Paper
Wednesday, July 13, 2005
This presentation is part of : Evidence-Based Nursing for the Chronically Ill
Improving Functional Capacity and Health Status in HIV Using Exercise and Oxandrolone
Barbara Smith, PhD, RN, FAAN, School of Nursing, University of Maryland, Baltimore, Baltimore, MD, USA, James L. Raper, DNS, CFNP, School of Nursing and Medicine, University of Alabama At Birmingham, Birmingham, AL, USA, and Michael Weaver, PhD, School of Nursing, The University of Alabama at Birmingham, Birmingham, AL, USA.
Learning Objective #1: Identify the pros and cons of using exercise and/or oxandrolone in HIV-infected adults
Learning Objective #2: Discuss the impact of a change in functional capacity on health status and quality of life

Objectives. Today in developed countries, HIV is viewed more as a chronic illness because of potent antiretroviral therapy and prophylaxis against opportunistic infections. However, despite treatment successes, there has been the emergence of new side effects that negatively impact functional capacity and health status including quality of life (QOL). The aim of this study was to examine the effects of exercise and oxandrolone on functional capacity measured by time on treadmill (TOT) and health status measured by the MOS-HIV in HIV infected adults.

Methods. Subjects were randomly assigned to oxandrolone+exercise or oxandrolone placebo+exercise. At baseline and week 12 we measured certain demographic variables, TOT and health status.

Results. Functional capacity (TOT) increased by 32% (3 minutes) in the oxandrolone+exercise group which was greater than the increase observed in the placebo+exercise group (F[GroupXTime] =5.5, p=0.03). Using a regression model including TOT, group, and age as predictors of a change in MOS-HIV subscales, only Health Distress showed a greater improvement in the oxandrolone+exercise group (F=7.4, p=0.01). Although there was no difference between the groups in change in Vitality (F=0.11, p=0.75) or QOL (F=0.10, p=0.75), there was a trend toward a greater increase in Vitality (F=3.8, p=0.07) and QOL (F=3.4, p=0.08) with an increase in TOT. In addition, there was a trend in older subjects toward an increase in Vitality (F=3.5, p=0.08) and QOL (F=3.6, p=0.08) for a given increase in TOT.

Conclusions. Subjects in both groups benefited from this intervention. Those who received oxandrolone+exercise had the added benefit of an increase in functional capacity as measured by TOT; however, other than an improved Health Distress score, oxandrolone+exercise had little impact over placebo+exercise on other MOS-HIV subscales.