Lloyd Leach

A systematic review of the effects of exercise interventions on body composition in HIV+ adults

Over the years, physical activity and exercise have been used to positively impact the health and quality of life of persons infected with HIV and, more recently, has been associated with a spectrum of body composition changes. The aim of this review was to examine the effects of various exercise interventions on body composition in HIV positive adults, using a search strategy of randomized, controlled trials (RCTs). A systematic review was performed by five independent reviewers using a predetermined protocol adapted from previous research for assessing the articles for inclusion, the extracted data, and methodological quality. Eight RCTs involving 430 (26% female) HIV positive adults performing exercise a minimum of thrice weekly for at least six weeks were finally selected: Four were progressive resistance training (PRT) studies, three were aerobic training (AT) studies, and one involved yoga. In the PRT studies, there were significant increases in three anthropometric measures, namely, body mass, sum of skinfolds and sum of limb girths. In the AT studies, significant decreases were found in seven anthropometric measures, namely, body mass index, waist-hip ratio, body mass, triceps skinfold, waist circumference and sum of skinfolds. With yoga, the changes were non-significant. Exercise contributes to improved body composition and, when applied safely, appears to be beneficial for adults living with HIV/AIDS. However, these findings should be interpreted cautiously due to the relatively few RCTs published to date. Future studies would benefit from increased attention to sample size, female participants, participant follow-up, complete statistical analysis and intention-to-treat analysis.

Effects of an exercise programme with people living with HIV: research in a disadvantaged setting

This study aimed to analyse the physical health effects of a community based 10-week physical activity programme with people living with HIV. It was developed, implemented and evaluated in a disadvantaged community in South Africa. A pre-post research design was chosen. Major recruitment and adherence challenges resulted in a small sample. Among the 23 participants who took part in both baseline and final testing, compliant participants (n = 12) were compared to non-compliant participants (n = 11). Immunological (CD4, viral load), anthropometric (height, weight, skinfolds and waist to hip ratio), muscular strength (h1RM) and cardiopulmonary fitness (time on treadmill) parameters were measured. The compliant and non-compliant groups were not different at baseline. Muscular strength was the parameter most influenced by compliance with the physical activity programme (F = 4.516, p = 0.047). Weight loss and improvement in cardiopulmonary fitness were restricted by the duration of the programme, compliance and influencing factors (e.g. nutrition, medication). The increase in strength is significant and meaningful in the context, as the participants’ goals were to look healthy and strong to avoid HIV related stigma. The improvements in appearance were a motivational factor, especially since the changes were made visible in a short time. Practical implications for health promotion are described. More research contextualised in disadvantaged settings is needed.

Social-Ecological, Motivational and Volitional Factors for Initiating and Maintaining Physical Activity in the Context of HIV.

Sport and exercise can have several health benefits for people living with HIV. These benefits can be achieved through different types of physical activity, adapting to disease progression, motivation and social-ecological options. However, physical activity levels and adherence to exercise are generally low in people living with HIV. At the same time, high drop-out rates in intervention studies are prevalent; even though they often entail more favourable conditions than interventions in the natural settings. Thus, in the framework of an intervention study, the present study aims to explore social-ecological, motivational and volitional correlates of South African women living with HIV with regard to physical activity and participation in a sport and exercise health promotion programme. The qualitative data was produced in the framework of a non-randomised pre-post intervention study that evaluated structure, processes and outcomes of a 10-week sport and exercise programme. All 25 participants of the programme were included in this analysis, independent of compliance. Data was produced through questionnaires, participatory group discussions, body image pictures, research diaries and individual semi-structured interviews. All participants lived in a low socioeconomic, disadvantaged setting. Hence, the psychological correlates are contextualised and social-ecological influences on perception and behaviour are discussed. The results show the importance of considering social-cultural and environmental influences on individual motives, perceptions and expectancies, the fear of disclosure and stigmatisation, sport and exercise-specific group dynamics and self-supporting processes. Opportunities and strategies to augment physical activity and participation in sport and exercise programmes in the context of HIV are discussed.

The link between parenting approaches and health behavior: a systematic review

ABSTRACT The familial home environment, where parenting takes place, plays an important role in the health behaviors that children and adolescents engage in and has implications on health and well-being in later life. Lifestyle-related behaviors predispose children and adolescents to the global burden of non-communicable and other lifestyle-related diseases. This review therefore examined and described previous studies looking at the associations between health behaviors and parenting approaches. It suggests that engagement in health behaviors, which promotes overall health and well-being, was associated with autonomy, supportive parenting, parental encouragement, behavior control, parental nurturance, warmth and responsiveness, and parental involvement. The review highlights the gap in literature focusing on the health behavior of children and adolescents as well as on parenting. In addition, the review also provides an overview of the continents where fewer studies have examined the presented associations. The findings presented also serve as a guide for program development and implementation to address the increase in non-communicable and other lifestyle-related diseases.

A six week contextualised physical activity intervention for women living with HIV and AIDS of low socioeconomic status: a pilot study

ABSTRACT Research has consistently shown the benefits of regular physical activity (PA) for women living with HIV and AIDS (WLWHA). This study is a pilot, randomised controlled crossover trial, reporting the effects of a contextualised PA intervention amongst a sample of 21 HIV positive Xhosa-speaking women of low socioeconomic status (SES). The study determined total moderate-to-vigorous PA (TMVPA) as measured subjectively by the Global Physical Activity Questionnaire (GPAQ), total weekly steps (TWS) as measured by a pedometer, and self-efficacy for PA as measured by the Physical Exercise Self-efficacy scale (PESES). Multivariate analysis of covariance (MANCOVA) was used to compute the impact of the intervention on TMVPA, TWS, and self-efficacy for PA from baseline to six weeks, and baseline to 12 weeks post-intervention controlling for pre-test differences in TMVPA. Results showed that participants exposed to the intervention had significant increases in PA as measured by TMVPA (p = .027), TWS (p = .032), as well as exercise self-efficacy (p = .000) from pre-test to 6 weeks. Insignificant findings were reported for all three variables when measured from baseline to 12 weeks. In conclusion, the findings of the pilot study suggest that the intervention was effective in producing significant increases in PA in a sample of PLWHA of low SES over six weeks. Careful consideration of behavioural constructs, such as self-efficacy, can help WLWHA of low SES to adopt regular PA as a complementary therapy for managing their health.

Predicting swimming performance using state anxiety

Competitive state anxiety is a common response to stressful competitive sports situations that could affect athletic performance. The effects of state anxiety on swimming performance need further inquiry. The aim of the study was to determine the component of state anxiety that best predicts swimming performance. A quantitative, cross-sectional study design that made use of the Competitive State Anxiety Inventory-2 to measure precompetitive state anxiety was used. A total of 61 male high school swimmers whose age ranged between 14 and 19 years (M = 16.16, standard deviation = 1.66 years) completed the Competitive State Anxiety Inventory-2 1 hr before competing in a 50-m individual swimming event. Performance was evaluated using finishing position. Due to the relatively short duration of the 50-m event, the available literature would suggest that Somatic Anxiety would have a greater effect on Performance—there is not enough time to allow cognitive anxiety to have a detrimental impact on performance. Thus, it was hypothesized that somatic rather than cognitive anxiety will best predict swimming performance. It emerged that both cognitive (b = .787; p < .001) and somatic anxieties (b = .840; p < .001) can independently predict swimming performance. However, when both cognitive and somatic anxieties were regressed onto swimming performance, somatic anxiety partially dominated cognitive anxiety (b = .626; p < .001) and became the significant predictor of swimming performance. It is recommended that swimmers and swimming coaches make use of specific intervention strategies that eradicate the detrimental effects of somatic anxiety immediately before competition.

Research capacity development in a South African higher education institution through a north-south collaboration

One of the constraints that prevent institutions in developing countries from engaging in effective and essential research is a lack of research capacity. This study reports on a north-south collaboration between a group of Flemish universities and a higher education institution in South Africa with the specific goal of improving productivity, quality and capacity amongst researchers. A collaborative project with multiple sub-projects was established in 2003, and extended over two consecutive five-year phases. Document analysis was conducted of annual reports, monitoring and evaluation reports, curriculum vitae of participating members, and progress reports of students and supervisors during this time. The findings of this study illustrate the extent to which research capacity objectives can be achieved through a north-south partnership. Members of the collaboration were able to develop intra- and inter-disciplinary partnerships that resulted in maximising the capacity- building efforts, enhancing both individual and institutional research capacity. Keywords: International partnerships; professional development; student development; staff development.

Physical activity behaviours of persons living with HIV of low socioeconomic status: domain, intensity and sociodemographic correlates

ABSTRACT Physical activity (PA) is healthy for People Living with HIV and AIDS (PLWHA). This study examined the PA profile of 978 PLWHA based on PA domains and PA intensity. The study also sought to determine whether employment status and level of education can predict PA among PLWHA of low SES. PA and sociodemographic data of 978 PLWHA of mean age 35 (8.77) years were collected using the global physical activity questionnaire and a sociodemographic questionnaire. Results showed that, participants engaged more in work-related PA [160.11 (346.95) min/wk], followed by transport related PA [115.21(SD = 142.04) min/wk], and lastly in leisure related PA [40.84 (SD = 110.37) min/wk]. Participants also engaged more in moderate PA [265.86 (SD = 335.45) min/wk], than in vigorous PA [50.29 (SD = 205.30) min/wk]. Employment was a significant predictor of overall PA controlling for age, CD4 count and education level. The model explained 2.5% of the variance (R2 = 0.025) on overall PA and tested significant at a 0.01 alpha level (p < 0.01). PA interventions for this population should be domain- and intensity-specific. Researchers promoting healthy lifestyle behaviour change can benefit from determining the factors that facilitate domain-specific PA.

Physical activity, social support and socio-economic status amongst persons living with HIV and AIDS: a review

Physical activity can be used for the effective and comprehensive management of HIV and AIDS. Social support and socio-economic status (SES) are two factors that shape physical activity behaviours. Individuals of low SES carry a disproportionate burden of the HIV and AIDS epidemic. In addition, limited resources constitute socio-ecological barriers predisposing such individuals to physical inactivity. The purpose of this narrative review is to examine the available literature on physical activity, social support and SES and to generate recommendations for designing and implementing physical activity interventions targeting people living with HIV and AIDS (PLWHA) of low SES. The review used literature from Google, Google Scholar and PubMed on physical activity of PLWHA, social support for physical activity, and SES and physical activity. Qualitative and quantitative studies in English were included from 1970 to 2016. The results show that social support plays a major role in promoting physical activity and counteracting the barriers to PA in PLWHA of low SES. The results on the role of social support and the influence of SES are integrated to help design appropriate physical activity interventions for PLWHA of low SES. Well-designed interventions should utilise social support and be contextualised for PLWHA of low SES, whose living conditions present multiple barriers to physical activity.