The effects of exercise training on metabolic and morphological outcomes for people living with HIV: a systematic review of randomised controlled trials.
OBJECTIVE
to determine the effects of exercise on metabolic and morphological outcomes among people with HIV using a systematic search strategy of randomized, controlled trials (RCTs).


METHODS
two independent reviewers assessed studies using a predetermined protocol.


RESULTS
nine RCTs (469 participants, 41% females) of moderate quality were included. Compared to nonexercising controls, aerobic exercise (AE) resulted in decreased body mass index (weighted mean difference [WMD] -1.31; 95% CI, -2.59, -0.03; n=186), triceps skinfold thickness of subcutaneous fat (WMD -1.83 mm; 95% CI,-2.36, -1.30; n=144), total body fat (%) (standardised mean difference [SMD],-0.37; 95% CI, -0.74, -0.01; n=118), waist circumference (SMD -0.74 mm, 95% CI, -1.08, -0.39; n=142), and waist:hip ratio (SMD -0.94; 95% CI, -1.30, -0.58; n=142). Progressive resistive exercise (PRE) resulted in increased body weight (5.09 kg; 95% CI, 2.13, 8.05; n=46) and arm and thigh girth (SMD 1.08 cm; 95% CI, 0.35, 1.82; n=46). Few studies examined blood lipids, glucose, and bone density.


CONCLUSIONS
few RCTs exist and their quality varies. AE decreases adiposity and may improve certain lipid subsets. PRE increases body weight and limb girth. No additional effects of combining AE and PRE are evident. Larger, higher quality trials are needed to understand the effects of exercise on metabolic outcomes (eg, lipids, glucose, bone density) relevant to persons with chronic, treated HIV.
Physiotherapy Department, The Alfred, Melbourne, Victoria, Australia Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. s.fillipas@alfred.org.au
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Fillipas
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Cherry
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Cicuttini
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Smirneos
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Holland
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D001835:Body Weight / Q000502:physiology; D002784:Cholesterol / Q000097:blood; D015444:Exercise / Q000502:physiology*; D005260:Female; D006678:HIV; D015658:HIV Infections / Q000097:blood / Q000378:metabolism* / Q000473:pathology / Q000534:rehabilitation*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D016032:Randomized Controlled Trials as Topic; D012885:Skinfold Thickness; D014057:Tomography, X-Ray Computed; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference / Q000502:physiology; D049629:Waist-Hip Ratio
D001786:Blood Glucose; D014280:Triglycerides; D002784:Cholesterol