Creatine Fails to Augment the Benefits from Resistance Training in Patients with HIV Infection: A Randomized, Double-Blind, Placebo-Controlled Study

BackgroundProgressive resistance exercise training (PRT) improves physical functioning in patients with HIV infection. Creatine supplementation can augment the benefits derived from training in athletes and improve muscle function in patients with muscle wasting. The objective of this study was to determine whether creatine supplementation augments the effects of PRT on muscle strength, energetics, and body composition in HIV-infected patients.Methodology/principal findingsThis is a randomized, double blind, placebo-controlled, clinical research center-based, outpatient study in San Francisco. 40 HIV-positive men (20 creatine, 20 placebo) enrolled in a 14-week study. Subjects were randomly assigned to receive creatine monohydrate or placebo for 14 weeks. Treatment began with a loading dose of 20 g/day or an equivalent number of placebo capsules for 5 days, followed by maintenance dosing of 4.8 g/day or placebo. Beginning at week 2 and continuing to week 14, all subjects underwent thrice-weekly supervised resistance exercise while continuing on the assigned study medication (with repeated 6-week cycles of loading and maintenance). The main outcome measurements included muscle strength (one repetition maximum), energetics ((31)P magnetic resonance spectroscopy), composition and size (magnetic resonance imaging), as well as total body composition (dual-energy X-ray absorptiometry). Thirty-three subjects completed the study (17 creatine, 16 placebo). Strength increased in all 8 muscle groups studied following PRT, but this increase was not augmented by creatine supplementation (average increase 44 vs. 42%, difference 2%, 95% CI -9.5% to 13.9%) in creatine and placebo, respectively). There were no differences between groups in changes in muscle energetics. Thigh muscle cross-sectional area increased following resistance exercise, with no additive effect of creatine. Lean body mass (LBM) increased to a significantly greater extent with creatine. CONCLUSIONS / SIGNIFICANCE: Resistance exercise improved muscle size, strength and function in HIV-infected men. While creatine supplementation produced a greater increase in LBM, it did not augment the robust increase in strength derived from PRT.Trial registrationClinicalTrials.gov NCT00484627

The Effectiveness of a Pram-Walking Exercise Programme in Reducing Depressive Symptomatology for Postnatal Women

The purpose of the research project was to examine the effects of exercise, social support and depression on postnatal women who reported experiencing Postnatal Depression (PND). A 12 week randomised controlled trial was conducted investigating the effects of an exercise intervention group (3 sessions/wk of 60%-75% intensity) compared to a social support group (1 session/wk). Participants in both groups had given birth in the past 12 months and were experiencing depressive symptomatology. Pre-test data of physical fitness and structured questionnaires were compared to post-test effects. The exercise intervention consisted of a pram walking program for mothers and their babies and the social support intervention involved non-structured sessions, similar to a play group. The primary outcomes were to reduce the depressive syptomatology and improve fitness levels of participants in the pram walking group. Secondary outcomes were to improve the social support levels of the participants in both groups and explore women's views about the programs. It was hypothesised that the pram walking group would improve their feelings of depression and fitness levels compared to the social support group, but that both groups would improve their perceived levels of social support. The results showed that mothers in the pram walking intervention group improved their fitness levels (VO2 max = p 0.05). These results are encouraging and suggest that a pram walking intervention has the potential to improve depressive symptomatology and fitness levels for women who reported experiencing postnatal depression. Therefore, a direct association between improvement in fitness was related to improvement in depression for the pram walking group. However, it is also suggested that other factors in combination with improvements in fitness influenced improvements in depressive levels. Tailored pram walking programs have the potential to provide primary and secondary treatment options for postnatal women. It is a recommendation that pram walking programs for mothers with PND be implemented as pilot research into existing available services. These conclusions and recommendations are tentative and could be confirmed with larger studies with larger cohorts

Exercising with Others Exacerbates the Negative Effects of Mirrored Environments on Sedentary Women’s Feeling States

The unique and interactive effects of mirrored exercise environments and the presence of co-exercisers on sedentary women\u27s exercise-induced feeling states (FS) were examined. Participants (n = 92; mean age = 20.2) performed 20 min of moderate intensity exercise in one of four environments: (a) alone/mirrored, (b) not alone/mirrored, (c) alone/unmirrored, or (d) not alone/unmirrored. FS were measured pre-, mid-, and 5 min post-exercise. Self-consciousness, perceived social evaluation and social comparisons were also assessed post-exercise. Multilevel modeling procedures indicated that women in the not alone/mirrored environment experienced smaller increases in post-exercise revitalization than the other conditions (p \u3c 0.05), and were the only condition to experience increased physical exhaustion (p \u3c 0.05). Women in the not alone/mirrored condition also reported greater self-consciousness and more social comparisons than those in alone/mirrored condition (ps \u3c 0.01). Findings are consistent with Objective Self-Awareness Theory, and suggest that mirrored, group exercise environments are not conducive to psychological well-being among women unaccustomed to exercise