Experiences Engaging in a Group-based Physiotherapist-led Exercise Programme for Adults Living with HIV and Complex Multimorbidity: a Qualitative Study

Overview

Journal BMJ Open

Specialty General Medicine

Date 2021 Jul 28

PMID 34315789

Citations 1

Authors

Tina S Homayouni

Alex Ruth

Zoe Abbott-Tate

Helen Burger

Shaera Rahim

Carolann Murray

Ryan Wannamaker

Soo Chan Carusone

Kelly K OBrien

Affiliations

Soon will be listed here.

Abstract

Objective: To explore experiences participating in a group-based physiotherapist (PT)-led exercise programme among people living with HIV and complex multimorbidity.

Design: We conducted a qualitative descriptive study using semistructured interviews.

Recruitment And Setting: We recruited community-dwelling adults living with HIV who engaged in a group-based PT-led exercise programme within an HIV-specialty hospital in Toronto, Canada. Interviews were conducted in-person or by telephone.

Participants: Eight men and two women with a median age of 58 years and median of six concurrent conditions in addition to HIV, who had attended ≥2 classes of the exercise programme.

Data Collection: Interviews explored (1) reasons for engaging in the programme, (2) experiences with exercise prior to and after joining the programme, (3) facilitators and barriers to engagement and (4) perceived impacts of participation on health and disability. We administered the HIV Disability Questionnaire and a demographic questionnaire.

Results: Experiences spanned perspectives prior to, during and after the PT-led exercise programme. Reasons for engaging in the programme included addressing health-related goals. Participants identified accessibility, the flexible schedule, interprofessional staff and the HIV-specific, group-based environment as facilitators to engagement. Participants reported high attendance rates, but identified episodic health challenges and overcrowded space as potential barriers to attending exercise classes. Perceived impacts on health and disability outcomes included improved physical, mental, social and cognitive health, and activities of daily living. Anticipated or actual experiences transitioning to independent exercise included facilitators (supportive programme leaders) and barriers (challenges motivatiing self to exercise alone).

Conclusions: Features of the programme that facilitated engagement included the interprofessional, group-based environment that offered tailored exercise in an HIV-specific facility, whereby participants perceived benefits in domains of health and disability. However, challenges transitioning to independent exercise remain. Group-based PT-led exercise programmes may facilitate engagement in exercise among adults living with HIV and complex multimorbidity.

Citing Articles

Qualitative Description of Exercise Perceptions and Experiences Among People With Human Immunodeficiency Virus in the High-Intensity Exercise to Attenuate Limitations and Train Habits Study.

Adhiambo H, Cook P, Erlandson K, Jankowski C, Oliveira V, Do H J Cardiovasc Nurs. 2024; 40(2):E101-E109.

PMID: 38447065 PMC: 11377861. DOI: 10.1097/JCN.0000000000001082.

References

Moser A, Korstjens I . Series: Practical guidance to qualitative research. Part 3: Sampling, data collection and analysis. Eur J Gen Pract. 2017; 24(1):9-18. PMC: 5774281. DOI: 10.1080/13814788.2017.1375091. View

OBrien K, Bayoumi A, Solomon P, Tang A, Murzin K, Chan Carusone S . Evaluating a community-based exercise intervention with adults living with HIV: protocol for an interrupted time series study. BMJ Open. 2016; 6(10):e013618. PMC: 5073553. DOI: 10.1136/bmjopen-2016-013618. View

OBrien K, Tynan A, Nixon S, Glazier R . Effectiveness of aerobic exercise for adults living with HIV: systematic review and meta-analysis using the Cochrane Collaboration protocol. BMC Infect Dis. 2016; 16:182. PMC: 4845358. DOI: 10.1186/s12879-016-1478-2. View

OBrien K, Solomon P, Trentham B, MacLachlan D, MacDermid J, Tynan A . Evidence-informed recommendations for rehabilitation with older adults living with HIV: a knowledge synthesis. BMJ Open. 2014; 4(5):e004692. PMC: 4024604. DOI: 10.1136/bmjopen-2013-004692. View

OBrien K, Ibanez-Carrasco F, Solomon P, Harding R, Brown D, Ahluwalia P . Research priorities for rehabilitation and aging with HIV: a framework from the Canada-International HIV and Rehabilitation Research Collaborative (CIHRRC). AIDS Res Ther. 2020; 17(1):21. PMC: 7236512. DOI: 10.1186/s12981-020-00280-5. View

Krasny-Pacini A, Hiebel J, Pauly F, Godon S, Chevignard M . Goal attainment scaling in rehabilitation: a literature-based update. Ann Phys Rehabil Med. 2013; 56(3):212-30. DOI: 10.1016/j.rehab.2013.02.002. View

OBrien K, Bayoumi A, Stratford P, Solomon P . Which dimensions of disability does the HIV Disability Questionnaire (HDQ) measure? A factor analysis. Disabil Rehabil. 2014; 37(13):1193-201. DOI: 10.3109/09638288.2014.949358. View

Cobbing S, Chetty V . Participants' Reflections on a Home-Based Rehabilitation Intervention for People Living With HIV in KwaZulu-Natal, South Africa. J Assoc Nurses AIDS Care. 2019; 30(2):218-223. DOI: 10.1097/JNC.0000000000000009. View

Quigley A, Baxter L, Keeler L, MacKay-Lyons M . Using the Theoretical Domains Framework to identify barriers and facilitators to exercise among older adults living with HIV. AIDS Care. 2018; 31(2):163-168. DOI: 10.1080/09540121.2018.1499860. View

10.

Spirig R, Nicca D, Voggensperger J, Unger M, Werder V, Niepmann S . The Advanced Nursing Practice Team as a model for HIV/AIDS caregiving in Switzerland. J Assoc Nurses AIDS Care. 2004; 15(3):47-55. DOI: 10.1177/1055329003261960. View

11.

Neff H, Kellar-Guenther Y, Jankowski C, Worthington C, McCandless S, Jones J . Turning disability into ability: barriers and facilitators to initiating and maintaining exercise among older men living with HIV. AIDS Care. 2018; 31(2):260-264. PMC: 6318073. DOI: 10.1080/09540121.2018.1493186. View

12.

Blank M, Hanrahan N, Fishbein M, Wu E, Tennille J, Have T . A randomized trial of a nursing intervention for HIV disease management among persons with serious mental illness. Psychiatr Serv. 2012; 62(11):1318-24. PMC: 5072175. DOI: 10.1176/ps.62.11.pss6211_1318. View

13.

Borg G . Perceived exertion: a note on "history" and methods. Med Sci Sports. 1973; 5(2):90-3. View

14.

Worthington C, Myers T, OBrien K, Nixon S, Cockerill R . Rehabilitation in HIV/AIDS: development of an expanded conceptual framework. AIDS Patient Care STDS. 2005; 19(4):258-71. DOI: 10.1089/apc.2005.19.258. View

15.

Chung C, Lou V . Effects of Supervised Exercise on Physical Health and Quality of Life Among Older Adults Living With HIV in Hong Kong. J Assoc Nurses AIDS Care. 2019; 31(3):353-358. DOI: 10.1097/JNC.0000000000000099. View

16.

. Survival of HIV-positive patients starting antiretroviral therapy between 1996 and 2013: a collaborative analysis of cohort studies. Lancet HIV. 2017; 4(8):e349-e356. PMC: 5555438. DOI: 10.1016/S2352-3018(17)30066-8. View

17.

OBrien K, Tynan A, Nixon S, Glazier R . Effectiveness of Progressive Resistive Exercise (PRE) in the context of HIV: systematic review and meta-analysis using the Cochrane Collaboration protocol. BMC Infect Dis. 2017; 17(1):268. PMC: 5389006. DOI: 10.1186/s12879-017-2342-8. View

18.

Gomes Neto M, Conceicao C, Carvalho V, Brites C . Effects of Combined Aerobic and Resistance Exercise on Exercise Capacity, Muscle Strength and Quality of Life in HIV-Infected Patients: A Systematic Review and Meta-Analysis. PLoS One. 2015; 10(9):e0138066. PMC: 4574781. DOI: 10.1371/journal.pone.0138066. View

19.

Moreno-Montoya J, Barragan A, Martinez M, Rodriguez A, Gonzalez A . Quality of life and perceived social support in people with HIV in Bogotá, Colombia. Biomedica. 2019; 38(4):577-585. DOI: 10.7705/biomedica.v38i4.3819. View

20.

Serrao R, Pinero C, Velez J, Coutinho D, Maltez F, Lino S . Non-AIDS-related comorbidities in people living with HIV-1 aged 50 years and older: The AGING POSITIVE study. Int J Infect Dis. 2018; 79:94-100. DOI: 10.1016/j.ijid.2018.10.011. View