Effects of High-Intensity Functional Exercise on Cardiorespiratory Fitness and Physical Function in Older Adults With HIV: A Telerehabilitation Randomized Trial

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Abstract Background People with HIV (PWH) represent a high-risk patient group that will benefit from easily accessible exercise programs, particularly those centered on high intensity. Yet, limited telerehabilitation programs are available. Methods In a 12-week randomized clinical trial of PWH ≥50 years of age, we evaluated a novel exercise strategy called Functional Interval Training for Veterans Exercising Through Telehealth (FITVET) to determine the effects on cardiorespiratory fitness, exercise endurance, physical function, and body composition as compared with standard of care. The intervention consisted of center-based group exercise sessions delivered by live videoconferencing 3 times weekly. Results Among the 89 participants randomized to FITVET or standard-of-care control, the mean (SD) age was 62.9 (7.0) years, and the majority self-identified as Black (88%) and male (97%). Cardiorespiratory fitness increased 4.3% after FITVET (mean [SD], 1.96 [0.47] to 2.07 [0.53] VO2peak L/min; P = .018), but the between-group difference was not significant. Exercise endurance increased 9.3% with a significant between-group difference (P = .012). Significant between-group differences were also found for physical function outcomes: 30-second arm curl reps (15.1% vs 6.8%, P = .003), “8-foot up and go” time (−6.6% vs 0%, P = .024), timed chair stands (−15.7% vs −3.9%, P = .024), and 2-minute step test (22.0% vs 1.3%, P < .001). Measures of total and regional adiposity significantly decreased after FITVET, with android fat mass and percentage body fat showing significant between-group differences. Conclusions A telerehabilitation program of high-intensity functional exercise in older PWH improved physical function, increased exercise endurance, and reduced adiposity.

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