What type of exercise is recommended?
The co-morbidities and functional impairments of people with HIV should guide what forms of exercise that they engage in (3). Short-term resistance training improves muscular strength and body composition, but has little effect on quality of life. Aerobic training increases cardiorespiratory fitness and enhances body composition and quality of life (3). Combining resistance and aerobic training appears to provide the broadest benefits for improving functional capacity, body composition and quality of life for people with HIV (3).
What is a typical exercise session?
Exercise training typically begins with a light-intensity warm-up (when you can still hold a conversation) lasting 5-10 minutes using large muscle groups. Resistance training normally involves a combination of concentric (shortening) and eccentric (lengthening) muscle contractions performed with weight machines and/or free weights that target different muscle groups. Resistance training is performed completing a certain number of sets and repetitions of different exercises within each set. Aerobic exercise is usually performed by walking at a brisk pace, running or cycling on a stationary bicycle either continuously or intermittently with rest periods. Resistance and aerobic exercise are usually followed by a short light-intensity warm-down lasting around 5 minutes. Because people with HIV often have poor physical conditioning and exercise tolerance, they should start an exercise programme at low intensity, and progress gradually to higher intensities.
How intense should the exercise be?
Specific guidelines for exercise intensity for people with HIV have not been established. The necessary intensity will vary between people, but as a general rule, exercising at a ‘moderate’ intensity is required to gain physiological benefits (3). To improve muscular strength, it is recommended to perform 8-12 repetitions at an intensity of 60-90% one repetition maximum in each set. To improve muscular endurance, it is recommended to perform 15-25 repetitions at 50% one repetition maximum in each set. To improve aerobic capacity, exercise should be performed between 11 and 14 on Borg’s scale of ratings of perceived exertion (RPE) or between 50-85% of maximum heart rate. If exercise tolerance is poor, then intermittent training can be performed. This involves performing intervals of exercise at >14 on Borg’s RPE scale or >75% maximum heart rate for 30 seconds to 3 minutes, with equal periods of low-intensity exercise or rest between the intervals.
Before beginning an exercise program, you should undergo an extensive medical evaluation by your doctor to identify any HIV related complications.
Accredited Exercise Physiologist (AEP)
Assessment and evaluation of your body is also recommended by an accredited exercise physiologist. An AEP can then deliver an expertly prescribed exercise program tailored to your individual requirements and goals.