Date of Award

1-1-2010

Document Type

Campus Access Dissertation

Department

Exercise Science

First Advisor

Gregory A. Hand

Abstract

PLWHA are inflicted with a variety of psychological and physiological symptoms associated with the virus itself, related medications, or a combination of both. Due to the nature of these symptoms being experienced concurrently the general well-being and overall quality of life in this population is often reduced. Further, the frequency of reported symptoms is believed to be associated with increased disease progression, decreased functional capacity, reduced adherence to pharmacological treatment, self-medication, and increased psychological disturbances such as anxiety and depression. HIV-related co morbidities associated with risk of chronic diseases have reportedly decreased among PLWHA in recent investigations following prescribed exercise training. The benefits of exercise in reducing chronic stress and disease have long been established among general populations and various clinical groups from longitudinal investigations. Recent studies are suggesting that PLWHA can obtain similar benefits within 6 weeks following a prescribed physical activity routine.

The aim of this dissertation was three fold. First a cross-sectional statistical design was utilized for testing the associations of HIV-related symptoms and their distress among psychological and physiological indicators of stress. Significant correlations were further examined to identify mediators of symptom distress. In addition, the effectiveness of a 6 week moderate intensity exercise prescription combining aerobic and resistance training was tested among psychological and physiological variables in PLWHA. These included perceived stress, frequency of symptoms, symptom distress, and circulating resting cortisol measured at wake. The strongest correlates were observed in fatigue and symptom frequency (rs = 0.59, p < 0.001), as well as fatigue and symptom distress (rs = 0.63, p < 0.001). Significant predictors of symptom distress included symptom frequency, depression/dejection, anger/hostility, and fatigue. Only depression/dejection and fatigue remained significant after testing for mediators (p < 0.001). Salivary cortisol (CORT), a physiological indicator of stress, was collected at three time points within two hours following wake and used to identify the total area under the curve (AUC). Resting CORT was collected for comparison pre and post intervention. The data show a significant decrease in the AUC of CORT following 6 weeks of moderate intensity exercise (p < 0.001), whereas no change was observed within the CON group. It was also shown that the 6 week intervention design reduced total mood disturbances measured using the profile of mood states short form (POMS-30) (p < 0.001) as well as the depression/dejection subscale (p < 0.001). Results from the present study show PLWHA are able to reduce the level of psychological and physiological stress experienced daily following a moderate intensity exercise intervention when completed twice a week for six weeks. Further, to our knowledge this is the first investigation to identify partial mediators of HIV-related symptom distress. In conclusion, these results indicate PLWHA are able to obtain psychological and physiological benefits in six weeks when completing a combination aerobic and resistance exercise prescription of moderate intensity twice a week.

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