O'Brien Kelly K, Tynan Anne-Marie, Nixon Stephanie A, Glazier Richard H
Department of Physical Therapy, University of Toronto, 500 University Avenue, Room 160, Toronto, ON, Canada.
Rehabilitation Sciences Institute (RSI), University of Toronto, 500 University Avenue, Room 160, Toronto, ON, Canada.
BMC Infect Dis. 2017 Apr 12;17(1):268. doi: 10.1186/s12879-017-2342-8.
HIV is increasingly considered a chronic illness. More individuals are living longer and aging with the health-related consequences associated with HIV and multi-morbidity. Exercise is a self-management approach that can promote health for people aging with HIV. We examined the safety and effectiveness of progressive resistive exercise (PRE) interventions on immunological, virological, cardiorespiratory, strength, weight, body composition, and psychological outcomes in adults living with HIV.
We conducted a systematic review using the Cochrane Collaboration protocol. Searching databases up to April 2013, we included randomized controlled trials that compared PRE with no exercise or another intervention performed at least three times per week for at least four weeks with adults living with HIV. Two reviewers independently determined study eligibility. We extracted data from included studies and assessed risk of bias using the Cochrane Collaboration risk of bias tool. Meta-analyses were conducted using random effects models with Review Manager (RevMan) computer software.
Twenty studies met inclusion criteria (n = 764 participants at study completion); the majority of participants were men (77%) taking antiretroviral therapy (14/20 included studies). Exercise interventions included PRE alone (8 studies) or a combination of resistive and aerobic exercise (12 studies) ranging from 6 to 52 weeks in duration. Thirty-four meta-analyses were performed. Results demonstrated statistically significant improvements in cardiorespiratory status (maximum oxygen consumption, exercise time), strength (chest press, knee flexion), weight, and body composition (arm and thigh girth, leg muscle area) among exercisers versus non-exercisers. We found no significant differences in change in CD4 count and viral load. We were unable to perform meta-analyses for psychological outcomes however results from individual studies demonstrated improvements in health-related quality of life with exercisers compared with non-exercisers.
Performing progressive resistive exercise (PRE) or a combination of resistive and aerobic exercise at least three times per week for at least six weeks is safe and can lead to improvements in cardiorespiratory fitness, strength, weight, and body composition for adults with HIV. Exercise may be considered a safe and beneficial for enhancing the health of medically stable adults aging with HIV.
越来越多的人认为人类免疫缺陷病毒（HIV）感染是一种慢性病。随着HIV感染者寿命延长以及年龄增长，与之相关的健康问题和多种疾病并存的情况日益凸显。运动是一种自我管理方式，对HIV感染的老年人有益健康。我们研究了渐进性抗阻运动（PRE）干预措施对HIV感染成人的免疫、病毒学、心肺功能、力量、体重、身体成分和心理状况的安全性和有效性。
我们按照Cochrane协作网的方案进行了系统评价。检索截至2013年4月的数据库，纳入了将PRE与不运动或其他干预措施进行比较的随机对照试验，干预措施每周至少进行3次，持续至少4周，研究对象为HIV感染成人。两名评价员独立确定研究的纳入标准。我们从纳入的研究中提取数据，并使用Cochrane协作网的偏倚风险工具评估偏倚风险。使用Review Manager（RevMan）计算机软件的随机效应模型进行荟萃分析。
20项研究符合纳入标准（研究完成时n = 764名参与者）；大多数参与者为男性（77%），正在接受抗逆转录病毒治疗（14/20项纳入研究）。运动干预措施包括单独的PRE（8项研究）或抗阻运动与有氧运动相结合（12项研究），持续时间为6至52周。进行了34项荟萃分析。结果显示，与不运动者相比，运动者的心肺功能（最大摄氧量、运动时间）、力量（卧推、膝关节屈曲）、体重和身体成分（上臂和大腿围度、腿部肌肉面积）有统计学意义的改善。我们发现CD4细胞计数和病毒载量的变化无显著差异。我们无法对心理状况进行荟萃分析，但个别研究的结果表明，与不运动者相比，运动者的健康相关生活质量有所改善。
每周至少进行3次渐进性抗阻运动（PRE）或抗阻运动与有氧运动相结合，持续至少6周，对HIV感染成人是安全的，并且可以改善心肺功能、力量、体重和身体成分。运动可能被认为对促进HIV感染的病情稳定的老年人的健康是安全且有益的。
