Impact of supervised aerobic exercise on clinical physiological and mental parameters of people living with HIV: a systematic review and meta-analyses of randomized controlled trials

Figures & data

Figure 1. The Flow Diagram of search strategy and study selection process. AE: Aerobic exercise; PEDro: Physiotherapy Evidence Database; RCT: Randomized controlled trial.

Figure 2. Forest plots of VO₂ max (4A), depressive symptom (4B) and FEV₁ (4C) comparing outcomes of exercise and control groups.

Figure 3. Forest plots of CD4 count (5A), systolic (5B), and diastolic (5C) blood pressure comparing outcomes of exercise and control groups.

Table

	Study/Country	Participants, n (%Women) Pre, Post	Intervention	Intervention characteristics				Outcome measures	Results
				Duration /session	Frequency / week	Duration (Weeks)	Intensity			Intervention group			Control group
										Μ±SD		Statistical significance within group	Μ±SD	Statistical significance within group	Statistical significance between groups
1.	Anandh 2014, India^43	Pre: 24 (29.2%) Post: 20 (NA) IG: n = 10 CG: n = 10	Treadmill walking + arm ergo meter + elliptical trainer	30′	3	12	50-70% of HR	CD4 count 6MWT	CD4 count
									PRE		510.66 ± 112.87	P < 0.05	509.75 ± 114.62	P > 0.05	P > 0.05
									POST		562.08 ± 126.97		480.00 ± 139.07
									6MWT
									PRE		649.08 ± 48.07	P < 0.05	604.25 ± 91.24	P < 0.05	P < 0.05
									POST		725.66 ± 76.37		589.33 ± 96.60
2.	Aweto 2016, Nigeria^44	Pre:40 (62.5%) Post: 33 (69.7%) IG: n = 18 CG: n = 15	Bicycle ergo meter	30′	3	6	50- 60% of HRR	depression, FEV1, FVC	Depression
									PRE		BDI: 10.33 (6.48)	P < 0.05	BDI:10.06 ± 5.96	P > 0.05	P < 0.05
									POST		BDI: 3.50 (1.27)		BDI: 8.33 ± 5.80
									FEV1
									PRE		1.32 ± 0.65	P < 0.05	1.23 ± 0.52	P > 0.05	P < 0.05
									POST		1.98 ± 0.55		1.2 ± 0.53
									FVC
									PRE		1.99 ± 0.75	P < 0.05	1.72 ± 0.73	P > 0.05	P < 0.05
									POST		2.70 ± 0.65		1.66 ± 0.67
3.	Baigis 2002, USA^45	Pre: 99 (20%) Post: 78 (NA) IG: 43 CG: 35	Fitness ski machine	20′	3	15	75- 85% of HRmax	CD4 count VO2 max	CD4 count
									PRE		351.8 ± 81.5	P > 0.05	365.3 ± 88.9	P > 0.05	P > 0.05
									POST		365.0 ± 153.0		361.4 ± 158.8
									VO2 max
									PRE		30.2 ± 6.4	P > 0.05	32.0 ± 7.1	P > 0.05	P > 0.05
									POST		30.5 ± 6.3		30.8 ± 8.5
4.	Grigoletti, 2018, Brazil^46	Pre: 10 (50%) Post: 10 (50%) IG: n = 5 CG: n = 5	Cycling		3	4	60-80% of VO2 max	SBP, DBP	SBP
									PRE			–			–
									POST		127.75 ± 9.29		117.4 ± 7.93
									DBP
									PRE		–	–	–	–	–
									POST		80.75 ± 8.18		76.4 ± 5.32
5.	Jaleta 2018, Ethiopia^47	Pre: 58 (56.9%) Post: 43 (65.1%) IG: n = 23 CG: n = 20	Aerobic exercise on treadmill	40′	3	12	Moderate (without details)	CD4 count	CD4 count
									PRE		456.69 ± 65.36	P < 0.05	460.05 ± 68.01	P > 0.05	P < 0.05
									POST		513.13 ± 55.60		456.70 ± 70.90
6.	John 2018, Nigeria^48	Pre: 60 (60%) Post: 52 (63.5%) IG: n = 25 CG: n = 27	Aerobic exercise of progressive intensity on treadmill	45′ maximum	3	6	Up to 75% of HRmax	VO2 max SBP, DBP	VO2 max
									PRE		41.4 ± 5.73	P < 0.05	40.5 ± 4.17	P > 0.05	P < 0.05
									POST		65 ± 9.05		40.6 ± 4.24
									SBP
									PRE		123 ± 15.79	P < 0.05	125 ± 15.39	P > 0.05	P < 0.05
									POST		117 ± 13.36		124.2 ± 14.54
									DBP
									PRE		76 ± 10.77	P < 0.05	79 ± 10.50	P > 0.05	P < 0.05
									POST		71.3 ± 6.11		78 ± 9.79
7.	Lox 1996, USA^41	Pre: 21 (0%) Post: 21 (0%) IG:11 CG: 10	Cycling	24′	3	12	50-80% of HRR	VO2 max	VO2 max
									PRE		2.31 ± 0.98 (L)	P < 0.05	1.73 ± 0.92(L)	P > 0.05	P < 0.05
									POST		3.47 ± 1.23(L)		1.65 ± 1.19(L)
8.	Maduagwu 2015, Nigeria^42	Pre: 82 (59.7%) Post: 64 (64%) IG:32 CG: 32	Aerobic exercise on treadmill	30′	3	12	50-75% of HRR	CD4 count	CD4 count
									PRE		491.18 ± 152.73	P < 0.05	489.53 ± 108.78	P < 0.05	P < 0.05
									POST		672.25 ± 227.59		522.66 ± 123.06
9.	Smith 2001, USA^39	Pre: 60 (13.3%) Post: 49 (8.2%) IG:19 CG: 30	Walking, jogging, running on treadmill or on the track + cycling, stair stepper, cross- country machine	at least 30′	3	12	ΗR at 60-80% of VO2 max	CD4 count, VO2 max, FEV1	CD4 count
									PRE		331.9 ± 68.8	P > 0.05	357 ± 97.2	P > 0.05	P > 0.05
									POST		339.1 ± 127		389.5 ± 118.1
									VO2 max
									PRE		34.9 ± 5.7	P > 0.05	31.0 ± 5.9		P > 0.05
									POST		37.5 ± 6.1		32.0 ± 6.9
									FEV1
									PRE		4.0 ± 0.6	P > 0.05	3.6 ± 0.9	P > 0.05	P > 0.05
									POST		4.1 ± 0.8		3.6 ± 1.1
10.	Neidig 2003, USA^40	Pre: 60 (13.3%) Post: 49 (8.2%) IG:19 CG: 30	Walking, jogging, running on treadmill or on the track + cycling, stair stepper, cross- country machine	at least 30′	3	12	ΗR at 60-80% of VO2 max	Depression	Depression
									PRE		BDI: 8.6 ± 6.0		BDI: 8.9 ± 5.9	-	P = 0.06
									POST		BDI: 5.6 ± 6.3		BDI: 8.7 ± 7.1

Note: BDI, Beck’s depression inventory; CG, Control Group; DBP, Diastolic Blood Pressure; FEV1, Forced Expiratory Volume in 1 second; FVC, Forced Vital Capacity; HR, Heart Rate; HRmax, Maximum Heart Rate; HRR, Heart Rate Reserve; IG, Intervention Group; 6MWT, 6 Minute Walk Test; Μ±SD, Mean ± standard deviation; NA, Not Available; SBP, Systolic Blood Pressure; VO₂ max, Maximal Oxygen Uptake.

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