Exploring the Effectiveness of Aerobic Exercise for Adults Living with HIV

Department of Physical Therapy Professor Dr. Kelly O’Brien has published a systematic review and meta-analysis on the effectiveness of aerobic exercise for adults living with HIV in BMC Infectious Diseases.

Dr. O’Brien and her co-investigators used the Cochrane Collaboration protocol to examine the safety and effectiveness of aerobic exercise interventions on immunological, virological, cardiorespiratory, strength, weight, body composition, and psychological outcomes in adults living with HIV.

Feet running on pavements; people running

Twenty-four studies met inclusion criteria, and the main results indicated statistically significant improvements in cardiorespiratory status, strength, body composition, depression symptoms and quality of life among exercisers compared with non-exercisers. Exercise did not affect CD4 count (white blood cells that play a major role in one’s ability to fight HIV and infection) or viral load.

“Results from this review demonstrated that performing aerobic exercise, or a combination of aerobic and resistive exercise, at least three times per week is safe and clinically beneficial for adults living with HIV who are medically stable” explains Dr. O’Brien. “Our goal was to clarify the risks and benefits of exercise for people living with HIV so that appropriate exercise can be undertaken by people living with HIV and to highlight self-management strategies in HIV care.”

MD Magazine also published a synopsis of this analysis, which is the fourth update conducted by Dr. O’Brien and her colleagues. “This systematic review was my first introduction to research as a new physical therapist back in 1999 with Stephanie Nixon and Rick Glazer at St. Michael’s Hospital. It was an opportunity to explore the evidence for rehabilitation interventions in the context of HIV.”

Dr. O’Brien notes that research evidence investigating the impact of exercise for people living with HIV has greatly increased over the years. When this systematic review was first published in The Cochrane Library in 2001 it included six studies; this fourth update published in BMC Infectious Diseases includes 24 studies, further highlighting the emerging evidence on rehabilitation interventions and the importance of exercise for people living with HIV.

“This is a seminal review that Dr. O’Brien has lead for over 15 years as new data emerges” says co-investigator and fellow Department of Physical Therapy Associate Professor Dr. Stephanie Nixon. “It is the single-most comprehensive review and go-to resource for questions surrounding the effects of aerobic exercise in adults living with HIV worldwide.”



  • Dr. Stephanie Nixon, Department of Physical Therapy, University of Toronto, Rehabilitation Sciences Institute (RSI), University of Toronto
  • Dr. Richard Glazier, Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Institute for Clinical Evaluative Sciences, Department of Family and Community Medicine, St. Michael’s Hospital, Department of Family and Community Medicine, University of Toronto
  • Anne-Marie Tynan, Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, St. Michael’s Hospital



Head shot of Kelly O'BrienDr. Kelly O’Brien is an Assistant Professor in the Department of Physical Therapy at University of Toronto, cross-appointed with the Institute of Health Policy, Management and Evaluation (IHPME), Clinical Epidemiology and Rehabilitation Sciences Institutes (RSI).  She holds a New Investigator Award from the Canadian Institutes of Health Research (CIHR).  Her research is focused on disability and rehabilitation in the context of HIV and chronic disease.  Dr. O’Brien is also a founding member of the Canada-United Kingdom HIV and Rehabilitation Research Collaborative (CUHRRC).

Dr. O’Brien is currently accepting graduate students in the IHPME and RSI.