Effectiveness of Aerobic Exercise in Adults Living with HIV/AIDS: Systematic Review

Kelly O'Brien; Stephanie Nixon; Anne-Marie Tynan; Richard H. Glazier

Disclosures

Med Sci Sports Exerc. 2004;36(10) 

In This Article

Abstract and Introduction

Purpose: The objective of this systematic review was to examine the effectiveness and safety of aerobic exercise interventions on immunological/virological, cardiopulmonary, and psychological outcomes in adults living with HIV/AIDS.
Methods: Ten randomized trials of HIV-positive adults performing aerobic exercise three times per week for at least 4 wk were identified by searching 13 electronic databases, abstracts from conferences, reference lists, and personal contact with authors from 1980 to November 2002. At least two independent reviewers assessed articles for inclusion, extracted data, and assessed methodological quality. Random effects models were used for meta-analysis.
Results: Main results indicated that aerobic exercise was associated with small nonsignificant changes in CD4 count (weighted mean difference: 14 cells·mm-3, 95% CI: -26, 54), viral load (weighted mean difference: 0.40 log10 copies, 95% CI: -0.28, 1.07), and O2max (weighted mean difference: 1.84 mL·kg-1·min-1, 95% CI: -0.53, 4.20). Individual studies suggested that aerobic exercise may improve psychological well-being for adults living with HIV/AIDS. These findings are limited to those participants who continued to exercise and for whom there was adequate follow-up.
Conclusion: In conclusion, performing constant or interval aerobic exercise, or a combination of constant aerobic exercise and progressive resistive exercise for at least 20 min, at least three times per week for 4 wk may be beneficial and appears to be safe for adults living with HIV/AIDS. However, these findings should be interpreted cautiously due to small sample sizes and large dropout rates within the included studies. Future research would benefit from increased attention to participant follow-up and intention-to-treat analysis.

The profile of HIV infection has changed dramatically since the advent of highly active antiretroviral therapy (HAART). Once viewed as an illness progressing steadily toward death, HIV infection can now present as a chronic and episodic disease for people who are able to access and tolerate HAART. These developments have been mirrored by a perceived increasing prevalence of impairments, activity limitations, and participation restrictions for many people living with HIV.[19]

Exercise is one possible management strategy for addressing these issues. Exercise has potential prophylactic benefits associated with increased lean body mass and cardiovascular fitness. Exercise is also closely linked to body image, which has particular significance in certain HIV-affected communities (Shernoff, M. Pumped up: gay men and gym culture. GayHealth, December 18, 2000. Available at: www.gayhealth.com/iowa-robot/fitness/workout/?record=340; accessed December 19, 2002). Exercise has been shown to improve strength, cardiovascular function, and psychological status in general populations,[2] but the effectiveness and safety of aerobic exercise for adults living with HIV infection have not been established. If the risks and benefits of exercise for people living with HIV infection are better understood, appropriate exercise prescription may be practiced by health care providers and may enhance the effectiveness of HIV management, thus improving overall outcomes for adults living with HIV infection.

The purpose of this systematic review and meta-analysis was to examine the effectiveness and safety of aerobic exercise interventions on immunological/ virological, cardiopulmonary, and psychological outcomes in adults living with HIV.

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