Combination of resistance and aerobic exercise for six months improves bone mass and physical function in HIV infected individuals: A randomized controlled trial

Abstract

To evaluate the effect of combined resistance and aerobic training (RT+AT) on regional bone mineral density (BMD) and physical performance in people living with HIV (PLWH). Forty PLWH (20 men and 20 women) were randomized into RT+AT group (n = 20; age = 38.3 ± 4.9) or non‐exercise control group (n = 20; age = 37.9 ± 5.1). The RT+AT group was required to perform a nonlinear periodized resistance training program targeting large muscle groups followed by 20 min aerobic exercise at 65‐80% of maximal heart rate. Participants in RT+AT performed three supervised sessions per week for 6‐months, whereas participants in the control group were instructed to continue with their current lifestyle habits. The primary outcome was bone mineral density (lumbar spine (L2‐L4), femoral neck, and distal 1/3 radius). Secondary outcomes included physical function, anthropometry, inflammatory markers, and growth factors. The RT+AT group demonstrated a significant increase in BMD at follow‐up for the Lumbar spine (L2‐L4), femoral neck, and 1/3 radius (all, P < .05), and There were no gender differences in the training response between men and women for any of the BMD regions. Similar findings were also observed for lean body mass, IGF1and Adiponectin (P < .001). We observed a decrease in percent body fat, fat mass, IL‐6, TNF‐α, and myostatin in the RT+AT group (P < .001). Finally, there was a significant increase in handgrip strength and gait speed for both women and men in the RT+AT group (P < .001). A combination of resistance and aerobic training appears to be a feasible and effective means for counteracting bone loss and improving various inflammatory markers, physical function, and growth hormones in PLWH.

Effect of HIV infection on growth and bone density in peripubertal children in the era of antiretroviral therapy: a cross-sectional study in Zimbabwe

“…High impact physical activity is thought to be osteogenic, and has been associated with improved bone density at the hip in healthy adolescents. 24 In 2021, a small randomised trial in young adults living with HIV suggested that a combination of resistance and aerobic exercise might improve bone mass; 27 whether the same is applicable for children with HIV remains to be confirmed. In 2019, the first small randomised controlled trial of the oral bisphosphonate, alendronate, given to children with HIV, showed some evidence of improved bone density over 48 weeks of treatment; 28 however, longer term effects on PBM, fracture risk, and rare side-effects are unknown.…”

Exercise Effects on Bone Mineral Density in Men

“…In parallel, we used Doi plots and the Luis Furuya-Kanamori index (LFK index) [31] to check asymmetry. Finally, we applied influence analyses excluding two "critical" studies [11,14] from the analysis for BMD-LS and FN. A p-value < 0.05 was considered as the significance level for all tests.…”

“…In total, our search identified twelve studies [11][12][13][14][15][16][17][18][19][20][21][22] (Figure 1) with 16 exercise and control groups: 362). Table 1 presents the study and participant characteristics of the eligible studies that determined the effect of exercise on bone mineral density among men.…”

“…Table 1 presents the study and participant characteristics of the eligible studies that determined the effect of exercise on bone mineral density among men. In addition to the information given in Table 1, all but one study [22] focused on Caucasian men 36 ± 7 [14] to 79 ± 5 years [18] old. Although not always consistently stated, BMD was addressed as the primary outcome in 11 of 12 studies [11][12][13][14][15][16][17][18][19]21,22].…”

Effect of HIV Infection on Growth and Bone Density in Peripubertal Children in the Era of Antiretroviral Therapy: A Cross-Sectional Study in Zimbabwe

“…High impact physical activity is thought to be osteogenic, and has been associated with improved bone density at the hip in healthy adolescents. 24 In 2021, a small randomised trial in young adults living with HIV suggested that a combination of resistance and aerobic exercise might improve bone mass; 27 whether the same is applicable for children with HIV remains to be confirmed. In 2019, the first small randomised controlled trial of the oral bisphosphonate, alendronate, given to children with HIV, showed some evidence of improved bone density over 48 weeks of treatment; 28 however, longer term effects on PBM, fracture risk, and rare side-effects are unknown.…”