Complementary Therapies in the Aging Process of People Living With HIV

Summary

PROBLEM DELIMITATION AND JUSTIFICATION Complementary therapies, including physical exercise and massage therapy, are ways to mitigate the side effects of aging, HIV infection and ART. In parallel, there are studies that seek to propose a way to analyze muscle strength and endurance, balance, walking ability, body composition, immunological, metabolic and biochemical parameters, sarcopenia, frailty syndrome, sleep quality, self-perception of health, self-esteem, perception of body image, anxiety, depression, cognitive function, medication adherence, quality of life, diet and level of physical activity in people living with HIV (PLWH). However, the impact of concurrent training, massage therapy and aromatherapy on these parameters together in PLWH with different times of diagnosis and consequences of the low CD4/CD8 ratio during their clinical history has not yet been investigated.

RELEVANCE Understanding the impact of concurrent training, massage therapy and aromatherapy, as complementary therapies, on physical, biochemical and psychosocial parameters according to the time of diagnosis and consequences of the low CD4/CD8 ratio is a way to evaluate the effect of these interventions on different profiles of the same population, and consequently, favor the development of other studies that can propose training and massage for PLWH, considering the time of diagnosis and the impact of HIV on their body.

GENERAL OBJECTIVE To evaluate the impact of complementary therapies on variables associated with the aging of people living with HIV, considering the time of diagnosis and the CD4/CD8 ratio.

Study design The research project has a multidesign characteristic, that is, different study designs will be used that communicate with each other to provide a broad approach to the effect of complementary therapies on the aging process of PLWH. The study designs used will be: systematic review and meta-analysis, cross-sectional observational study, and blinded clinical trial.

Intervention protocol The kinetics of heart rate and oxygen consumption, peak running speed (Vpeak), running speed at the ventilatory threshold, and respiratory exchange ratio will be assessed before and after the 12-week intervention. In addition, the estimated maximum load (1RM) in strength training will be verified in exercises for the upper limbs: front pulldown, bench press on the machine, and lateral elevation of the shoulders with dumbbells; and lower limbs: leg press 90°, adductor and abductor chair, and plantar flexion on the bench before and after the 12-week intervention. Massage and aromatherapy sessions will be performed once a week for 12 weeks for 30 minutes in the dorsal region. The massage protocol that will be used includes classic massage movements (superficial sliding, deep sliding, friction, rolling, kneading) with grape seed vegetable oil mixed with lavender essential oils, being a 2% mixture (50 drops of essential oil for 100ml of vegetable oil).

Statistical analysis In this project, the variables considered as independent are concurrent training and relaxing massage with the use of essential oils. An initial exploratory analysis will be performed to check the distribution behavior of the data. If the data present a normal distribution, a descriptive analysis (measures of central tendency, SD, CI) of the outcome variables in the periods (pre- and post-intervention) will be performed. If there is no normal distribution of the data, the description of the outcome variables will occur through median, minimum and maximum value, and 25th and 75th interquartile range.

If there is a normal distribution of the data, the t-test for dependent samples will be used to identify differences in the pre- and post-intervention period for the intervention and control groups. Subsequently, the one-way ANOVA will be used to verify differences between the intervention and control groups, in the pre- and post-intervention period. If there is no normal distribution, the Mann-Whitney U test for dependent samples will be used to identify differences in the pre- and post-intervention period for the intervention and control groups. Subsequently, the Wilcoxon test for independent samples will be used to verify differences between the intervention and control groups, in the pre- and post-intervention period. It is not the objective of this project to compare the effect of the intervention between concurrent training and relaxing massage with the use of essential oils. The effect size (η2) of concurrent training and relaxing massage with the use of essential oils on the outcome variables will be calculated. The analyses will be performed in SPSS 23.0 software, assuming prior statistical significance (α = 0.05).

Conditions

• HIV

Interventions

OTHER

Concurrent Training

Strength and aerobic training in the same training session for a period of 12 weeks, 3 times a week and with an average training time of 60 minutes

OTHER

Massage therapy and Aromatherapy

Massage Therapy with Aromatherapy twice a week for a period of 12 weeks and an average time of 40 minutes per session.

Sponsors & Collaborators

• Hospital das Clínicas, University of Sao Paulo Medical School

  collaborator UNKNOWN

• Ministry of Education, Brazil

  collaborator OTHER_GOV

• University of Sao Paulo

  lead OTHER

Principal Investigators

• Andre P dos Santos, Professor Doutor · University of Sao Paulo

• Euripedes B G Gomide, Professor Doutor · Claretiano - Centro Universitário, Batatais, Brasil

• Gianna F Marchiori, Doutora · Grupo de Pesquisa em Saúde Coletiva da Universidade Federal do Triângulo Mineiro, Uberaba, Brasil

• Jéssica F C Cordeiro, Doutora · Faculdade de Desporto da Universidade do Porto, Porto, Portugal

• Igor M Correia, Doutorando · University of Sao Paulo

• Chimenny A L C de Moraes, Mestre · University of Sao Paulo

• Alcivandro de S Oliveira, Mestrando · University of Sao Paulo

• Camile V R de Oliveira, Graduada · University of Sao Paulo

• Joana Brilhadori, Mestranda · University of Sao Paulo

• Leandro C Nunes, Graduado · University of Sao Paulo

• Lisa F Mazzonetto, Mestre · University of Sao Paulo

• Jeferson R C dos Anjos, Mestre · University of Sao Paulo

• Lara S Silva, Graduanda · Claretiano - Centro Universitário, Batatais, Brasil

• Giovana Finco, Graduada · University of Sao Paulo

Study Design

Allocation

NON_RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

DOUBLE

Model

PARALLEL

Eligibility

Min Age

50 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2025-04-30

Primary Completion

2025-12-20

Completion

2027-12-20