FITNESS AND LONGEVITY IN EXERCISE: FLEX

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 这项建议的目的是研究衰老影响HIV感染成年人身体机能和有氧能力的机制，并确定有氧运动训练是否改善机能和心血管表现。结果将被用于设计和测试针对感染艾滋病毒的老年人的具体运动干预措施。我们的长期目标是制定有效的预防和治疗策略，以改善和保护快速增长的老年患者群体的功能。目的：探讨20周有氧运动训练(16周耐力训练+4周短跑间歇训练)对老年HIV感染者骨骼肌氧化功能和有氧能力的影响。我们将对60名HIV受试者进行随机试验=55年。治疗组(N=30)和对照组(N=30)将在基线、16周和20周评估以下参数：a)有氧能力(VO2峰值)；b)功能表现；c)骨骼肌氧化功能(细胞色素C氧化酶(COX)和琥珀酸脱氢酶(SDH)；d)骨骼肌线粒体形态(电子显微镜)和mtDNA(聚合酶链式反应测定mt/核DNA比率)；e)瘦体重(DEXA；CT扫描)；f)骨骼肌组织学(HIV相关肌病)。假设1.骨骼肌氧化功能障碍是导致老年HIV患者有氧能力降低和功能受限的机制因素。假设2：有氧运动训练将改善肌肉氧化功能障碍，与久坐不动的老年HIV对照组相比，老年HIV受试者的相关功能限制和有氧能力降低；然而，改善可能受到骨骼减少和HIV相关肌病的程度的限制。设计/程序：这项随机试验比较了55岁HIV感染者20周有氧运动训练和伸展运动控制的效果。结果包括生理、功能、肌肉、代谢和身体成分测量，这些测量将在基线、16周和20周进行评估。所有受试者都将感染艾滋病毒，并接受稳定、高效的抗逆转录病毒治疗(HAART)。大多数志愿者将从巴尔的摩退伍军人医疗中心(VAMC)的ID诊所(人口普查620)和马里兰大学成人艾滋病毒诊所、伊夫林·乔丹中心(EJC)(人口普查1800)和社区招募。我们将使用最近采用的相同招募策略和资格标准，将63名感染艾滋病毒的老年成年人纳入一项横断面运动研究(Get Fit，H-25827)。六十名合资格的参加者将按性别及爱滋病病史分为四个组别：(一)男性，有爱滋病病史；(二)男性，无爱滋病病史；(三)女性，有爱滋病病史；(四)女性，无爱滋病病史。将每一层中可获得的受试者随机1：1分配到试验组或拉伸控制组，采用封闭包络法。有氧训练组每个训练阶段的目标以心率储备百分比(HRR)表示。对照组将完成为期20周的以中心为基础的监督伸展计划。研究阶段在这里列出：阶段1--筛选测试和随机化。阶段2--基线结果测试。第三阶段-有氧基础训练(4周)，目标是在60-70%的HRR下进行30分钟的训练。阶段4-耐力训练(12周)，目标是70-85%HRR的45分钟阶段5-后续测试#1阶段6-短期短跑间歇训练(4周)，目标是6组30秒的间歇训练，90+%HRR，4-6分钟恢复。阶段7-后续测试#2

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The objective of this proposal is to investigate the mechanisms by which aging affects physical functioning and aerobic capacity in HIV-infected adults, and to determine if aerobic exercise training improves functional and cardiovascular performance. Results will be used to design and test specific exercise interventions for older adults infected with HIV. Our long-term objective is to devise effective prevention and treatment strategies that will improve and preserve function in this rapidly growing older patient population. Specific Aim: To determine the effect of 20 week aerobic exercise training (16 weeks endurance training plus 4 weeks short-sprint interval training) on skeletal muscle oxidative function and aerobic capacity in older HIV adults. We will conduct a randomized trial of 60 HIV subjects = 55 years. The following parameters will be assessed at baseline,16 weeks, and 20 weeks in the treatment group (N=30) and control group (N=30): a) aerobic capacity (VO2peak); b) functional performance; c) skeletal muscle oxidative function (Cytochrome C oxidase (COX) and succinate dehydrogenase (SDH); d) skeletal muscle mitochondrial morphology (electron microscopy) and mtDNA (mt/nuclear DNA ratio by PCR); e) lean body mass (DEXA;CT scan); f) skeletal muscle histology (HIV-related myopathy). Hypothesis 1. Skeletal muscle oxidative dysfunction is a mechanistic factor underlying reduced aerobic capacity and functional limitations in older HIV adults. Hypothesis 2. Aerobic exercise training will improve muscle oxidative dysfunction, and the associated functional limitations and reduced aerobic capacity in older HIV subjects compared to sedentary older HIV controls; however, improvements may be limited by the extent of sarcopenia and HIV-related myopathy. Design/procedure: This randomized trial compares the effect of 20-weeks aerobic exercise training versus stretching control in HIV-infected adults = 55 years. Outcomes include physiologic, functional, muscular, metabolic, and body composition measures which will be assessed at baseline, 16 weeks, and 20 weeks. All subjects will be HIV-infected and on stable highly active antiretroviral therapy (HAART). The majority of the volunteers will be recruited from the ID Clinic at the Baltimore VA Medical Center (VAMC)(census 620) and the University of Maryland adult HIV clinic, Evelyn Jordan Center (EJC) (census 1,800), and the community. We will use the same recruitment strategies and eligibility criteria recently employed to enroll 63 older HIV-infected adults into a cross-sectional exercise study (GET Fit, H-25827). Sixty eligible participants will be will be stratified by gender and AIDS history into one of four strata: (1) Male, history of AIDS ; (2) Male, no history of AIDS; (3) Female, history of AIDS; (4) Female, no history of AIDS. Available subjects in each stratum will be assigned at random 1:1 to either the experimental group or the stretching control group, using the closed envelope method. Targets per training phase for the aerobic training group are expressed as percent heart rate reserve (HRR). The control group will complete 20 weeks of a supervised center-based stretching program. The study phases are listed here: Phase 1- Screening testing and randomization. Phase 2- Baseline outcomes testing. Phase 3- aerobic base training (4 weeks), goal end is 30 minutes at 60-70% HRR. Phase 4- endurance training (12 weeks), goal is 45 minutes at 70-85% HRR Phase 5- follow-up testing #1 Phase 6- short-term sprint interval training (4 weeks), goal is 6 sets of 30 second intervals at 90+% HRR with 4-6 minutes recovery. Phase 7- follow-up testing #2