Development of Evidence-Based Exercise Recommendations for Older HIV-Infected Patients

Abstract

Advances in antiretroviral therapy (ART) have decreased HIV-related morbidity and mortality and contributed to rapidly increasing numbers of older people living with HIV. Successful management of ART-related side effects (metabolic syndrome) and age-related comorbidities (frailty) are major challenges for patients and providers. Exercise has proven beneficial for younger HIV-infected patients, but we know little about which exercise regimens to recommend to the elderly. Our goal was to develop age-appropriate, evidence-based exercise recommendations for older HIV-infected adults (age > 50). We reviewed randomized controlled trials on the effects of physical exercise for: (a) HIV-infected young adults, (b) frail older adults, and (c) elderly individuals with metabolic syndrome. We recommend a combination of endurance and resistance exercises 3 times per week for at least 6 weeks to improve cardiovascular, metabolic, and muscle function. Further research is warranted to study the benefits and risks of physical exercise in older HIV-infected patients.

Effects of an exercise programme with people living with HIV: research in a disadvantaged setting

“…Besides aiming to reduce body weight, particularly central fat weight, the main goal of the participants was to improve appearance, and to look good, healthy and strong. In that sense, their goals were in line with the recommendations of the stateof-the-art, which are to combine aerobic and progressive resistance training (O'Brien et al 2004, Robinson et al 2007, Hand et al 2009, Lazzarotto et al 2010, O'Brien et al 2010, Souza et al 2011, Yahiaoui et al 2011). …”

“…Results of a Cochrane review indicated that regular progressive resistance training is safe, and improves the physical factors of strength, weight and body composition, and may also contribute to an improvement in cardiopulmonary fitness and psychological status of adults living with HIV (O'Brien et al, 2004). Thus a combination of aerobic and progressive resistance training is widely recommended (Robinson et al 2011, Yahiaoui et al 2011. However, many questions remain unanswered, such as how to achieve these physical and physiological effects in the specific context of people living with HIV in disadvantaged communities.…”

Effect of Exercise on Cardiac and Metabolic Outcomes in People Living With HIV

“…Training partners can motivate PLWH to continue exercising and are effective for a long-term commitment to behavior change (Yahiaoui, McGough, & Voss, 2012). There is general agreement that moderate aerobic and/or resistance exercise does not negatively impact viral load or CD4 T cell counts (Clem & Borchers, 2007;Smith et al, 2001).…”

Nutrition and Physical Exercise in Older Patients with HIV

“…Yahiaoui et al [ 30 ] demonstrated good results with a combined protocol consisting of a mix of endurance and resistance exercises three times per week for at least 6 weeks to improve cardiovascular, metabolic, and muscle function. Stretching, before and after exercising, is also recommended to prevent injuries [ 30 ].…”