***TASK*** the task is to summarize an input biomedical literature in six sentences 
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    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Objective Our objective was to examine the effects of exercise training ( EXS ) on quality of life ( QoL ) in highly active antiretroviral therapy (HAART)-treated HIV-positive ( HIV+ ) subjects with body fat redistribution ( BFR ) in Rw and a. Methods The effects of a r and omised controlled trial of EXS on QoL were measured using World Health Organisation Quality of Life (WHOQOL)-BREF  in HIV+ subjects with BFR r and omised to EXS ( n = 50 ; BFR + EXS ) or no exercise training ( n = 50 ; BFR + noEXS ) . Results At 6 months , scores on the psychological [ 1.3 ( 0.3 ) vs. 0.5 ( 0.1 ) ; P < 0.0001 ] , independence [ 0.6 ( 0.1 ) vs. 0.0 ( 0.0 ) ; P < 0.0001 ] , social relationships [ 0.6 ( 0.2 ) vs. 0.0 ( 0.0 ) ; P < 0.0001 ] and HIV HAART-specific QoL domains [ 1.4 ( 0.2 ) vs. −0.1 ( 0.2 ) ; P < 0.0001 ] improved more in BFR + EXS than BFR + noEXS group , respectively . Self-esteem [ 1.3 ( 0.8 ) vs. 0.1 ( 0.6 ) ; P < 0.001 ] , body image [ 1.5 ( 0.6 ) vs. 0.0 ( 0.5 ) ; P < 0.001 ] and emotional stress [ 1.6 ( 0.7 ) vs. 0.2 ( 0.5 ) ; P < 0.001 ] improved more in the BFR + EXS group than BFR + noEXS group , respectively . Psychological [ 1.5 ( 0.2 ) vs. 1.1 ( 0.3 ) ; P < 0.0001 ] , social relationship [ 0.8 ( 0.2 ) vs. 0.4 ( 0.2 ) ; P < 0.0001 ] , and HIV HAART-specific well-being [ 1.8 ( 0.2 ) vs. 1.0 ( 0.0 ) ; P < 0.0001 ] improved more in BFR + EXS female than male subjects . Conclusions Exercise training improved several components of QoL in HAART-treated HIV+ African subjects with BFR .  Exercise training is an inexpensive and efficacious strategy for improving QoL in HIV+ African subjects , which may improve HAART adherence and treatment initiatives in re source -limited areas of sub-Saharan Africa QUESTION What is the effect of a six-month , supervised , aerobic and resistance exercise program on self-efficacy in men living with human immunodeficiency virus ( HIV ) ? DESIGN R and omised , controlled trial . PARTICIPANTS 40 ( 5 dropouts ) men living with HIV , aged 18 years or older . INTERVENTION The experimental group participated in a twice-weekly supervised aerobic and resistance exercise program for six months and the control group participated in a twice-weekly unsupervised walking program and attended a monthly group forum . OUTCOME MEASURES The primary outcome measure was self-efficacy using the General Self-Efficacy Scale . Secondary outcome measures were cardiovascular fitness using the Kasch Pulse Recovery test , and health-related quality of life using the Medical Outcomes Study HIV Health Survey . Measures were taken by an assessor blinded to group allocation . RESULTS By six months , the experimental group had improved their self-efficacy by 6.8 points ( 95 % CI 3.9 to 9.7 , p < 0.001 ) and improved their cardiovascular fitness by reducing their heart rate by 20.2 bpm ( 95 % CI -25.8 to -14.6 , p < 0.001 ) more than the control group . Health-related quality of life improved in only two out of the eleven dimensions : the experimental group improved their overall health by 20.8 points ( 95 % CI 2.0 to 39.7 , p = 0.03 ) and their cognitive function by 14 points ( 95 % CI 0.7 to 27.3 , p = 0.04 ) more than the control group . CONCLUSION The findings of this study add to the known benefits of exercise for the HIV-infected population Currently infection with the human immunodeficiency virus-1 ( HIV-1 ) is in most instances a chronic disease that can be controlled by effective antiretroviral therapy ( ART ) . However , chronic use of ART has been associated with a number of toxicities ; including significant reductions in bone mineral density ( BMD ) and disorders of the fat metabolism . The peroxisome proliferator-activated receptor gamma ( PPARγ ) transcription factor is vital for the development and maintenance of mature and developing adipocytes . Alterations in PPARγ expression have been implicated as a factor in the mechanism of HIV-1-associated lipodystrophy . Both reduced BMD and lipodystrophy have been well described as complications of HIV-1 infection and treatment , and a question remains as to their interdependence . Interestingly , both adipocytes and osteoblasts are derived from a common precursor cell type ; the mesenchymal stem cell . The possibility that dysregulation of PPARγ ( and the subsequent effect on both osteoblastogenesis and adipogenesis ) is a contributory factor in the lipid- and bone-abnormalities observed in HIV-1 infection and treatment has also been investigated . This review deals with the hypothesis that dysregulation of PPARγ may underpin the bone abnormalities associated with HIV-1 infection , and treats the current knowledge and prospect i ve developments , in our underst and ing of PPARγ involvement in HIV-1-associated bone disease OBJECTIVES : Human Immunodeficiency Virus ( HIV ) infection worsens the frailty of elderly people , compromising their quality of life . In this study we prospect ively evaluated eleven patients living with HIV and 21 controls older than 60 years and without prior regular physical activity , who engaged in a one-year progressive resistance exercise program  to compare its effects on muscular strength , physical fitness and body composition . METHODS : Exercises for major muscular groups were performed 2 times/week , under professional supervision . Strength increase was evaluated bimonthly , while body composition , lipid and glycaemic profiles ( only of those living with HIV ) and physical fitness were evaluated before and after the one-year training . RESULTS : The participants living with HIV were lighter , had smaller Body Mass Index and were initially much weaker than controls . However , their strength increased more ( 1.52 - 2.33 times the baseline values for those living with HIV x 1.21 - 1.48 times for controls , p<0.01 ) , nullifying the differences initially seen . These effects were seen independently of gender , age or baseline physical activity . In addition , those living with HIV improved their fasting glucose levels and showed a tendency to improve their lipids after the one year training program . These effects were slightly more pronounced among those not using protease inhibitors , although not significantly . CONCLUSIONS : Resistance exercise safely increased the strength of older patients living with HIV adults , allowing them to achieve performance levels observed among otherwise healthy controls . These findings favor the recommendation of resistance exercise for elderly adults living with HIV adults PURPOSE The purpose s of the present study were to assess the effects of a 12-wk laboratory based aerobic exercise program on cardiopulmonary function , CD4 cell count , and physician-assessed health status among symptomatic pre-AIDS HIV-infected individuals ( N = 28 ) and to assess the degree to which ill health was associated with exercise relapse . METHODS Responses to grade d exercise test , physician-assessed health status , and CD4 cell counts were determined at baseline and 12-wk follow-up for participants r and omly assigned to exercise or control conditions , and reasons for exercise noncompliance were recorded . RESULTS Approximately 61 % of exercise-assigned  participants complied ( > 50 % attendance ) with the exercise program , and analyses of exercise relapse data indicated that obesity and smoking status , but not exercise-associated illness , differentiated compliant from noncompliant exercisers . Compliant exercisers significantly improved peak oxygen consumption ( VO2peak ; 12 % ) , oxygen pulse ( O2pulse ; 13 % ) , tidal volume ( TV ; 8 % ) , ventilation ( VE ; 17 % ) , and leg power ( 25 % ) to a greater degree than control participants and noncompliant exercisers ( all P < 0.05 ) . Although no group differences in health status were found , a significant interaction effect indicated that noncompliant exercisers ' CD4 cells declined ( 18 % ) significantly , whereas compliant exercisers ' cell counts significantly increased ( 13 % ; P < 0.05 ) . CONCLUSION We conclude that although aerobic exercise can improve cardiopulmonary functioning in symptomatic HIV-infected individuals with minimal health risks , attention to factors associated with exercise adherence is warranted PURPOSE Highly active antiretroviral therapy has improved the prognosis of human immuno deficiency virus type 1 (HIV-1)-infected individuals , but it has been associated with the development of metabolic and fat distribution abnormalities known as the lipodystrophy syndrome . This study tested the hypothesis that aerobic exercise training added to a low-lipid diet may have favorable effects in HIV-1-infected individuals with dyslipidemia and lipodystrophy . METHODS Thirty healthy subjects , carriers of HIV-1 , with dyslipidemia and lipodystrophy , all of whom were using protease inhibitors and /or non-nucleoside reverse transcriptase inhibitors , were r and omly assigned to participate in either a 12-wk program of aerobic exercise or a 12-wk stretching and relaxation program . All subjects received recommendations for a low-lipid diet . Before and after intervention , peak oxygen uptake , body composition , CD4 , viral load , lipid profile , and plasma endothelin-1 levels were measured . RESULTS Peak oxygen uptake increased significantly in the diet and exercise group ( mean + /- SD : 32 + /- 5 mL x kg(-1 ) x min(-1 ) before ; 40 + /- 8 mL x kg(-1 ) x min(-1 ) after ) but not in the diet only group ( 34 + /- 7 mL x kg(-1 ) x min(-1 ) before ; 35 + /- 8 mL x kg(-1 ) x min(-1 ) after ) . Body weight , body fat , and waist-to-hip ratio decreased significantly and similarly in the two groups . There were no significant changes in immunologic variables in either group . Likewise , plasma triglycerides , total cholesterol , and HDL cholesterol levels did not change significantly in either group . Plasma endothelin-1 levels were elevated in both groups and presented no significant changes during the study . CONCLUSION HIV-seropositive individuals with lipodystrophy and dyslipidemia su bmi tted to a short-term intervention of low-lipid diet and aerobic exercise training are able to increase their functional capacity without any consistent changes in plasma lipid levels Loss of lean body and muscle mass characterizes the acquired immunodeficiency syndrome ( AIDS ) wasting syndrome ( AWS ) .  Testosterone and exercise increase muscle mass in men with AWS , with unclear effects on muscle composition . We examined muscle composition in 54 eugonadal men with AWS who were r and omized to 1 ) testosterone ( 200 mg i m weekly ) or placebo and simultaneously to 2 ) resistance training or no training in a 2 x 2 factorial design . At baseline and after 12 wk , we performed assessment s of whole body composition by dual-energy X-ray absorptiometry and single-slice computed tomography for midthigh cross-sectional area and muscle composition . Leaner muscle has greater attenuation . Baseline muscle attenuation correlated inversely with whole body fat mass ( r = -0.52 , P = 0.0001 ) . This relationship persisted in a model including age , body mass index , testosterone level , viral load , lean body mass , and thigh muscle cross-sectional area ( P = 0.02 ) . Testosterone ( P = 0.03 ) and training ( P = 0.03 ) increased muscle attenuation . These data demonstrate that thigh muscle attenuation by computed tomography varies inversely with whole body fat and increases with testosterone and training . Anabolic therapy in these patients increases muscle leanness Patients on highly active antiretroviral therapy ( HAART ) spend less time on vigorous activities due to lower aerobic capacity with functional limitations that can be attributed to a detraining effect , result ing in a poor quality of life ( QoL ) . The overall aims of rehabilitation are to restore , to maintain , and to enhance the QoL and this detraining effect could possibly be reversed by a rehabilitation program . This r and omized controlled prospect i ve longitudinal descriptive study evaluated the impact of a rehabilitation program of moderate-intensity cycling and treadmill walking exercises with a home program on the QoL for individuals on HAART . Fifty-two participants with baseline QoL values formed the experimental and control groups with a 3-month pretest and posttest using the short-form health survey ( SF-36 ) question naire . No adverse effects from exercises were experienced , and 20 ( 77 % ) of the experimental and 16 ( 62 % ) of the controls completed the program . A significantly higher number of women dropped out ( P 
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Conclusions There was evidence that engaging in moderate intensity aerobic exercises ( 55–85 % Maximum heart rate-MHR ) , for 30–60 min , two to five times/week for 6–24 weeks significantly improves role activity limitation due to physical health problems , otherwise physical(aerobic or/ and resistance ) exercises have no significant effects on CD4 + count and other domains of QoL. Also , there is lack of evidence on the impact of exercises on BMD in PLWHA due to the paucity of RCTs .
The moderate grade evidence for this review suggests that further research may likely have an important impact on our confidence in the estimate of effects and may change the estimate