BACKGROUND: Sputum expectoration of lung secretionsin HIV infected children with associated respiratory conditions is often difficult. Chest physiotherapy is often recommended to assist in this process but is not always successful. Aerobic exercises may have beneficial effects on sputum expectoration but its safety is uncertain. AIM: The primary aim of this study was to determine if cycle ergometer and rebound exercises are safe for mild to moderately symptomatic HIV infected children and if these aerobic exercises followed by chest physiotherapy could augment sputum expectoration. METHOD: Thirty six African 8 to 12 year old males performed 15 minutes of either cycle ergometer or rebound exercises. A modified 6 minute walking test to ensure fitness of the enrolled subjects prior to randomization was performed. Heart and respiratory rates, blood pressure and oxygen saturation was monitored for safety. Sputum expectorated was measured in a calibrated vial at baseline, 5, 10, and 15 minutes post exercise followed by 30 minutes of conventional chest physiotherapy. RESULTS: Total sputum produced during and post rebounding exercise was significantly higher than cycle ergometerexercises (12.6 versus 9.8mls p = 0.0002). The quantity of sputum obtained over each time point after rebound exercise was significantly more than cycle ergometer (5, 10 and 15 minutes; p = 0.0084, p = 0.0002, p = 0.0002 respectively). There were no significant differences in heart and respiratory rates, blood pressure and oxygen saturation of enrolled subjects between these exercises and no cases reached the threshold for stopping the exercise. CONCLUSION: Cycle ergometer and rebound exercises are safe for mild to moderately symptomatic HIV infected children. Rebound exercises followed by chest physiotherapy can be used as a safe adjunct to significantly increases putum expectoration.

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