EFFECT OF AEROBIC EXERCISES ON QUALITY OF LIFE, RATE OF PERCEIVED EXERTION AND PULMONARY FUNCTION TEST IN HIV FEMALES

Introduction: AIDS (Aquired Immuno Deficiency Syndrome) is caused by a retrovirus called Human Immuno Deficiency Virus (HIV). The profile of HIV infection has changed dramatically since the advent of Highly Active Anti Retroviral Therapy (HAART). These developments have been mirrored by perceived increasing prevalence of impairments, activity limitations and participation restriction for many people living with HIV. There is changing gender trend in HIV cases. Although HAART allows for reduction in HIV related mortality the extension in patient’s life can be associated with reduction in Quality of life. Exercise has been proven to health benefits like increased aerobic fitness to improve mood of general population. Aerobic exercise has been reported to reduce negative psychological states, but also to improve an array of positive states.

rapidly in comparison [3].There are multiple biological, social, economic and environmental risk factors that increase women likely hood of contracting HIV.Physiology of female genital tract makes it more vulnerable to HIV than men.Social and gender inequalities such as poverty.Unequal educational opportunities force women to rely on male partners for financial support making it more In India it is estimated that around 2.4 million people are currently living with HIV [1].The prevalence of HIV at antenatal clinics in Maharashtra was 0.5 % in 2007 [2].Evaluation of CDC data revealed a changing gender trend in HIV cases, while number of cases in males continue demand concern the percentage of women with HIV is growing rather difficult for them to insist on intervention that reduce their risk of acquiring HIV.
Considering the discomfort associated with disease progression the social impact of diagnosis the emotional consequences of dealing with the diagnosis of HIV and related stigma and economic hardship faced by many takes it toll on its victims QOL [4][5][6].
Studies have shown that many women choose not to disclose HIV status for fear of abandonment, rejection, discrimination, violence and accusation of infidelity from their partners, families and communities [6].
With the advent of HAART has dramatically altered the survival rate of persons with HIV/ AIDS in countries where such treatment is available.
With the advent of highly active anti-retroviral therapy, new problems have emerged are complicated dosing regimens [7].These developments due to HAART have been mirrored by perceived increasing prevalence of impairments, activity limitations and participation restriction for many people living with HIV [8].Some anti-retroviral medications are known to directly increase depressive moods and anxiety in many cases it may be the negative psychological responses instead due to adverse effect of HAART [9,10].Health related QOL for patients living with HIV is becoming important with the other goals of therapy to reduce the symptoms, suppression of the virus and extension of survival.Adverse effect of potent ART can worsen QOL [11].
Exercise has been proven to health benefits like increased aerobic fitness to improve mood of general population.Aerobic exercise has been reported to reduce negative psychological states, but also to improve an array of positive states.There is growing evidence that exercise is sufficient to increase positive mood state, energy and positive well -being consent was obtained.Baseline data was obtained from them in the form of demographic data and information sheet was completed.MOS-HIV QOL questionnaire was completed by interview format.Six minute walk test was conducted and all the three parameters were noted at the start of the test and after 6 min.Rate of perceived exertion were rated on CR'10 scale.
Subjects were trained at the 50-70% of HR max on treadmill10 mins warm up followed by 30 mins treadmill and 15 mins cool down exercises for 3 times a week for 6 week.At the end of treadmill session RPE was noted.Aerobic capacity was assessed using a Spirotech clarity spirometer.
Procedure was explained and best of three was considered.All the data was again collected after 3 weeks and at the end of 6 weeks.Subjects were also informed if they have any discomfort they can report during the training.They could stop the training further if they were not comfortable or faced any health issues.The above graph shows statistically significant in RPE after 6 weeks  The results of the study suggests that effect of aerobic exercises on QOL p<0.005 which is statistically significant improvement, PFT p< 0.05highly significant and on RPE p<0.003 which shows statistically significant improvement.The results indicated that, at least, the exercise program did not cause harm with regards to the immunological function.On the other hand, a significant improvement in perception of life satisfaction was observed for the participants.There was no previous sample calculation according to the characteristics of the HIVinfected patients.It is known that it is difficult to compose large groups with this type of patient, because of the likelihood of dropouts due to clinical problems.Moreover, these patients do not always want to have disclosed their condition.For this reason, most of the available studies on the relationship between AIDS and exercise were performed with small samples, such as de Souza et al.
Sneha D Ghuman, Shilpa Parab.EFFECT OF AEROBIC EXERCISES ON QUALITY OF LIFE, RATE OF PERCEIVED EXERTION AND PULMONARY FUNCTION TEST IN HIV FEMALES.
[12].Exercise has shown to improve strength, cardiovascular function and psychological status in general population, but the effectiveness and safety of aerobic exercise for adults living with HIV infection have not been established.The insufficient number of HIV women subject's makes it difficult to characterize and understand the disease in HIV females and their health status.Hence this study was conducted to find out the effect of aerobic exercises on QOL, Rate of perceived exertion and pulmonary function test in HIV females.The aim of the study was to study the effect of aerobic exercises on Quality of life, Rate of perceived exertion & pulmonary function test in HIV females.Objectives of the study were :(1)To study the effect of aerobic exercises on quality of life using MOS HIV QOL in HIV females.(2)Tostudy the effect of aerobic exercise on rate of perceived exertion in HIV females pre and post aerobic exercises (3)To study the changes in aerobic capacity of HIV females during aerobic training.The null hypothesis is aerobic exercise does not have effect on Quality of life, rate of perceived exertion and pulmonary function test in HIV females and Alternate hypothesis is aerobic exercise have effect on Quality of life, rate of perceived exertion and pulmonary function test in HIV females MATERIALS AND METHODS The institutional research ethical committee approval was obtained.Research design: It is Quassy Experimental study.The patients with HIV stage 1 were included in the study.The study was conducted at a hospital physiotherapy set-up which receives patients from urban as well as rural areas.25 subjects were included in the study.Inclusion Criteria: (1) Patient having HIV stage 1 (2) Age 18-40 yrs (3) female population.Exclusion Criteria: (1) Having any secondary complications like skin lesions, systemic rashes, and undefined weight loss.(2)Doing exercises regularly.(3) Having any pulmonary, cardiac complications, neurological problems & musculoskeletal disorders.(4)Pregnant women.(5)Not willing to participate.Procedure: Subjects were selected as per inclusion and exclusion criteria, 25 could meet the inclusion and exclusion criteria.Nature of the study was explained to them.Written Sneha D Ghuman, Shilpa Parab.EFFECT OF AEROBIC EXERCISES ON QUALITY OF LIFE, RATE OF PERCEIVED EXERTION AND PULMONARY FUNCTION TEST IN HIV FEMALES.
software version 12. Pre and post data was analyzed using Repeated measures of ANOVAs.All non-parametric data was analyzed using Kruskal Wallis test.Level of significance was set at p < 0.05 Analysis: Mean & Standard deviation was calculated.All analysis was made using SPSS DISCUSSION The present study was designed to evaluate the effectiveness of aerobic training program on Quality of life, Rate of perceived exertion, and pulmonary function test in HIV females.The study was conducted on 25 females diagnosed as HIV stage 1.
(14 patients in the experimental group, without CG), Dolan et al. (40 patients in the experimental group, home-based program, without GC), Driscoll et al. (11 patients in the experimental group and 14 controls), and Roubenoff and Wilson (6 patients in the experimental group and 19 controls), MacArthur, Levine and Birk (3 patients in the experimental group and 3 controls), Rigsby et al. (19 patients in the experimental group, without GC) or Spence et al. (24 patients in the experimental group and 12 controls) [13-16].In general, it is accepted that the preservation of physical and functional fitness contributes to a better perception of quality of life.The improvement of QOL & aerobic capacity of seropositive individuals observed in this study is consistent with previous researches and confirm their results.The study of LaPerriere et al. may have been the first to examine this relationship.However, the objective of this group was different since the participants were still unaware of their infection.Those who performed aerobic exercises and were seropositive for HIV had lower levels of depression in relation to individuals with the same results but that did not exercise [17].Aerobic exercise might contribute to the improvement of emotional status, increase the release of endogenous opioids and reduce the activity of the adrenocortical, pituitary and hypothalamic systems (ACPH) [18].Considering this model, physical activity could moderate the psychological and physiological sequels from chronic diseases, including HIV/ AIDS [19].It is relevant to mention yet, that the performance of these exercises in group, gathering people with same problems and anxieties, may have been a contribution to the results obtained [20].Better function is possible, though, by means of exercise as a means to improve aerobic capacity, thus implying better mitochondrial function.The result of our study coincides with the study of Keyser et al 2004 shown that people with HIV to have abnormally lowered capacity to utilize oxygen and perform physical work.It is likely that the etiology of this reduced work capacity is multifactorial, sparse evidence suggests that moderate to high intensity training is effective in improving functional aerobic capacity of HIV positive population [21].In conclusion, a physical training program of moderate intensity, combining aerobic, strengthening and flexibility exercises was able to significantly improve the perception of life satisfaction of seropositive subjects without causing immunological impairment, at least in the characteristics observed in the present study.Therefore, supervised physical activity programs can be effective tools for improving psychological well-being of patients with HIV.Thus aerobic exercises help to improve Quality of life, functional status of females affected by HIV.Sneha D Ghuman, Shilpa Parab.EFFECT OF AEROBIC EXERCISES ON QUALITY OF LIFE, RATE OF PERCEIVED EXERTION AND PULMONARY FUNCTION TEST IN HIV FEMALES.How to cite this article: Sneha D Ghuman, Shilpa Parab.EFFECT OF AEROBIC EXERCISES ON QUALITY OF LIFE, RATE OF PERCEIVED EXERTION AND PULMONARY FUNCTION TEST IN HIV FEMALES.Int J Physiother Res 2017;5(3):2061-2065.DOI: 10.16965/ijpr.2017.121

Table 1 :
Quality of Life (QOL) at baseline, 3 weeks and 6 weeks of training.The above table shows statistically significant improvement in Quality of life

Table 2 :
Rate of perceived exertion at baseline, 3 weeks and 6 weeks.

Table 3 :
Pulmonary function at baseline, 3 weeks and 6 weeks The above table shows p<0.05 which is statistically significant.