Exercise, wellness take on added weight for patients
Exercise, wellness take on added weight for patients
First exercise video for and by HIV-positive people
At a recent party celebrating the first known exercise video exclusively for people infected with HIV, a group of participants in the production were proudly displaying the results of protease inhibitors and sweaty workouts in the gym.
"I have muscles now. I never had muscles before," chimes Ilyse Tasdemir, flexing her biceps in front of her peers.
Tasdemir is experiencing what only a year ago many AIDS patients would never had dreamed about a strong body and positive outlook on her future. And as new therapies add years of survival to AIDS patients’ lives, new studies are providing hard data showing that exercise and wellness programs not only improve peace of mind, but boost the immune system as well.
"Now that people have hope, we need to start thinking about physical health, and that includes physical exercise," says Kimball Johnson, MD, an AIDS specialist in Atlanta with training in sports medicine. "We know exercise makes people feel better and enhances mood, but it increases the immune system as well."
At Atlanta’s Positive Moves Inc., a nonprofit fitness program dedicated to HIV-positive patients, instructor Carmela Tafoya saw enough positive results with a combination of weight training and Chi Kung during the past year that she decided to make a video for and by her clients. The video, produced through volunteer work for about $50,000, was recently completed. Her goal is to provide a copy of the video to every HIV-positive person in the country.
Getting more HIV-positive people into exercise and wellness programs would be a good thing, says Steven Pizzo, MS, a clinical exercise physiologist at the University of New England in Biddleford, ME. At the recent National Lesbian and Gay Health Association’s annual conference in Atlanta, Pizzo presented clinical results of seven AIDS patients enrolled in a holistic wellness program. The 12-week study provided thrice-weekly sessions in exercise, education, and alternative therapies, such as self-massage, Reiki, and yoga.
Unpublished data showed that the patients experienced a mean 4.7 kg increase in lean body mass, a 28% increase in aerobic fitness, and an average 75 cell increase in CD4 counts. Although most of the patients were on protease inhibitors during the program, treatment was not altered during the period, Pizzo says.
"Every variable remained the same, yet there was an increase in CD4 counts," he says. "We think the physiological benefit is secondary to the primary benefit of stress management, and exercise is a stress management tool along with education."
The wellness program for HIV-positive patients is primarily designed to change lifestyle behaviors that cause stress, much like programs devised for cardiovascular patients, Pizzo notes. Although insurance companies don’t reimburse HIV patients for wellness programs, Pizzo’s and other studies are providing more hard data that could eventually lead to reimbursement, he adds.
Exercise combined with education
The exercise portion of the program was made up of 30 to 40 minutes of resistance training for the major muscle groups, followed by cardiovascular exercises. After each session, the participants joined focus groups and education sessions that provide strategies for long-term survival with AIDS, such as energy conservation, nutrition, and pain management. Sessions were also provided in alternative therapies, the most popular being Reiki healing, says Judy Vezina, a trainer in the program.
"Our focus is toward changing that mind set of Hold my hand and tell me how sorry you are that I am sick,’ to Okay, you have a chronic disease, not a terminal one, and we can help you increase your quality of life,’" she says. "We can increase your physical endurance, your muscle strength, so that maybe if you do get sick, you are going to come back a lot faster than someone who is watching TV and doing nothing."
Getting patients to join exercise programs is easier now than it was before improved therapies, Johnson says. But the most effective motivator can be the clinician. "If your doc says you should exercise, rather than your mother saying it, you are more likely to do it," she says.
One advantage of the exercise video is that patients can go through the routines without having to leave their home, Tafoya says, adding that many cities still don’t offer HIV-specific exercise programs.
[Editor’s note: For more information about ordering the video or supporting Positive Moves, contact Carmela Tafoya at (404) 876-5192.]
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