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）

• 批准号: 9926614
• 负责人: Kristine Mace Erlandson
• 金额: $ 79.99万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 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/9926614
• 关键词: Accelerometer; Address; Adherence; Aerobic; Aerobic Exercise; Age; Aging; Attenuated; Behavior; Behavioral; Bioenergetics; Body fat; Caring; Chronic Disease; Clinical; Clinical Trials; 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; Text Messaging; Time; Training; United States National Institutes of Health; Universities; Vulnerable Populations; Walking; Woman; aged; analytical method; antiretroviral therapy; arm; biobehavior; 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; trial comparing

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，预期寿命更长正在改变艾滋病毒的人口统计 流行病，近一半在美国患艾滋病毒的人现在已经50岁以上了。患有艾滋病毒的人， 即使接受有效的HIV药物，与HIV相比，发病率和死亡率过高 未感染的人群。增加年龄，合并负担和生活方式因素的增长贡献大于 每日功能的关键组成部分的预期损害和老年人的疲劳负担很大 与艾滋病毒一起生活。需要有效，可扩展，非药理策略来改善健康状态 这个脆弱的人口。 该提案的总体目标是确定高强度间隔训练（HIIT）是否可以 克服1）身体功能障碍和增加疲劳和2）线粒体损伤 艾滋病毒（PWH）老年人的生物能学比连续中等强度的运动更大程度 （CME）。我们进一步寻求确定在HIIT之后或 CME可以促进长期遵守体育锻炼，这是可持续性的关键组成部分 干涉。我们以前表现出的身体机能和A的预期障碍比 HIV老年人的疲劳患病率很高。我们发现CME和抵抗运动有所改善 较旧的PWH的身体功能，具有高强度的有氧运动和 抵抗运动计划。此外，只有我们的高强度连续有氧运动干预 PWH中疲劳减少。最后，我们不到一半的参与者至少继续运动一次 有监督干预后的一周，这表明即使锻炼是有益的，也可以是 PWH难以维护。一起，我们的发现表明一种创新的运动方法是 需要改善身体机能，减轻疲劳并保持长期运动习惯 较老的PWH。 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部储备大学的人口至1）比较HIIT与CME 关于身体功能和疲劳，2）比较HIIT与CME在骨骼肌肉和外周血上 单核细胞线粒体生物能学，3）测试教练干预与对身体的控制 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 严格的关于运动和疲劳反应的数据，相关的线粒体适应， 并研究灌输持续的，自我指导的运动行为的策略。总体而言，我们的发现将告知 根据老化PWH的独特需求量身定制的可扩展，有效的运动建议。