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Supervised Physical Activity and Improved Functional Capacity among Adults Living with HIV: A Systematic Review.

ABSTRACT: Physical activity (PA) combats the effects of multimorbidity and antiretroviral therapy in people living with HIV (PLWH), but PLWH often don't meet recommended PA guidelines. The purpose of our review was to investigate whether supervised PA improved functional capacity in PLWH. Preferred Reporting Items for Systematic Reviews and Meta-Analyses were followed. Five databases were searched for randomized controlled trials in English, with participants ages 18 years and older, and a supervised PA intervention. A database search yielded 8,267 articles, with 15 eligible for review inclusion. We found a low risk of bias within and across studies. Combined aerobic/progressive resistance training (PRT) improved strength, cardiovascular, and flexibility outcomes; aerobic interventions alone showed no significant improvements; PRT improved strength outcomes; yoga or yoga/meditation showed no outcome differences; and t'ai chi showed cardiovascular and flexibility improvements. We found that supervised PA increased functional capacity in PLWH and that self-report was not a reliable assessment.

SUBMITTER: Voigt N

PROVIDER: S-EPMC7089845 | biostudies-literature | 2018 Sep - Oct

REPOSITORIES: biostudies-literature

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Supervised Physical Activity and Improved Functional Capacity among Adults Living with HIV: A Systematic Review.

Voigt Natalie N Cho Hwayoung H Schnall Rebecca R

The Journal of the Association of Nurses in AIDS Care : JANAC 20180531 5

Physical activity (PA) combats the effects of multimorbidity and antiretroviral therapy in people living with HIV (PLWH), but PLWH often don't meet recommended PA guidelines. The purpose of our review was to investigate whether supervised PA improved functional capacity in PLWH. Preferred Reporting Items for Systematic Reviews and Meta-Analyses were followed. Five databases were searched for randomized controlled trials in English, with participants ages 18 years and older, and a supervised PA i ...[more]

PMID: 29861318

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Project description:BACKGROUND: The purpose was to conduct systematic reviews of the relationship between physical activity of healthy community-dwelling older (>65 years) adults and outcomes of functional limitations, disability, or loss of independence. METHODS: Prospective cohort studies with an outcome related to functional independence or to cognitive function were searched, as well as exercise training interventions that reported a functional outcome. Electronic database search strategies were used to identify citations which were screened (title and abstract) for inclusion. Included articles were reviewed to complete standardized data extraction tables, and assess study quality. An established system of assessing the level and grade of evidence for recommendations was employed. RESULTS: Sixty-six studies met inclusion criteria for the relationship between physical activity and functional independence, and 34 were included with a cognitive function outcome. Greater physical activity of an aerobic nature (categorized by a variety of methods) was associated with higher functional status (expressed by a host of outcome measures) in older age. For functional independence, moderate (and high) levels of physical activity appeared effective in conferring a reduced risk (odds ratio ~0.5) of functional limitations or disability. Limitation in higher level performance outcomes was reduced (odds ratio ~0.5) with vigorous (or high) activity with an apparent dose-response of moderate through to high activity. Exercise training interventions (including aerobic and resistance) of older adults showed improvement in physiological and functional measures, and suggestion of longer-term reduction in incidence of mobility disability. A relatively high level of physical activity was related to better cognitive function and reduced risk of developing dementia; however, there were mixed results of the effects of exercise interventions on cognitive function indices. CONCLUSIONS: There is a consistency of findings across studies and a range of outcome measures related to functional independence; regular aerobic activity and short-term exercise programmes confer a reduced risk of functional limitations and disability in older age. Although a precise characterization of a minimal or effective physical activity dose to maintain functional independence is difficult, it appears moderate to higher levels of activity are effective and there may be a threshold of at least moderate activity for significant outcomes.

Project description:ObjectiveTo evaluate the construct validity and responsiveness of the Rapid Assessment of Physical Activity (RAPA) for measuring physical activity (PA) in adults living with HIV.DesignSecondary analysis of an interrupted time-series intervention study.SettingCommunity-based fitness facility in Toronto, Canada.ParticipantsSixty-seven adults (N=67) living with HIV (n=5 women; mean age, 51.8±11.6 years) with available baseline data to assess for construct validity of the RAPA, of which 50 (n=4 women; age, 53.2±11.4 years) had follow-up data to evaluate responsiveness.InterventionsTwo months of a community-based exercise intervention involving thrice weekly multicomponent exercises.Main outcome measuresWe used a single-item PA questionnaire as a convergent outcome to the RAPA, while peak oxygen consumption, general health status, and number of concurrent health conditions were divergent outcomes. We tested 11 a priori hypotheses (6 construct validity, 5 responsiveness) using Spearman ρ, Wilcoxon signed-rank tests, Cohen's d, standardized effect size (SES), and standardized response mean (SRM). We considered acceptable construct validity and responsiveness if >75% of hypotheses were confirmed.ResultsAll of the hypotheses (100%) for construct validity were confirmed. The RAPA demonstrated moderate correlations with the single-item PA questionnaire (ρ=0.61), and negligible correlations with divergent outcome measures (ρ=0.08-0.21). Two of the 5 hypotheses (40.0%) for responsiveness were confirmed. RAPA scores were significantly greater after 2 months of training (P<.001) and demonstrated a small to moderate effect size (d=0.50, SES=0.47, SRM=0.48). There was a low correlation between change in RAPA scores and change in single-item PA questionnaire scores (ρ=0.48).ConclusionsThe RAPA demonstrated acceptable construct validity and poor responsiveness in adults living with HIV. Therefore, the RAPA can be used cross-sectionally but may be used in conjunction with other measures of PA for adults living with HIV.

Project description:BackgroundIn recent years, there has been a global trend toward an increase in life expectancy and the proportion of elderly people among the population. In this regard, it becomes important to promote active and healthy aging. Physical inactivity and social isolation are both risk factors of many chronic illnesses and highly prevalent in older adults. This challenges communities to develop interventions that reduce these risk factors among elderly populations. The main aims of this study were to summarize community-based interventions that aim to simultaneously promote social participation and physical activity in older adults and to examine their effects.MethodsWe performed a systematic review based on the PRISMA standards. Literature searches were conducted in six scientific databases in July 2021. Articles were included if they had an interventional design, focused on older adults living in the community and measured social participation and physical activity as an outcome. The data were summarized narratively due to the heterogeneity of studies and the variety of outcome measures.ResultsOverall, 46 articles published in English were included. The studies were grouped in (1) interventions with main focus on physical activity promotion; (2) social activities that included a physical activity component; (3) health behavior interventions/ health education interventions; (4) multicomponent interventions; (5) environmental interventions. The majority of the reviewed studies reported positive effects of interventions on physical activity and/or social participation. No study reported negative effects. Analysis of quantitative studies showed that multicomponent interventions have great positive effects on both outcomes. In qualitative studies positive effects were found regardless of intervention type.ConclusionThis review summarizes the evidence about the effects of community-based interventions that aim to promote social participation and physical activity in older adults. Multicomponent interventions seem to be most suitable for simultaneous promotion of physical activity and social participation. However, high variability in measurement methods used to assess both social participation and physical activity in the included studies made it difficult to compare studies and to indicate the most effective.Systematic review registrationwww.crd.york.ac.uk, identifier: PROSPERO [CRD42021268270].

Project description:IntroductionIn the HIV-infected individuals, physical activity improves physical strength, quality of life and reduces the risk of developing non-communicable diseases. In Sub-Saharan Africa, HIV-infected patients report being less active compared to HIV-uninfected individuals. We assessed the levels and correlates of objectively measured physical activity and capacity among HIV-infected antiretroviral therapy (ART)-naive individuals compared to HIV-uninfected individuals in Mwanza, Tanzania.MethodWe conducted a cross-sectional study among newly diagnosed HIV-infected ART-naive individuals and HIV-uninfected individuals frequency-matched for age and sex. Socio-demographic data, anthropometrics, CD4 counts, haemoglobin level, and C-reactive protein (CRP) were collected. Physical activity energy expenditure (PAEE) was assessed as measure of physical activity whereas sleeping heart rate (SHR) and grip strength were assessed as measures of physical capacity. Multivariable linear regression was used to assess the correlates associated with physical activity and capacity.ResultsA total of 272 HIV-infected and 119 HIV-uninfected individuals, mean age 39 years and 60% women participated in the study. Compared to HIV-uninfected individuals, HIV-infected had poorer physical activity and capacity: lower PAEE (-7.3 kj/kg/day, 95% CI: -11.2, -3.3), elevated SHR (7.7 beats/min, 95%CI: 10.1, 5.3) and reduced grip strength (-4.7 kg, 95%CI: -6.8, -2.8). In HIV-infected individuals, low body mass index, moderate-severe anaemia, low CD4 counts and high CRP were associated with lower physical activity and capacity. In HIV-uninfected individuals, abdominal obesity and moderate anaemia were associated with lower physical activity and capacity.ConclusionHIV-infected participants had lower levels of physical activity and capacity than HIV-uninfected participants. Correlates of physical activity and capacity differed by HIV status. Management of HIV and related conditions needs to be provided effectively in health care facilities. Interventions promoting physical activity in these populations will be of importance to improve their health and reduce the risk of non-communicable diseases.

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Supervised Physical Activity and Improved Functional Capacity among Adults Living with HIV: A Systematic Review.

Publications

Supervised Physical Activity and Improved Functional Capacity among Adults Living with HIV: A Systematic Review.

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