The High-Intensity Exercise to Attenuate Limitations and Train Habits (HEALTH) in Older Adults with HIV

高强度运动可减轻老年艾滋病毒感染者的限制并培养习惯（健康）

基本信息

批准号：
10448379
负责人：
Kristine Mace Erlandson
金额：
$ 76.63万
依托单位：
UNIVERSITY OF COLORADO DENVER
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-04-15 至 2025-03-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10448379
关键词：
Accelerometer Address Adherence Aerobic Aerobic Exercise Age Aging Attenuated Behavior Behavioral Bioenergetics Body fat Caring Chronic Disease Clinical Colorado Coronary Arteriosclerosis Data Development Diabetes Mellitus Elderly Electron Transport Epidemic Exercise Fatigue Goals HIV Habits Health Healthy People 2020 Heart Rate High Prevalence Impairment Interval training Intervention Interview Knowledge Life Life Expectancy Maintenance Methods Mitochondria Moderate Exercise Morbidity - disease rate Outcome Participant Patients Perception Performance Peripheral Blood Mononuclear Cell Persons Pharmaceutical Preparations Physical Function Physical activity Population Quality of life Randomized Recommendation Reporting Resistance Resources Respiration Sample Size Self-Direction Site Skeletal Muscle Specific qualifier value Supervision Symptoms Testing Time Training United States National Institutes of Health Universities Vulnerable Populations Walking Woman aged analytical method antiretroviral therapy arm biobehavior co-clinical trial common symptom comorbidity daily functioning demographics design early experience exercise adherence exercise intensity exercise intervention exercise program exercise regimen experience healthspan improved innovation lifestyle factors mortality muscle form preservation reduce symptoms resistance exercise response tailored messaging trial comparing

项目摘要

PROJECT ABSTRACT With advances in treatment and care,a longer life expectancy is changing the demographics of the HIV epidemic, and nearly half of those living with HIV in the U.S. are now 50 years or older. People living with HIV, even while receiving effective HIV medications, have excess morbidity and mortality compared to HIV- uninfected populations. Increasing age, comorbid burden, and lifestyle factors, contribute to greater than expected impairments in key components of daily function and a high burden of fatigue among older adults living with HIV. Effective, scalable, non-pharmacological strategies are needed to improve the healthspan of this vulnerable population. The overall goals of this proposal are to determine whether high-intensity interval training (HIIT) can overcome 1) physical function impairments and increased fatigue and 2) impairments in mitochondrial bioenergetics of older people with HIV (PWH) to a greater extent than continuous moderate-intensity exercise (CME). We further seek to determine whether a biobehavioral coaching intervention following either HIIT or CME can promote long-term adherence to physical activity, a crucial component of the sustainability of the intervention. We have previously demonstrated greater than expected impairments in physical function and a high prevalence of fatigue among older adults with HIV. We found that CME and resistance exercise improves physical function in older PWH, with additional improvements from a higher-intensity aerobic and resistance exercise program. Additionally, only our higher-intensity continuous aerobic exercise intervention reduced fatigue among PWH. Lastly, less than half of our participants continued to exercise at least once a week following the supervised intervention, which suggests that even when exercise is beneficial it can be difficult for PWH to maintain. Together, our findings suggest that an innovative approach to exercise is needed to improve physical function, reduce fatigue, and to maintain a long-term exercise habit among older PWH. To address this critical need, our proposed study will leverage the resources of two diverse participant populations at the University of Colorado and Case Western Reserve University to 1) Compare HIIT vs CME on physical function and fatigue, 2) Compare HIIT vs CME on skeletal muscle and peripheral blood mononuclear cell mitochondrial bioenergetics, and 3) Test a coaching intervention vs control on physical activity adherence, assessing perceptions of these approaches using mixed methods. This study will generate rigorous data on physical function and fatigue responses to exercise, the associated mitochondrial adaptations, and investigate strategies to instill sustained, self-directed exercise behavior. Overall, our findings will inform the development of scalable, effective exercise recommendations tailored to the unique needs of aging PWH.

项目摘要随着治疗和护理的进步，预期寿命的延长正在改变艾滋病毒感染者的人口结构目前，美国近一半的艾滋病毒感染者年龄在 50 岁或以上。艾滋病毒感染者，即使在接受有效的艾滋病毒药物治疗的情况下，与艾滋病毒相比，发病率和死亡率仍然过高未感染人群。年龄的增长、合并症负担和生活方式因素导致超过老年人日常功能的关键组成部分预计会受到损害，并且疲劳负担较高感染艾滋病毒。需要有效的、可扩展的、非药物策略来改善患者的健康寿命这个弱势群体。该提案的总体目标是确定高强度间歇训练（HIIT）是否可以克服 1) 身体功能损伤和疲劳增加以及 2) 线粒体损伤与持续中等强度运动相比，老年艾滋病毒感染者 (PWH) 的生物能学效果更大（芝商所）。我们进一步寻求确定 HIIT 或 HIIT 后是否进行生物行为指导干预 CME 可以促进长期坚持身体活动，这是可持续发展的重要组成部分干涉。我们之前已经证明了身体功能的损害程度超出了预期，并且感染艾滋病毒的老年人中疲劳的发生率很高。我们发现 CME 和阻力运动可以改善老年感染者的身体机能，以及更高强度的有氧运动和运动的进一步改善阻力锻炼计划。此外，只有我们更高强度的持续有氧运动干预减少感染者的疲劳。最后，不到一半的参与者至少继续锻炼一次监督干预后一周，这表明即使锻炼是有益的，它也可能 PWH 难以维持。总之，我们的研究结果表明，一种创新的锻炼方法是改善身体机能，减少疲劳，保持长期锻炼习惯较年长的遗孀。为了满足这一关键需求，我们提出的研究将利用两个不同参与者的资源科罗拉多大学和凯斯西储大学的人群 1) 比较 HIIT 与 CME 对身体功能和疲劳的影响，2) 比较 HIIT 与 CME 对骨骼肌和外周血的影响单核细胞线粒体生物能量学，以及 3) 测试教练干预与身体控制活动依从性，使用混合方法评估对这些方法的看法。这项研究将产生关于身体功能和运动疲劳反应、相关线粒体适应的严格数据，并研究灌输持续、自我导向的锻炼行为的策略。总的来说，我们的研究结果将告知针对老龄化感染者的独特需求，制定可扩展、有效的运动建议。