headshot of CWRU nursing faculty Allison Webel
Allison Webel

HIV patients may soon be prescribed home exercise to help ward off chronic illnesses

headshot of CWRU nursing faculty Allison Webel
Allison Webel

In addition to antiretroviral medications, people with HIV may soon begin receiving a home exercise plan from their doctors, according to a researcher at Case Western Reserve University’s Frances Payne Bolton School of Nursing.

“People with HIV are developing secondary chronic illnesses earlier and more frequently than their non-HIV counterparts,” said Allison Webel, assistant professor of nursing. “And heart disease is one for which they are especially at risk.”

An estimated 1.2 million people nationally live with HIV, according to the Centers for Disease Control and Prevention.

Studies have shown that people with HIV can engage in a variety of moderate to intensive physical exercises that result in a range of benefits, from lower cholesterol to better cognitive and mental health outcomes.

But a search of research literature turned up just two programs specifically designed for people with HIV to exercise at home.

With the long-term goal of creating a new evidence-based, home-exercise intervention that doctors can share with HIV patients, researchers from Case Western Reserve, Kent State University and University Hospitals Case Medical Center wanted to first find out whether people with HIV even exercise at home.

They recruited 102 HIV patients to study their weekly exercise habits and found that most did exercise, but not intensely enough.

According to The Journal of the Association of Nurses in AIDS Care article, “A Cross-Sectional Description of Age and Gender Differences in Exercise Patterns in Adults Living with HIV,” the researchers found that women exercised an average of 2.4 hours a week and men for 3.5 hours. The predominant exercise was walking, followed by climbing stairs, stretching and lifting weights.

Remove walking from the routine and the amount of time women spent exercising per week fell to 1.1 hours. They found that men exercised longer, but less strenuously than the women.

The American Heart Association recommends 30 minutes of moderate-intensity aerobic exercises five days a week, or 25 minutes of vigorous exercises three days a week and moderate muscle strengthening at least two days a week.

The study’s participants were all on antiretroviral therapies, had an average age of 48 and were predominantly African-American (83 percent). They had lived with HIV for slightly more than 13 years and were on antiretroviral therapy for more than nine years. Most (80 percent) had a co-occurring health condition. Depression and hypertension topped the list.

Each had his or her height, weight and vital signs measured at the beginning of the study. All were asked to complete a computer survey of social and demographic questions and keep a seven-day diary to document daily exercise and its duration, frequency and intensity.

Now that the researchers know people with HIV exercise at home, Webel said the next step is to design a flexible plan that meets people at their initial levels and helps them progress to more intensive levels to maximize the health benefits of exercising.

Jacob Barkley, associate professor in exercise science at Kent State University; Christ T. Longenecker, assistant professor of medicine at Harrington Heart and Vascular Institute, CWRU; Alison Mettelsteadt, registered dietician at University Hospitals Case Medical Center; Barbara Gripshover, associate professor of medicine; and Robert A. Salata, professor of medicine and chair of the Division of Infectious Diseases and HIV Medicine at CWRU, contributed to the study.

The study received support from the National Institute of Allergy and Infectious Disease (grant #P30AI36219) and the National Center for Research Resources and National Center for the Advancing Translational Science, National Institutes of Health (grant #5KL2RR024990 and #KL2TR000440).