They covered physiotherapy ( n = 11), occupational therapy ( n = 2), prosthetics ( n = 1), exercise physiology ( n = 1) and multidisciplinary ( n = 4) services. The methodological quality varied ( n = 10 high quality, n = 6 medium, n = 3 low); common flaws being missing information on the pre-redesign setting and characteristics of the populations. Seven articles assessed access processes or referral management strategies (e.g. self-referral), four focused on extending/modifying the roles of service providers (e.g. to triage) and eight changed the model of care delivery (e.g. mode of intervention). The different redesign strategies had positive effects on waiting times in outpatient rehabilitation services. Conclusions This review highlights the positive effects of many service redesign strategies. These findings suggest that there are several effective strategies to choose from to reduce waiting times and help better respond to the needs of persons experiencing physical disabilities.

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Jacob, C., K. Roff, J. Fleet, J. Jones, C. A. Wood, H. Jensen, S. Allen, et al. "58 Can Volunteers Improve the Well-Being, Participation and Activity of Patients on An Acute Older-Persons’ Unit in Hospital?" Age and Ageing 49, Supplement_1 (February 2020): i14—i17. http://dx.doi.org/10.1093/ageing/afz186.12.

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Abstract Background A multi-disciplinary led, charity-funded initiative was implemented to deliver an Activity Promotion Project (APP) on the older adult wards of a large teaching hospital, providing acute medical management for adults over 65 with complex needs. Introduction Previous local studies show that our patients are inactive, lonely and their activity is inhibited by ward culture. Cognitively impaired patients experiencing long delays for placement are often agitated and restless. Staff feel disheartened by their inability to spare time for non-medical needs. To respond to the Social Prescribing directive the APP aims to create a sustainable volunteer team to provide patients with company, stimulation and opportunities to be active. Methods A Volunteer and Activity Coordinator (VAC) was appointed to recruit, train and coordinate applicants for the volunteer role on the unit which is advertised on the trust website. Analysis of volunteer team impact has been through patient, carer and staff surveys. Observational studies recorded patients’ physical position, activity and company as well as use of the dayrooms before and during the project. Interventions Patients of all functional abilities can be referred by any staff member. Individual and group activities include conversation, games, reminiscence quizzes, lunch and tea parties, musical bingo, walking tours, trips to hospital facilities and gardens and visits from therapy dogs and musicians. Before discharge participating patients are given information about local social and exercise opportunities. Results All staff surveyed would recommend the project to colleagues, 97% thought it improved patient mood. One noted: ‘volunteers have created a new energy on the ward, the patients appear to be much more engaged and occupied, and the dayroom is being used as it is intended to be’. Observational data showed a change in the percentage of patients resting in bed from 59% before the intervention to 49% during and a decrease in patients who were alone from 83% to 60%. Conclusions The volunteer team has had a positive effect on ward culture and patient well-being and could be replicated in other ward settings. The programme’s impact is contingent on the consistency and reliability of volunteers, which makes the role of the VAC essential for careful management and communication of clear expectations. The VAC role will be proposed in business planning for next financial year.

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Golec, Joanna, Damian Turzański, Justyna J. Golec, Krzysztof Tomaszewski, Elżbieta Szczygieł, Agata Masłoń, Dorota Czechowska, and Edward Golec. "Evaluation of transverse abdominal muscle thickness and the quality of life in patients undergoing rehabilitation due to disc-root conflict in the lumbo-sacral spine treated surgically using the spinal disc resection method." Rehabilitacja Medyczna 23, no. 1 (February 12, 2019): 4–10. http://dx.doi.org/10.5604/01.3001.0013.0252.

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Purpose: The aim of the study was to determine the relationship between the changes in abdominal transverse muscle thickness (TrA) after therapy that included elements of reeducation of central stabilisation, and pain reduction as well as quality of patients’ life after intervertebral disc resection of lumbar spine. Material and methods: The study group consisted of 30 patients (17 women and 13 men) aged 28-87 (58 ± 15) participating in a rehabilitation stay. All subjects underwent intervertebral disc resection (LS level) within the years 2012-2016. All subjects included in the study underwent ultrasound evaluation of the thickness of the TrA muscle, evaluation of activation ratio, percentage change in muscle thickness, evaluation of the quality of life with SF-36, assessment of pain components on the VAS scale and level of disability using the Barthel index. All the subjects were referred to a 3-week therapy programme combined with motor control re-education including deep muscle training. The tests were performed before and after the physiotherapy on the basis of the original exercise programme. Results and conclusions: The percentage of TrA muscle thickness change in the first exam was 15.84 ±0.1%, and 16.09 ±0.13% after treatment. There were no statistically significant differences between the measurements. In the assessment of quality of life, patients in the first exam reached the score of 113.23 ±28.07 points, whereas in the second one - 85.1 ±27.05 points. The difference between the results was statistically significant (p<0.001). Pain components on the VAS scale were assessed at 4.3 ±0.83 points on average in the former exam, and 2.83 ±1.04 points in the latter one. The difference in measurements was statistically significant (p<0.001). The assessment of the level of disability using the Barthel scale with an average score of 93.66 ±8.4 points, conducted in the first exam, indicated that the studied persons were characterised by full efficiency. The original therapy, carried out among subjects operated on due to disc-root conflict of the LS spine, has a positive effect on the thickness of the TrA muscle both in contraction and at rest, and also reduces the level of pain while improving quality of life.

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Drain, Paul K., Roland Kupka, Ferdinand Mugusi, and Wafaie W. Fawzi. "Micronutrients in HIV-positive persons receiving highly active antiretroviral therapy." American Journal of Clinical Nutrition 85, no. 2 (February 1, 2007): 333–45. http://dx.doi.org/10.1093/ajcn/85.2.333.

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MOR, S. M., J. A. AMINAWUNG, A. DEMARIA, and E. N. NAUMOVA. "Pneumonia and influenza hospitalization in HIV-positive seniors." Epidemiology and Infection 139, no. 9 (November 26, 2010): 1317–25. http://dx.doi.org/10.1017/s0950268810002669.

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SUMMARYHIV-positive persons and the elderly have increased risk for influenza-related complications, including pneumonia. Using claims data for pneumonia and influenza (P&I) hospitalization in the USA, we described the temporo-demographic trends and in-patient case-fatality in persons aged ⩾65 years by HIV status. Our results showed a near doubling in the fraction of P&I admissions representing HIV-positive persons between 1991 and 2004 [relative risk (RR) 1·95, 95% confidence interval (CI) 1·80–2·13]. HIV-positive adults were younger (70·3 vs. 79·9 years, P<0·001), and had higher case-fatality (18·0% vs. 12·6%, P<0·001). Adjusting for other variables, case-fatality decreased by 5·8% in HIV-positive persons with the availability of highly active antiretroviral therapy (P=0·032). However, HIV-positive seniors were still 51% more likely to die during hospitalization than HIV-negative persons in 2004 (OR 1·51, 95% CI 1·23–1·85). HIV-infected persons represent a growing fraction of the elderly population hospitalized with P&I. Additional measures are needed to reduce case-fatality associated with P&I in this population.

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Ryom, Lene, Amanda Mocroft, and Jens D. Lundgren. "Antiretroviral therapy, immune suppression and renal impairment in HIV-positive persons." Current Opinion in HIV and AIDS 9, no. 1 (January 2014): 41–47. http://dx.doi.org/10.1097/coh.0000000000000023.

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Targ, Elisabeth F., Dan H. Karasic, Pamela N. Diefenbach, Daniel A. Anderson, Alexander Bystritsky, and Fawzy I. Fawzy. "Structured Group Therapy and Fluoxetine to Treat Depression in HIV-Positive Persons." Psychosomatics 35, no. 2 (March 1994): 132–37. http://dx.doi.org/10.1016/s0033-3182(94)71786-2.

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Podolak-Dawidziak, Maria Helena, Janusz Zawilski, Mariola Bober, Ewa Stefanska-Windyga, Anna Buczma, and Iwona Prajs. "The Influence of Personalized 2-Year Physiotherapy on Musculoskeletal Health and Quality of Life in Severe Hemophilia Patients with Inhibitor - Interim Analysis after 1 Year of the Program." Blood 136, Supplement 1 (November 5, 2020): 36. http://dx.doi.org/10.1182/blood-2020-139151.

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Development of factor VIII (FVIII) inhibitor is a serious complication of factor replacement therapy observed in about 15-30% of severe hemophilia A (HA) patients. Inhibitors interfere with the treatment by neutralizing intravenously injected FVIII. Although bleeding rate is not increased in severe HA patients who developed the inhibitor, the inhibitors reduce the efficacy of factor replacement therapy during bleeding episodes and in consequence accelerate the progression of hemophilic arthropathy. In Poland, prophylaxis in hemophilia with inhibitors has been introduced in 2016, and therefore many HA patients with inhibitor still suffer from particularly severe arthropathy, and have a reduced quality of life. The aim of the study was to evaluate the musculoskeletal health and quality of life in patients with severe hemophilia A with inhibitor before initiation of personalized physiotherapy and after 2 years of the personalized physiotherapeutic program. The study was performed in 24 persons with severe HA with inhibitor (mean age 42.1 years, median age 42 years) receiving prophylaxis regimen with aPCC 85 ± 15 IU/kg 3 times a week. At the beginning of the project, the patients were examined by hematologist and physiotherapist. Joint condition was evaluated using the Hemophilia Joint Health Score (HJHS) and magnetic resonance imaging of the most affected joint. Quality of life was evaluated using EQ-5D scale (EuroQoL). aPCC dosing schedule in context of rehabilitation program was adjusted by the hematologist. Each patient was enrolled to a personalized exercise program developed based on age, general condition, stage of arthropathy, date of the last bleeding episode, and a history of physiotherapy. The program consisted of weekly 60 to 90 minutes rehabilitation sessions at home, and participated in four 5-day rehabilitation camps with 5 hours of rehabilitation sessions a day organized in Poznan after 6, 12, 18 and 24 months of the program. All patients were examined by hematologist, and the rehabilitation was provided only to the patients on regular prophylaxis with aPCC provided that a dose of aPCC was always administered 1 hour before the initiation of rehabilitation session. HJHS varied among the participants, with mean value at baseline 34.2 (median 36.5). Baseline mean EQ-5D score was 54.2 (median 60). Evaluation at month 12 was performed in 18 participants (2 patients withdrawn from the program, and 4 patients could not participate in the evaluation due to COVID-19 pandemics). The results obtained at month 12 show a significant improving the quality of life and musculoskeletal health of patients with HA after combined prophylaxis and personalized rehabilitation. Mean HJHS decreased from 34.2 to 30.4 points (median from 36.5 to 31 points). An average 3.8 point decrease confirms positive effects of long-term aPCC prophylaxis with personalized, regular rehabilitation. Increase in mean EQ-5D score from 54.2 to 70.1 (median from 60 to 72) show enhancing patients' mood resulted from the improved health status and regained capability to conduct more normal lifestyle. After the first year of the project we can conclude that regular prophylaxis with aPCC and personalized, once-a-week rehabilitation program positively influence joint status and quality of life of adult HA patients with inhibitor complicated with significant arthropathy. Regular rehabilitation may slow down the progression of arthropathy due to the choice of the exercise program appropriate for each patient. These positive effects justify the continuation of the project in patients with hemophilia A with inhibitor. Figure Disclosures No relevant conflicts of interest to declare.

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Titanji, Boghuma, Alfonso C. Hernandez-Romieu, and Max W. Adelman. "Incidence and Severity of COVID-19 in HIV-Positive Persons Receiving Antiretroviral Therapy." Annals of Internal Medicine 174, no. 4 (April 2021): 580–81. http://dx.doi.org/10.7326/l20-1398.

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del Amo, Julia, Rosa Polo, Santiago Moreno, Asunción Díaz, Esteban Martínez, José Ramón Arribas, Inma Jarrín, and Miguel A. Hernán. "Incidence and Severity of COVID-19 in HIV-Positive Persons Receiving Antiretroviral Therapy." Annals of Internal Medicine 174, no. 4 (April 2021): 581–82. http://dx.doi.org/10.7326/l20-1399.

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del Amo, Julia, Rosa Polo, Santiago Moreno, Asunción Díaz, Esteban Martínez, José Ramón Arribas, Inma Jarrín, and Miguel A. Hernán. "Incidence and Severity of COVID-19 in HIV-Positive Persons Receiving Antiretroviral Therapy." Annals of Internal Medicine 173, no. 7 (October 6, 2020): 536–41. http://dx.doi.org/10.7326/m20-3689.

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Marceau, Geoffroy, Vincent Sapin, Christine Jacomet, Sylvie Ughetto, Louis Cormerais, Christel Regagnon, Bernard Dastugue, Hélène Peigue-Lafeuille, Jean Beytout, and Henri Laurichesse. "Frequency, Risk Factors, and Outcome of Hyperlactatemia in HIV-positive Persons: Implications for the Management of Treated Patients." Clinical Chemistry 49, no. 7 (July 1, 2003): 1154–62. http://dx.doi.org/10.1373/49.7.1154.

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Abstract Background: The nucleoside reverse transcriptase inhibitors used for the treatment of HIV-positive persons are now clearly associated with metabolic disorders. We determined the prevalence of and risk factors for hyperlactatemia in HIV-positive persons to assess the relevance of lactate venous blood concentrations during antiretroviral therapy. Methods: We conducted a prospective cross-sectional study of venous lactate determinations with 282 consecutive HIV-positive persons who, in addition to a physical examination, had blood samples taken every 3–4 months for routine biochemical, immunologic, and viral assessment. The frequencies of hyperlactatemia and lactic acidosis were determined, and the risk factors were analyzed by a multivariate logistic regression model. The effect of modification of antiretroviral therapy in patients with moderate hyperlactatemia was also assessed. Results: From 782 blood lactate determinations, we identified 65 (23%) patients with moderate hyperlactatemia and 5 (1.8%) with lactate concentrations >5 mmol/L (2 with severe lactic acidosis; 0.7%). Older age, drug regimens containing stavudine [adjusted odds ratio (OR) = 2.5] or a combination of stavudine-didanosine (adjusted OR = 3.1), and the use of buprenorphine (adjusted OR = 14.7) were independent predictors of hyperlactatemia. Among 65 patients with moderate hyperlactatemia, 39 did not have their treatments changed, and 26 had a new combination therapy that was associated with a clinical improvement and a more pronounced decrease in lactate (−1.66 vs −0.99 mmol/L; P <0.05). Conclusions: Chronic compensated and moderate hyperlactatemia was common in our population study. Measurement of lactate, under standardized conditions, may be useful in optimizing management of HIV-positive persons on antiretroviral therapy.

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Toft, Lars, Martin Tolstrup, Merete Storgaard, Lars Østergaard, and Ole S. Søgaard. "Vaccination against oncogenic human papillomavirus infection in HIV-infected populations: review of current status and future perspectives." Sexual Health 11, no. 6 (2014): 511. http://dx.doi.org/10.1071/sh14015.

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Background Men and women with HIV infection are at increased risk of developing cancers associated with human papillomavirus (HPV). The two licensed prophylactic HPV vaccines protect against de novo infection with HPV-16 and HPV-18, which cause the majority of HPV-associated cancers. Currently, no vaccine efficacy data are available for persons with HIV infection. Nevertheless, some countries have implemented specific HPV vaccination recommendations for HIV-positive populations. To specifically recommend prophylactic HPV vaccination in people with HIV, the vaccines must be safe and immunogenic in immunosuppressed people at a high risk of HPV infection. This review aims to summarise the current knowledge from published HPV vaccine trials in HIV-infected populations, to compile scheduled and ongoing HPV vaccine trials with HIV-positive study populations and to extrapolate the relevant knowledge about HPV vaccine efficacy in HIV-negative populations to an HIV context. Methods: The databases PubMed, Scopus and ClinicalTrials.gov were searched for peer-reviewed articles and scheduled or ongoing clinical HPV vaccine trials enrolling HIV-positive persons. Results: Current data indicate that prophylactic HPV vaccines are safe and immunogenic in different HIV-positive populations (children, female adolescents, adults). Increased immunogenicity has been reported in persons on antiretroviral therapy compared with antiretroviral-naïve persons, whereas no clear association has been found between CD4+ cell count at immunisation and vaccine response. Several scheduled and ongoing HPV vaccine trials aim to determine vaccine efficacy against disease endpoints in HIV-infected study populations. Conclusion: Prophylactic HPV vaccination appears safe, immunogenic and, by extrapolation, likely to reduce HPV-associated cancer development among persons with HIV infection.

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Heymer, Kelly-Jean, Matthias Wentzlaff-Eggebert, Elissa Mortimer, and David P. Wilson. "An economic case for providing free access to antiretroviral therapy for HIV-positive people in South Australia." Sexual Health 9, no. 3 (2012): 220. http://dx.doi.org/10.1071/sh10148.

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Background As financial constraints can be a barrier to accessing HIV antiretroviral therapy (ART), we argue for the removal of copayment requirements from HIV medications in South Australia. Methods: Using a simple mathematical model informed by available behavioural and biological data and reflecting the HIV epidemiology in South Australia, we calculated the expected number of new HIV transmissions caused by persons who are not currently on ART compared with transmissions for people on ART. The extra financial investment required to cover the copayments to prevent an HIV infection was compared with the treatment costs saved due to averting HIV infections. Results: It was estimated that one HIV infection is prevented per year for every 31.4 persons (median, 24.0–42.7 interquartile range (IQR)) who receive treatment. By considering the incremental change in costs and outcomes of a change in program from the current status quo, it would cost the health sector $17 860 per infection averted (median, $13 651–24 287 IQR) if ART is provided as a three-dose, three-drug combination without requirements for user-pay copayments. Conclusions: The costs of removing copayment fees for ART are less than the costs of treating extra HIV infections that would result under current conditions. Removing the copayment requirement for HIV medication would be cost-effective from a governmental perspective.

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Mohite, Ashok R., Pravir A. Gambhire, Sunil V. Pawar, Samit S. Jain, Qais Q. Contractor, and Pravin M. Rathi. "Changing clinical profile and factors associated with liver enzyme abnormalities among HIV-infected persons." Tropical Doctor 47, no. 3 (June 24, 2016): 205–11. http://dx.doi.org/10.1177/0049475516655068.

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The spectrum of liver disease among HIV-infected patients is changing. In the era of antiretroviral therapy, opportunistic infections are diminishing and deranged liver function appears to be due usually to drug-induced liver injury, alcohol, non-alcoholic steatohepatitis (NASH) or chronic hepatitis B. To test this hypothesis, 98 HIV-positive patients with deranged liver function were compared with matched HIV-positive patients with normal liver function and likewise matched HIV-negative patients with normal liver function tests.

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Teer, Eman, and M. Faadiel Essop. "HIV and Cardiovascular Disease: Role of Immunometabolic Perturbations." Physiology 33, no. 1 (January 1, 2018): 74–82. http://dx.doi.org/10.1152/physiol.00028.2017.

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The successful rollout of anti-retroviral therapy ensured that HIV is increasingly managed as a chronic condition. HIV-positive persons are therefore exhibiting increased cardiovascular complications. This review focuses on the emerging role of ”immunometabolism” within the context of HIV-related immune dysregulation and cardiovascular disease onset. Here, persistent immune activation contributes to pathophysiological perturbations during early infection, resulting in immune cell metabolic reprogramming and the activation of coagulation pathways in HIV-positive individuals.

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Ajayi, Bamidele David, John Omotola Ogunkoya, and Folake Olubunmi Ajayi. "Latent Tuberculosis Infection and Isoniazid Preventive Therapy among Human Immunodeficiency Virus positive adults in Southern Nigeria." Research Journal of Health Sciences 10, no. 4 (December 8, 2022): 305–18. http://dx.doi.org/10.4314/rejhs.v10i4.1.

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Aim/objectives: It was aimed to assess the prevalence of latent TB among HIV+ patients, evaluate the coverage of isoniazid preventive therapy (IPT), the continuous risk of latent tuberculosis infection, and factors associated with the presence of latent Tb in HIV+ patients. Methods: This is an analytical cross-sectional study of HIV+ patients attending the HIV clinic or admitted not previously treated for TB and did not have clinical and laboratory evidence of active TB and matched HIV-negative population attending our GOC. Data collected with a pre-tested investigator administered questionnaire included the age, sex, height and weight, medical and drug history, and relevant physical examination findings such as body temperature and respiratory rate. Active TB was excluded by history, sputum AFB Z-N staining, or GeneXpert test and chest radiography. Whole blood samples were collected from participants for QuantiFERON TB Gold Plus for quantification of Interferon Gamma Release assay (IGRA) in order to diagnose or exclude latent TB. Data were analyzed using IBM SPSS version 25.0 software at a level of significance of p < 0.05. Association between means and qualitative variables was analyzed with student-t-test and Chi-square test Results: The mean ages of the HIV+ and control groups were 42.69 ± 9.91 and 41.29 ± 9.20 years respectively with no significant statistical difference. 76(95.0%) of HIV+ patients and 74(92.5%) controls had no symptoms of TB and chronic lung disease. 18(22.5%) HIV+ patients and 2(2.5%) controls were exposed to persons with chronic cough (p=<0.001). The prevalence of latent TB among HIV+ patients was 22.50% and 10.0% among controls (p- value=0.001). 8(44.4%) out of 18 with latent TB had prior use of IPT compared with 24 (38.7%) out of 62 without latent TB (p-value =0.67). CD4 count was a significant factor associated with the presence of latent TB among HIV+ persons (p-0.03). Similarly, there was a significant association between viral load and positive IGRA (p<0.001). Conclusion: Latent TB infection remains significantly higher among HIV+ than HIV-negative patients which may account for the higher incidence of active disease amongst them. Isoniazid preventive therapy coverage was poor amongst HIV+ patients in this study.

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Carrico, Adam W., Mallory O. Johnson, Judith T. Moskowitz, Torsten B. Neilands, Stephen F. Morin, Edwin D. Charlebois, Wayne T. Steward, et al. "Affect Regulation, Stimulant Use, and Viral Load Among HIV-Positive Persons on Anti-Retroviral Therapy." Psychosomatic Medicine 69, no. 8 (October 2007): 785–92. http://dx.doi.org/10.1097/psy.0b013e318157b142.

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Pallotta, Andrea M., Sana A. Pirzada, Rabin K. Shrestha, Belinda Yen-Lieberman, Leonard H. Calabrese, Alan J. Taege, Robert S. Butler, and Ume L. Abbas. "Presentation to HIV care and antiretroviral therapy initiation and response in clinical practice from 2003 through 2013." International Journal of STD & AIDS 30, no. 9 (July 7, 2019): 853–60. http://dx.doi.org/10.1177/0956462419841219.

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Universal HIV screening and treatment initiation of HIV-positive persons are well-established standards. However, late presentation to care is a barrier to early antiretroviral therapy (ART) and prevention of HIV transmission. We sought to determine the immunodeficiency at presentation to care and characterize the initiation and response to ART among HIV-positive persons over 2003–2013 in our urban HIV clinical practice at the Cleveland Clinic. Using a retrospective cohort study design, we assessed the CD4 cell count of HIV-positive patients at entry into care for each year and evaluated the trend over time. For patients who initiated treatment, we assessed the pretreatment CD4 cell count, consistency of timing and regimen with US treatment guidelines, and HIV RNA level at one-year and last follow-up visits. Regression analyses were used to determine predictors of study outcomes. We found that the cohort (N = 452) median CD4 cell count at presentation to care was 297 cells/mm3 (inter-quartile range: 104–479 cells/mm3), without any significant change over time (P = 0.62), and with 37% and 21% of presentations being late and advanced, respectively. Guideline-consistency (85%–100%) and regimen-consistency (41%–100%) were moderate to high and improved over time. Virologic suppression (<400 copies/ml) at one year and last follow-up was high (79% and 92%) and associated with regimen selection and durability. We conclude that CD4 cell count at first presentation to HIV care remained less than 350 cells/mm3 for 11 years in our clinical practice, despite advances in HIV testing and treatment guidelines. Early diagnosis and linkage to care and treatment are critical for ending the HIV epidemic.

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Cigarroa, Igor, Estefanía Díaz, Constanza Ortiz, Raquel Otero, Irene Cantarero, Fanny Petermann-Rocha, Solange Parra-Soto, Rafael Zapata-Lamana, and David Toloza-Ramírez. "Characteristics and effects of physical exercise programs for older cancer survivors: A scoping review (Características y efectos de los programas de ejercicio físico para personas mayores sobrevivientes de cáncer: Una revisión de alcance)." Retos 44 (November 20, 2021): 370–85. http://dx.doi.org/10.47197/retos.v44i0.90843.

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There is a discrepancy about the characteristics and effects of exercise-based programs in older cancer survivors (OCS). Therefore, this scoping review aimed to identify the characteristics and effects of physical activity programs in OCS health. This scoping review followed the PRISMA guidelines and included randomized clinical trials and clinical trials from MEDLINE by PubMed, Scopus, Scielo, and PEDro, published between 2010 and 2020. Results suggest that physical programs were carried out in health centers (54.2%) and were based on physical exercise (74.4%). The length of the exercise interventions was between 3–6 months (87.5%) was performed 2–3 times per week (73.1%) with a duration between 20–60 minutes (78.2%) and was run by health professionals (94.4%). The health outcomes with the most positive effects were physical activity, depression, and quality of life. In conclusion, physical programs for OCS based on aerobic exercises are safe and could be a therapeutic strategy to improve different health markers in OCS. Resumen. En la literatura existe discrepancia sobre las características y los efectos de los programas basados en el ejercicio físico en sobrevivientes de cáncer (SC) de edad avanzada. Por lo tanto, esta revisión de alcance tuvo como objetivo identificar las características y los efectos de los programas de actividad física en la salud de personas SC de edad avanzada. Esta revisión de ensayos clínicos aleatorizados y ensayos clínicos, se realizó considerando las siguientes bases de datos: MEDLINE (de Pubmed), Scopus, Scielo y PEDro, entre los años 2010 y 2020. Los resultados indican que los programas de ejercicio se realizaron en centros de salud (54.2%), y se basaron en ejercicio físico principalmente (74.4%). La extensión de las intervenciones físicas fue entre 3–6 meses (87.5%), se realizaron 2–3 veces por semana (73.1%) con una duración entre 20–60 minutos, y fueron dirigidas por profesionales de salud (94.4%). El impacto sobre la salud con mayores efectos positivos fueron la actividad física, la depresión y la calidad de vida. En conclusión, los programas de ejercitación física para personas SC en edad avanzada, basados en ejercicios aeróbicos son seguros y podrían ser una estrategia terapéutica para mejorar diferentes variables de salud en este grupo de personas.

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Lebelonyane, Refeletswe, Pamela Bachanas, Lisa Block, Faith Ussery, Mary Grace Alwano, Tafireyi Marukutira, Shenaaz El Halabi, et al. "To achieve 95-95-95 targets we must reach men and youth: High level of knowledge of HIV status, ART coverage, and viral suppression in the Botswana Combination Prevention Project through universal test and treat approach." PLOS ONE 16, no. 8 (August 10, 2021): e0255227. http://dx.doi.org/10.1371/journal.pone.0255227.

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Background Increasing HIV treatment coverage is crucial to reducing population-level HIV incidence. Methods The Botswana Combination Prevention Project (BCPP) was a community randomized trial examining the impact of multiple prevention interventions on population-level HIV incidence and was conducted from October 2013 through June 2017. Home and mobile campaigns offered HIV testing to all individuals ≥ age 16. All identified HIV-positive persons who were not on antiretroviral therapy (ART) were referred to treatment and tracked to determine linkage to care, ART status, retention in treatment, and viral suppression Results Of an estimated total of 14,270 people living with HIV (PLHIV) residing in the 15 intervention communities, BCPP identified 13,328 HIV-positive persons (93%). At study start, 10,703 (80%) of estimated PLHIV knew their status; 2,625 (20%) learned their status during BCPP, a 25% increase with the greatest increases occurring among men (37%) and youth (77%). At study start, 9,258 (65%) of estimated PLHIV were on ART. An additional 3,001 persons started ART through the study. By study end, 12,259 had initiated and were retained on ART, increasing coverage to 93%. A greater increase in ART coverage was achieved among men (40%) compared to women (29%). Of the 11,954 persons who had viral load (VL) test results, 11,687 (98%) were virally suppressed (HIV-1 RNA ≤400 copies/mL). Overall, 82% had documented VL suppression by study end. Conclusions Knowledge of HIV-positive status and ART coverage increased towards 95–95 targets with universal testing, linkage interventions, and ART. The increases in HIV testing and ART use among men and youth were essential to reaching these targets. Clinical trial number NCT01965470.

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Custer, Brian, Claire Quiner, Richard Haaland, Amy Martin, Mars Stone, Rita Reik, Whitney R. Steele, et al. "HIV antiretroviral therapy and prevention use in US blood donors: a new blood safety concern." Blood 136, no. 11 (September 10, 2020): 1351–58. http://dx.doi.org/10.1182/blood.2020006890.

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Abstract Antiretroviral therapy (ART) to treat and pre-exposure prophylaxis (PrEP) to prevent HIV infection are effective tools to help end the HIV epidemic. However, their use could affect HIV transfusion-transmission risk. Three different ART/PrEP prevalence analyses in blood donors were conducted. First, blood samples from HIV-positive and a comparison group of infection-nonreactive donors were tested under blind using liquid chromatography-tandem mass spectrometry for ART. Second, blood donor samples from infection-nonreactive, 18- to 45-year-old, male, first-time blood donors in 6 US locations were tested for emtricitabine and tenofovir. Third, in men who have sex with men (MSM) participating in the 2017 Centers for Disease Control and Prevention National HIV Behavioral Surveillance (NHBS) from 5 US cities, self-reported PrEP use proximate to donation was assessed. In blind testing, no ART was detected in 300 infection-nonreactive donor samples, but in 299 HIV confirmed-infected donor samples, 46 (15.4%; 95% confidence interval [CI], 11.5% to 20.0%) had evidence of ART. Of the 1494 samples tested from first-time male donors, 9 (0.6%; 95% CI, 0.03% to 1.1%) had tenofovir and emtricitabine. In the NHBS MSM survey, 27 of 591 respondents (4.8%; 95% CI, 3.2% to 6.9%) reported donating blood in 2016 or 2017 and PrEP use within the same time frame as blood donation. Persons who are HIV positive and taking ART and persons taking PrEP to prevent HIV infection are donating blood. Both situations could lead to increased risk of HIV transfusion transmission if blood screening assays are unable to detect HIV in donations from infected donors.

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Tegbaru, Belete, Dawit Wolday, Tsehaynesh Messele, Mengistu Legesse, Yared Mekonnen, Frank Miedema, and Debbie van Baarle. "Tuberculin Skin Test Conversion and Reactivity Rates among Adults with and without Human Immunodeficiency Virus in Urban Settings in Ethiopia." Clinical and Vaccine Immunology 13, no. 7 (July 2006): 784–89. http://dx.doi.org/10.1128/cvi.00098-06.

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ABSTRACT To investigate whether low CD4+ T-cell counts in healthy and human immunodeficiency virus (HIV)-infected Ethiopians influence tuberculosis (TB) immunological memory, tuberculin skin test (TST) conversion and reactivity rates were investigated among adults with and without HIV infection in urban settings in Ethiopia. Reaction to the TST was analyzed with purified protein derivative by the Mantoux technique. A total of 1,286 individuals with TST results of ≥5-mm (n = 851) and ≤4-mm (n = 435) induration diameters were included. Individuals with ≤4-mm induration sizes were followed up for 21.4 ± 9.5 months (mean ± standard deviation) to observe skin test conversion. The overall TST reactivity (≥5-mm induration diameter) was 66.2% (n = 851). Reactivity was significantly lower among HIV-positive persons (40.5%) than among HIV-negative persons (68.7%) (P < 0.001). Of the above persons, 32 incident TB patients were checked for their TST status 13.05 ± 11.1 months before diagnosis and reactivity was found among 22 (68.7%) of them. Of the TST-negative persons with 0- to 4-mm indurations who were followed up for 3 years, the conversion rate to positivity was 17.9/100 person-years of observation (PYO) (14.4/100 PYO and 18.3/100 PYO in HIV-positive and -negative persons, respectively). Despite lower absolute CD4+ T-cell numbers in Ethiopians, higher TST conversion and reactivity rates show the presence of a higher rate of latent TB infection and/or transmission. The lower TST positivity rate before a diagnosis of TB disease showed the lower sensitivity of the test. This indicates the need for other sensitive and specific diagnostic and screening methods to detect TB infection, particularly among HIV-positive persons, so that they can be given prophylactic isoniazid therapy.

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Mazaheri-Tehrani, Elham, Vahid Nejati, Alinaghi Seyed, Omid Dadras, Andrea Cossarizza, Cristina Mussini, Nasab Ahsani, et al. "Prevalence of HIV-associated neurocognitive disorder (HAND) and its subgroups among HIV-positive persons on anti-retroviral therapy in Iran." Psihologija 53, no. 2 (2020): 115–27. http://dx.doi.org/10.2298/psi190414001m.

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This study aimed to determine the prevalence and determinants of HIV-associated neurocognitive disorder (HAND) and its subgroups in HIV-positive patients in Tehran, Iran. Ninety-three HIV-positive individuals were assessed; the majority were male (60%) and the mean age of patients was 36.5 years (SD = 9), with 8 years as the median duration of HIV infection. The relationship between demographic and clinical variables was examined using logistic regression analysis. The overall prevalences of HAND and cognitive complaints were 50.5% and 73%, respectively. Lower nadir CD4 counts (? 200), lower educational levels (? 12 years), longer disease duration (? 5years), and higher depression rates were positively associated with the presence of HAND. This study shows that the prevalence of HANDs in Iran is high, but similar to the prevalence levels found in Western societies. Further studies are needed to longitudinally evaluate the presence of HAND, in particularly to recognize new biomarkers and specific neurocognitive domains in HIV.

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Fomundam, H. N., A. R. Tesfay, S. A. Mushipe, H. T. Nyambi, A. Larsen, M. Cheyip, G. Aynalem, and A. K. Wutoh. "Initiation of Isoniazid Prophylactic Therapy among Newly Diagnosed HIV-Positive Persons in Three High HIV-Burden Districts of South Africa." World Journal of AIDS 10, no. 02 (2020): 107–18. http://dx.doi.org/10.4236/wja.2020.102009.

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Adeneye, A. K., T. A. Adewole, A. Z. Musa, D. Onwujekwe, N. N. Odunukwe, I. D. Araoyinbo, T. A. Gbajabiamila, P. M. Ezeobi, and E. O. Idigbe. "Limitations to Access and Use of Antiretroviral Therapy (ART) Among HIV Positive Persons in Lagos, Nigeria." World Health & Population 8, no. 2 (April 15, 2006): 46–56. http://dx.doi.org/10.12927/whp.2006.18134.

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Journal articles on the topic 'HIV-positive persons Exercise therapy'

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