Abstract
BACKGROUND: HIV-associated neurocognitive disorder (HAND) affects an individual's capacity for independence and engagement in everyday activities, posing challenges in environments with limited resources and low social support. OBJECTIVES: To ascertain the efficacy of exercise (AE) for activity and participation (AP) level in people with HAND. METHOD: This is a randomised controlled trial that is parallel-group in nature, with intention-to-treat analysis and disguised allocation. Seventy-three people with HAND in total were randomised at random to the AE and control groups. Three 20-60-min sessions of moderate-intensity AE training on a cycle ergometer were included of the 12-week intervention. Individual tolerability served as the basis for progression. Three months after the intervention, at the conclusion of the intervention, and at the baseline, outcomes were measured. The AP constitutes the main outcome variable. To investigate the impact of AE on AP level, rank analysis of covariance was performed after log-transformation. RESULTS: When comparing the AE to the control group, there were significant increases in social wellbeing AP (Cohen d = 0.550; p = 0.021), emotion AP (Cohen d = 0.641; p = 0.007) and overall AP level (Cohen d = 0.896; p < 0.001). There was no discernible variation in AP across the groups three months following AE (Cohen d = 0.437; p = 0.067). CONCLUSION: AE induces a small increase in AP among individuals with HAND. CLINICAL IMPLICATIONS: For people with HAND, regular AE is a good way to manage AP restriction. Increasing AE participation may improve AP restriction.