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 postintervention (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. CONCLUSION: 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.