Journal Article

Impact of exercise training on symptoms of depression, physical activity level and social participation in people living with HIV/AIDS: a systematic review and meta-analysis

Uwakwe, Victor Chukwuebuka, Irem, Franklin Onyedinma, Ezuma, Amarachi Destiny, Ajidahun, Tunde Adedayo, Fortwengel, Gerhard, Myezwa, Hellen, Okonkwo, Uchenna Prosper, Ezenwankwo, Fortune Elochukwu, Ibeneme, Sam Chidi

2022

Overview

Background Symptoms of depression are prevalent in people living with human immune deficiency virus/acquired immune deficiency syndrome (PLWHA), and worsened by lack of physical activity/exercises, leading to restriction in social participation/functioning. This raises the question: what is the extent to which physical exercise training affected, symptoms of depression, physical activity level (PAL) and social participation in PLWHA compared to other forms of intervention, usual care, or no treatment controls? Method Eight databases were searched up to July 2020, according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) protocol. Only randomised controlled trials involving adults who were either on HAART/HAART-naïve and reported in the English language, were included. Two independent reviewers determined the eligibility of the studies, extracted data, assessed their quality, and risk of bias using the Physiotherapy Evidence Database (PEDro) tool. Standardised mean difference (SMD) was used as summary statistics for the mean primary outcome (symptoms of depression) and secondary outcomes (PAL and social participation) since different measuring tools/units were used across the included studies. Summary estimates of effects were determined using a random-effects model (I 2 ). Results Thirteen studies met the inclusion criteria with 779 participants (n = 596 participants at study completion) randomised into the study groups, comprising 378 males, 310 females and 91 participants with undisclosed gender, and with an age range of 18–86 years. Across the studies, aerobic or aerobic plus resistance exercises were performed 2–3 times/week, at 40–60 min/session, and for between 6-24 weeks, and the risk of bias vary from high to low. Comparing the intervention to control groups showed significant difference in the symptoms of depression (SMD = − 0.74, 95% confidence interval (CI) − 1.01, − 0.48, p ≤ 0.0002; I 2  = 47%; 5 studies; 205 participants) unlike PAL (SMD = 0.98, 95% CI − 0.25, 2.17, p = 0.11; I 2  = 82%; 2 studies; 62 participants) and social participation (SMD = 0.04, 95% CI − 0.65, 0.73, p = 0.91; I 2  = 90%; 6 studies; 373 participants). Conclusion Physical exercise training could have an antidepressant-like effect in PLWHA but did not affect PAL and social participation. However, the high heterogeneity in the included studies, implies that adequately powered randomised controlled trials with clinical/methodological similarity are required in future studies. Trail Registration number INPLASY202040048.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Acquired immune deficiency syndrome / Acquired Immunodeficiency Syndrome / Activities of daily living / Adolescent / Adult / Aged / Aged, 80 and over / AIDS / Antidepressants / Bias / Clinical trials / Complications and side effects / Confidence intervals / Depression - therapy / Depression, Mental / Exercise / Exercise Therapy / Exercise training / Female / Health aspects / Heterogeneity / Highly active antiretroviral therapy / HIV / HIV patients / HIV/AIDS / Human immunodeficiency virus / Humans / Infectious Diseases / Internal Medicine / Male / Medical Microbiology / Medicine / Medicine & Public Health / Mental depression / Mental health / Meta-analysis / Middle Aged / Parasitology / Physical activity / Physical activity level / Physical exercise / Physical fitness / Physical training / Physiological aspects / Psychological aspects / Quality assessment / Quality of Life / Research Article / Social aspects / Social Participation / Statistical analysis / Tropical Medicine / Young Adult