Comparing the Effectiveness of High Intensity Interval Training vs Continuous Moderate Intensity Exercise on Physical Function Among Older Adults With HIV - Scorecard - MDSpire
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Comparing the Effectiveness of High Intensity Interval Training vs Continuous Moderate Intensity Exercise on Physical Function Among Older Adults With HIV
Clinical Scorecard: Evaluating the Impact of High-Intensity Interval Training Compared to Continuous Moderate-Intensity Exercise on Physical Function in Older Adults Living with HIV
At a Glance
Category
Detail
Condition
Older adults living with HIV experiencing accelerated physical function decline
Key Mechanisms
HIV-specific factors including chronic inflammation and long-term ART exposure contribute to impaired physical function; exercise improves function via cardiovascular and metabolic benefits
Target Population
Sedentary people with HIV aged 50 years or older on stable antiretroviral therapy
Care Setting
Outpatient clinical and exercise research settings
Key Highlights
Both high-intensity interval training (HIIT) and continuous moderate-intensity exercise (CME) combined with resistance training significantly improved physical function in older adults with HIV.
No statistically significant difference in physical function improvement was observed between HIIT and CME after 16 weeks.
HIIT is safe, feasible, and may provide small additional benefits, but exercise modality should be selected based on individual preference.
Guideline-Based Recommendations
Diagnosis
Assess physical function decline in older adults with HIV using measures such as 400-meter walk time.
Screen for cardiovascular abnormalities with graded treadmill exercise testing before initiating exercise interventions.
Management
Prescribe 16 weeks of aerobic exercise combined with resistance training to improve physical function.
Offer either HIIT (5 bouts at 90% HRR for 4 minutes alternating with moderate intensity) or CME (continuous walking at 60% HRR) based on patient preference.
Ensure stable virologic suppression and manage comorbidities such as diabetes prior to exercise initiation.
Monitoring & Follow-up
Monitor exercise tolerance and cardiovascular responses during graded exercise testing and throughout the intervention.
Evaluate changes in physical function and muscle strength at baseline and after 16 weeks.
Risks
Screen for abnormal cardiovascular responses prior to exercise to mitigate risk of ischemic heart disease or abnormal heart rate/blood pressure responses.
Consider stable dosing of sex hormone supplementation and controlled diabetes status to reduce exercise-related risks.
Patient & Prescribing Data
Sedentary older adults with HIV aged ≥50 years on stable ART with virologic suppression
Both HIIT and CME combined with resistance training improve physical function; no significant superiority of HIIT over CME was found, supporting individualized exercise selection.
Clinical Best Practices
Encourage regular aerobic exercise combined with resistance training to improve physical function in older adults with HIV.
Perform cardiovascular screening before initiating high-intensity exercise programs.
Tailor exercise prescriptions to patient preferences to enhance adherence and outcomes.
Monitor physical function improvements using standardized measures such as 400-meter walk time.
Address comorbid conditions and ensure stable medical management before and during exercise interventions.
by Grace L Kulik, Vitor H F Oliveira, Melissa P Wilson, Vincent Khuu, Catherine M Jankowski, Evelyn Iriarte, Christine Horvat Davey, Paul Cook, Debashis Ghosh, Samantha MaWhinney, Allison R Webel, Kristine M Erlandson
