Effects of Exercise Interventions on Aerobic Capacity and Health-Related Quality of Life in People Living With Hiv/Aids: Systematic Review and Network Meta-Analysis

Author: Mansueto Gomes Neto1,2,3, Michelli Bernardone Saquetto1,2,3, Iura Gonzalez Alves3, Bruno Prata Martinez1,2,3, João Paulo B Vieira1, Carlos Brites1
Affiliation: <sup>1</sup> Programa de Pós-graduação em Medicina e Saúde da Universidade Federal da Bahia (UFBA). <sup>2</sup> Departamento de Fisioterapia, Curso de Fisioterapia, Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil. <sup>3</sup> Physiotherapy Research Group, Universidade Federal da Bahia (UFBA), Salvador.
Conference/Journal: Phys Ther
Date published: 2021 Mar 10
Other: Special Notes: doi: 10.1093/ptj/pzab092. , Word Count: 266


Objective:
Exercise is a recommended component of care for people living with HIV/AIDS; however, it is unclear which type of exercise is most effective. The purpose of this study was to investigate the relative effects of different types of exercise interventions on aerobic capacity measured by peak oxygen consumption (peak VO2) and health-related quality of life (HRQoL) in this population.

Methods:
For this systematic review and indirect-comparisons meta-analysis (network meta-analysis), different electronic databases were searched up to February 2020 for randomized controlled trials that evaluated the effects of different types of exercise interventions on peak VO2 and HRQoL of people living with HIV/AIDS. Mean differences, standardized mean difference (SMD), and 95% CIs were calculated. Fixed and random effects Bayesian network meta-analysis were used to compare the relative effectiveness of the different exercise interventions.

Results:
Forty studies met the study criteria, reporting on a total of 1518 patients. When comparing the exercise interventions with usual care (control group) for the peak VO2 outcome, combined aerobic and resistance exercise was the highest ranked exercise intervention with an SMD of 4.2 (95% CI = 2.5 to 5.9), followed by aerobic exercise (SMD = 3.1; 95% CI = 1.4 to 5.1). Compared with aerobic exercise, resistance training, and yoga, combined aerobic and resistance exercise was the best exercise intervention to promote improvement on physical function, general health, mental health and energy/vitality domains HRQoL.

Conclusions:
The combined aerobic and resistance exercise was the highest ranked exercise intervention to improve peak VO2 and HRQoL. Combined aerobic and resistance exercise should be considered as a component of care for people living with HIV/AIDS.

Keywords: Exercise Therapy; HIV Infections; Rehabilitation.

PMID: 33704496 DOI: 10.1093/ptj/pzab092