Effects of aerobic exercise on quality of life of people with HIV-associated neurocognitive disorder on antiretroviral therapy: a randomised controlled trial

Abstract

Background HIV-associated neurocognitive disorder (HAND) negatively impacts quality of life (QoL) of people living with HIV who are on antiretroviral therapy (ART). Behavioural intervention adjunct to ART may improve QoL of people with HAND. We determine the effect of a 12-week aerobic exercise programme on QoL in people with HAND who were receiving ART. Trial design This was a parallel-group, randomised controlled trial with concealed allocation and intention-to-treat analysis. Methods We identified 73 participants diagnosed with HAND. Participants were sampled from an earlier study that examined the prevalence of HAND according to the Frascati criteria. Participants were randomised and allocated to an intervention of 12-weeks of aerobic exercise, comprising three 20–60 min sessions per week of moderate-intensity aerobic exercise using a cycle ergometer. The primary outcome was QoL, which was evaluated using the World Health Quality of Life Questionnaire (WHOQoL)-BREF. Results Participants in the exercise (n = 39) and control (n = 35) groups had similar sociodemographic characteristics (p > 0.05). Following the 12-week aerobic exercise programme, participants in the exercise group had improved physical (p < 0.001), psychological (p = 0.008) and environmental (p = 0.001) domains of the QoL (p = 0.001) and overall QoL (p = 0.001) relative to the control group. Similarly, participants in the exercise group had lower depression scores than participants in the control group. Depression scores in the exercise group were still lower 3 months post-intervention (p = 0.007). Only the improvements in physical (p = 0.02) and psychological (p = 0.007) domains of QoL were sustained at 3 months post-intervention. Conclusions Aerobic exercise improves the QoL of people with HAND. To ensure sustained benefits, people with HAND may need to engage in long-term physical exercise. Trial registration The trial is registered with the PAN African Trial Registry (PACTR). Date: 01/09/2020, ID: PACTR202009483415745

Changes of Serum C-Reactive Protein Level in Patients With Depressive Disorders After Treatment With Agomelatine Combined With Aerobic Exercise and Its Significance

“…14 In addition, a recent study of exercise programs has shown that exercise can significantly reduce depression scores. 33 Collectively, the results of this study suggest that AG alone and the therapy of AG combined with AE can alleviate depressive symptoms in MSD patients, and the efficacy of AG + AE may be better than that of AG alone. This is consistent with the research by Imboden et al 34 ; in adults with depression disorders, the volume reduction of the hippocampus, anterior cingulate cortex, prefrontal cortex, striatum, and amygdala and the impairment of white matter integrity are often observed.…”

“…It has been reflected that AG is effective in the treatment of MSD, with significant reductions in HAM-D and SHAPS scores from baseline to endpoint 14 . In addition, a recent study of exercise programs has shown that exercise can significantly reduce depression scores 33 . Collectively, the results of this study suggest that AG alone and the therapy of AG combined with AE can alleviate depressive symptoms in MSD patients, and the efficacy of AG + AE may be better than that of AG alone.…”

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“…On the one hand, personal wellbeing and life satisfaction, showing itself as a promoter of health effects and on the other hand, Pickleball as an agent with preventive effects by reducing depression symptoms, indicating high values in its participants in both directions. Similarly, to other physical-sport activities, where higher frequency of physical activity leads to increased mental health ( Murphy et al, 2022 ; Nweke et al, 2022 ; Shaw et al, 2022 ).…”

Cognitive screening considerations for psychosocial clinical trials in HIV, aging, and cognition

“…In the literature, we noted that several clinical trials focused on HAND reported significant rates of pre-intervention attrition. [30][31][32][33][34][35] One clinical trial testing cognitive rehabilitation therapy in people living with HIV found that 49.6% (59/119) who met the criteria for HAND then declined to be randomized into the trial. 30 Another computer-delivered cognitive training randomized controlled trial (RCT) found 25.4% (14/55) of participants receiving a Mild Neurocognitive Disorder HAND diagnosis chose not to continue with randomization.…”