Effects of aerobic and resistance exercise alone or combined on strength and hormone outcomes for people living with HIV. A meta-analysis

Abstract

BackgroundInfection with human immunodeficiency virus (HIV) affects muscle mass, altering independent activities of people living with HIV (PLWH). Resistance training alone (RT) or combined with aerobic exercise (AE) is linked to improved muscle mass and strength maintenance in PLWH. These exercise benefits have been the focus of different meta-analyses, although only a limited number of studies have been identified up to the year 2013/4. An up-to-date systematic review and meta-analysis concerning the effect of RT alone or combined with AE on strength parameters and hormones is of high value, since more and recent studies dealing with these types of exercise in PLWH have been published.MethodsRandomized controlled trials evaluating the effects of RT alone, AE alone or the combination of both (AERT) on PLWH was performed through five web-databases up to December 2017. Risk of bias and study quality was attained using the PEDro scale. Weighted mean difference (WMD) from baseline to post-intervention changes was calculated. The I2 statistics for heterogeneity was calculated.ResultsThirteen studies reported strength outcomes. Eight studies presented a low risk of bias. The overall change in upper body strength was 19.3 Kg (95% CI: 9.8–28.8, p< 0.001) after AERT and 17.5 Kg (95% CI: 16–19.1, p< 0.001) for RT. Lower body change was 29.4 Kg (95% CI: 18.1–40.8, p< 0.001) after RT and 10.2 Kg (95% CI: 6.7–13.8, p< 0.001) for AERT. Changes were higher after controlling for the risk of bias in upper and lower body strength and for supervised exercise in lower body strength. A significant change towards lower levels of IL-6 was found (-2.4 ng/dl (95% CI: -2.6, -2.1, p< 0.001).ConclusionBoth resistance training alone and combined with aerobic exercise showed a positive change when studies with low risk of bias and professional supervision were analyzed, improving upper and, more critically, lower body muscle strength. Also, this study found that exercise had a lowering effect on IL-6 levels in PLWH.

Integrating smartphone technology, social support and the outdoor built environment to promote community-based aerobic and resistance-based physical activity: Rationale and study protocol for the ‘ecofit’ randomized controlled trial

“…The physical, psychological and clinical benefits of engaging in adequate amounts of physical activity are well established [88,89]. Resistance-based physical activity also provides important additional health benefits [[12], [13], [14]]. Despite this, the prevalence of meeting both the aerobic and resistance-based physical activity guidelines are low [90], and few community-based physical activity interventions to date have included both aerobic and resistance-based workout programs.…”

“…The majority of such interventions have focused on aerobic physical activity, and few have integrated both aerobic and resistance-based physical activity. Resistance-based physical activity provides additional benefits that are separate of aerobic exercise, which include lower risk of developing metabolic syndrome [12], increased muscular fitness [13], improved cardiovascular disease risk profile [14], increased lean body mass and reductions in body fat [15], as well as improved fall risk factors such as balance, postural control, mobility and leg strength in the elderly [16]. Therefore, there is a need for scalable community-based interventions which promote physical activity behavior change at multiple-levels to explicitly target sustainable change in aerobic and resistance-based physical activity.…”

Recreational exercise is associated with lower prevalence of depression and anxiety and better quality of life in German people living with HIV

“…It also effects the central nervous system (Firth et al, 2018;Kandola et al, 2019) and HIV chronic inflammation/oxidative stress (Ettorre et al, 2011;Ivanov et al, 2016). Meta-analyses have further shown significant improvements in fitness (including aerobic capacity and strength) in exercising vs. sedentary PLWH (Pérez et al, 2017(Pérez et al, , 2018. This suggests that planned, structured and repetitive PA done to improve or maintain fitness, may be beneficial in preventing anxiety and/or depression in PLWH.…”

Exercise, Comorbidities, and Health-Related Quality of Life in People Living with HIV: The HIBES Cohort Study

“…The benefits of different types of physical exercise such as aerobics, strength training, yoga, tai chi, and other forms of exercise for PWH are well known [8][9][10][11][12][13][14]. However, recent literature has focused on exploring the role of intensity and total volume of physical activity [15][16][17], but limited attention has been given to whether recreational exercises, other than aerobics, strength training, yoga, or tai chi itself, have specific effects on HRQOL.…”