Exergaming in Older People Living with HIV Improves Balance, Mobility and Ameliorates Some Aspects of Frailty

Abstract

Approximately 1.2 million people in the United States live with HIV infection. Medical advancements have increased the life expectancy and this cohort is aging. HIV-positive individuals have a high incidence of frailty (~20%) characterized by depression and sedentary behavior. Exercise would be healthy, but due to the frail status of many HIV-positive individuals, conventional exercise is too taxing. The aim of this study was to evaluate the effectiveness and acceptability of a novel game-based training program (exergame) in ameliorating some aspects of frailty in HIVinfected individuals. Ten older people living with HIV were enrolled in an exergame intervention. Patients performed balance exercises such as weight shifting, ankle reaching, and obstacle crossing. Real-time visual/audio lower-extremity joint motion feedback was provided using wearable sensors to assist feedback and encourage subjects to accurately execute each exercise task. Patients trained twice a week for 45 min for 6 weeks. Changes in balance, gait, psychosocial parameters and quality of life parameters were assessed at the beginning, midterm and at conclusion of the training program. Ten patients completed the study and their results analyzed. The mean age was 57.2 ± 9.2 years. The participants showed a significant reduction in center of mass sway (78.2%, p = .045) during the semi-tandem balance stance with eyes closed and showed a significant increase in gait speed during a dual task motor-cognitive assessment (9.3%, p = .048) with an increase in stride velocity of over 0.1 m/sec. A significant reduction in reported pain occurred (43.5%, p = .041). Preliminary results of this exergame intervention show promise in improving balance and mobility while requiring older people living with HIV to be more active. The exergame can be continued at home and may have long term as well as short-term benefits for ameliorating frailty associated with HIV infection.

Toward Smart Footwear to Track Frailty Phenotypes—Using Propulsion Performance to Determine Frailty

“…Our cutoff age was less than 65 years since we did not exclude those with chronic medical condition (e.g., diabetes mellitus, peripheral arterial disease, HIV, etc. ), in whom geriatric symptoms were reported at earlier age [ 44 , 45 , 46 ]. Exclusion criteria were sign of severe cognitive impairment, which was evaluated using Mini-Mental State Examination (MMSE) [ 47 ].…”

HIV Infection-Associated Frailty: The Solution for Now Is Antiretroviral Drugs: A Perspective

“…Furthermore, the Frailty Meter is easy to use, incorporating software that is intuitive, an improvement over the previous technology we used to measure frailty. 9…”

A systematic review of psychosocial interventions for older adults living with HIV

“…Of the eight studies that measured depression, five studies suggested that the interventions yielded significant improvement (p < 0.05), while no significant difference was reported in two studies (Ownby & Acevedo, 2016;Veeravelli et al, 2016), and one study measured depression at baseline only (Frain & Chen, 2018). Similarly, two studies suggested significant (p < 0.05) reduction in stressor burden among treatment participants compared to control group (Heckman et al, 2001(Heckman et al, , 2006.…”

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