title: Physical impairment in HIV infections and AIDS: responses to resistance and aerobic training.
abstract: OBJECTIVE
  The aim of this paper was to examine impairments in muscle strength and aerobic power associated with HIV and AIDS, to define optimal regimes of resistance and aerobic training, and to explore possible influences of HAART treatment upon responses.
  
  
  METHODS
  Data from HealthStar/Ovid (1985 to 2013) were supplemented by references in identified articles and material in the author's personal files, yielding 133 citations. Detailed analysis was restricted to controlled trials (16 studies of resistance training, 17 of aerobic training).
  
  
  RESULTS
  HIV infection and AIDS are often marked by substantial muscle wasting of multi-factorial origin. Impairment of aerobic function is more variable, with possible effects from physical inactivity, HAART therapy and muscular weakness. Most patients respond well to moderate resistance and aerobic training, showing substantial gains of strength, smaller improvements of aerobic power, and no adverse changes in CD4+ count or viral load. Moreover, these responses do not seem adversely affected by HAART therapy.
  
  
  CONCLUSIONS
  Patients with HIV and AIDS should participate in moderate combined resistance and aerobic training programs. Such training elicits substantial gains in strength and cardiac function, and improves mood state and quality of life without adverse effects upon disease progression. Moreover, responses are not adversely affected by HAART therapy. The main challenge in the western world is to maintain compliance, since adherence to rehabilitation programs is often poor. There is also a need to develop exercise programs appropriate to regions where the disease is most prevalent, and to monitor possible interactions between rehabilitation and newly emerging forms of treatment.
authors.affiliation: Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada - royjshep@shaw.ca.
authors.forename: R J
authors.initials: RJ
authors.lastname: Shephard
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy / Q000503:physiopathology*; D023241:Antiretroviral Therapy, Highly Active; D015658:HIV Infections / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D053580:Muscle Strength / Q000502:physiology*; D055070:Resistance Training