Supervised Physical Activity and Improved Functional Capacity Among Adults Living With HIV: A Systematic Review

Background: Physical activity (PA) is an important strategy for healthy aging. Regular PA has been shown to be safe and combat the effects of inflammation, multi-morbidity, and long-term effects of antiretroviral therapy among people living with HIV. However, people living with HIV often fail to meet recommended guidelines for PA. It is recommended that people living with HIV engage in 20-40 minutes of combined aerobic and resistance training at least three times per week. Supervised PA interventions in the uninfected population have produced greater increases in muscular strength, cardiovascular fitness, and body composition compared to control study participants. The purpose of this review was to investigate whether supervised PA interventions improved functional capacity among adults living with HIV.

Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed for this review. Five databases were searched for randomized controlled trials in English, with adults aged 18 and over, where supervised PAwas the intervention. Supervised PAwas defined as a physical activityintervention that was supervised by a health care or allied health professional.

Results: The database literature search yielded 8,267 articles. After the title/abstract and full-text screening phases, 15 articles were included in the review. Using the Cochrane Collaboration’s tool for assessing risk of bias, most studies fell in the ‘low risk of bias’ category within and across studies. Combined aerobic and progressive resistance training (PRT) improved strength, cardiovascular, and flexibility outcomes; three of four studies showed no significant improvements with aerobic interventions; PRT improved strength outcomes in all studies; yoga or combined yoga/meditation showed no difference between intervention and control groups; and, t’ai chi showed improvements in cardiovascular and flexibility outcomes.

Conclusions: Supervised PA interventions increase functional capacity among adults living with HIV. Combined aerobics and PRT showed improvements in strength, cardiovascular, and flexibility outcomes. Self-reported measures showed inconsistent results of functional capacity across studies.