A systematic review and meta-analysis evaluating the effectiveness of minimally supervised home and community exercise interventions in improving physical activity, body adiposity and quality of life in adults living with HIV

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL Preventive medicine Pub Date : 2024-09-29 DOI:10.1016/j.ypmed.2024.108144

Jeannine Anyingu A. Aminde , Nicola W. Burton , Caroline Thng , Kelly Clanchy

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Abstract

People living with HIV (PLWH) are physically inactive and risk cardiometabolic dysfunction. Home and community exercise (HCE) is pragmatic, cost-effective and improves health in varied chronic conditions. This review aimed to synthesize evidence on the effectiveness of minimally supervised HCE for physical activity (PA), adiposity, quality of life (QoL), and other physical and psychological health indices for PLWH.

Methods

Databases were searched for studies published January 2000 to April 2023. Risk of bias in experimental and quasi-experimental studies was assessed with the Cochrane Risk-of-Bias for Randomized Trials and Risk-of-Bias in Non-Randomized Studies of Interventions tools, respectively. A random-effects meta-analysis was conducted.

Results

From 9648 records, 13 studies (14 HCE groups) with 857 PLWH (average ages 29-56 years) were included; 12 comparator and one single group trial. Aerobic and strength HCE significantly improved PA relative to control by 0.377 units (95 %CI = 0.097, 0.657; p = 0.008) and 1097steps/day (95 %CI = 39.27, 2156.62; p = 0.042). There was a reduction from baseline in percent body fat of 3.36 % (95 %CI = -6.10, 0.42; p = 0.025), but no change in BMI (−0.21 kg/m2; 95 %CI = -0.67, 0.24; p = 0.351) relative to control. HCE improved QoL relative to control in the physical domain by 13points (95 %CI = 6.15, 19.86; p < 0.001), but not in other domains like general health (6.6points; 95 %CI = -1.19, 14.36; p < 0.097). HCE completed at moderate intensity or higher was associated with improvement in outcomes more so than lower intensity HCE. Walking-only interventions were at least as beneficial as other activities. No adverse events were recorded.

Conclusion

Minimally supervised HCE can improve PA, body fat, physical QoL and other health indices in PLWH.

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一项系统性综述和荟萃分析，评估了在最小监督下的家庭和社区锻炼干预措施在改善成年艾滋病病毒感染者的体育锻炼、身体脂肪含量和生活质量方面的有效性。

艾滋病病毒感染者（PLWH）缺乏运动，有可能出现心脏代谢功能障碍。家庭和社区锻炼（HCE）既实用又具有成本效益，还能改善各种慢性病患者的健康状况。本综述旨在归纳有关最低限度监督下的家庭和社区锻炼对艾滋病毒感染者的身体活动（PA）、脂肪、生活质量（QoL）以及其他身体和心理健康指数的有效性的证据：方法：在数据库中搜索 2000 年 1 月至 2023 年 4 月发表的研究。分别使用 Cochrane Risk-of-Bias for Randomized Trials 和 Risk-of-Bias in Non-Randomized Studies of Interventions 工具评估了实验研究和准实验研究的偏倚风险。然后进行了随机效应荟萃分析：从 9648 份记录中，共纳入了 13 项研究（14 组 HCE）和 857 名 PLWH（平均年龄 29-56 岁）；其中包括 12 项比较试验和 1 项单组试验。与对照组相比，有氧和力量型 HCE 显著改善了 PA，分别提高了 0.377 个单位（95 %CI = 0.097, 0.657; p = 0.008）和 1097 步/天（95 %CI = 39.27, 2156.62; p = 0.042）。与对照组相比，体脂百分比比基线值降低了 3.36% (95 %CI = -6.10, 0.42; p = 0.025)，但体重指数没有变化 (-0.21 kg/m2; 95 %CI = -0.67, 0.24; p = 0.351)。相对于对照组，HCE 在身体素质方面的 QoL 提高了 13 分（95 %CI = 6.15，19.86；p 结论：在最少监督下进行的 HCE 可以改善 PLWH 的 PA、体脂、身体 QoL 和其他健康指数。

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来源期刊

Preventive medicine 医学-公共卫生、环境卫生与职业卫生

CiteScore

7.70

自引率

3.90%

发文量

审稿时长

42 days

期刊介绍： Founded in 1972 by Ernst Wynder, Preventive Medicine is an international scholarly journal that provides prompt publication of original articles on the science and practice of disease prevention, health promotion, and public health policymaking. Preventive Medicine aims to reward innovation. It will favor insightful observational studies, thoughtful explorations of health data, unsuspected new angles for existing hypotheses, robust randomized controlled trials, and impartial systematic reviews. Preventive Medicine''s ultimate goal is to publish research that will have an impact on the work of practitioners of disease prevention and health promotion, as well as of related disciplines.