Effects of progressive resistive exercise in adults living with HIV/AIDS: systematic review and meta-analysis of randomized trials

Abstract

This systematic review examined the effectiveness and safety of progressive resistive exercise (PRE) interventions on immunological/virological, cardiopulmonary, weight, and body composition, strength and psychological outcomes in adults living with HIV. Using Cochrane Collaboration protocol, we included randomized controlled trials from 1980–2006 comparing PRE interventions with no PRE or another intervention. Ten studies met inclusion criteria. Seventeen meta-analyses were performed. Results indicated that PRE or a combination of PRE and aerobic exercise may lead to statistically significant increases in weight (WMD: 2.68 kg; 95%CI: 0.40, 4.97) and arm and thigh girth (WMD: 7.91 cm; 95%CI: 2.18, 13.65) among exercisers versus non-exercisers. Trends toward improvement in submaximum heart rate and exercise time also were found. Individual studies suggested that PRE contributed to improved strength and psychological status. Findings are limited to participants who continued to exercise. Progressive resistive exercise appears to be safe and may be beneficial for medically-stable adults living with HIV.

Acknowledgements

The authors gratefully acknowledge the contributions of Angela Eady, MLS, Health Information Research Unit, McMaster University and Elizabeth Uleryk, Director, Hospital Library, The Hospital for Sick Children for their assistance in refining the search strategies and conducting the searches; and Christopher Sulway and Jim Marianchuk for their role in data abstraction. The following authors or co-authors were valuable in providing us with additional data or information about individual studies for this review: Allen Jackson (for L. W. Rigsby), Curt Lox, Steven Grinspoon, Ira Wilson (for A.H. Shevitz), and Sara E. Dolan. We also thank Rosane Nisenbaum (PhD, research scientist and senior biostatistician, Centre for Research on Inner City Health) for her review of an earlier version of this manuscript. The authors gratefully acknowledge the Ontario HIV Treatment Network, Ontario, Canada and the Centre for Research on Inner City Health at the Keenan Research Centre in the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada for their support. The Centre for Research on Inner City Health is sponsored by the Ontario Ministry of Health and Long-Term Care. The views expressed in this manuscript are those of the authors and do not necessarily reflect the views of the Ontario Ministry of Health and Long Term Care. Kelly O'Brien is supported by a Fellowship from the Canadian Institutes of Health Research HIV/AIDS Research Program. Stephanie Nixon is supported by a Fellowship from the Ontario HIV Treatment Network. This manuscript is an update of an original systematic review published in The Cochrane Library: O'Brien K, Nixon S, Glazier RH, Tynan AM. Progressive resistive exercise interventions for adults living with HIV/AIDS. The Cochrane Database of Systematic Reviews 2004, Issue 4. Art. No: CD004248.pub2. DOI: 10.1002/14651858.CD004248.pub2.