Aging, Balance Problems, Cognitive Impairment, Depression, HIV/AIDS, Medication Adherence, Mobility Limitation, Quality of Life
Conditions
Keywords
HIV, Cognitive impairment, Aging, Physical Activity, Exercise, Yoga, Neuroplasticity
Brief summary
Approximately 50% of people living with HIV (and as many as 80% over the age of 50) have difficulties with cognitive functions such as memory and thinking that can have a profound negative impact on activities of daily living and quality of life. Problems with memory and thinking are also associated with forgetting to take anti-retroviral drugs and experiencing challenges to balance, walking and mental health (anxiety and depression). There is increasing evidence that, in the general population, exercise has positive effects on cognition, physical functioning and mental health. Despite the recognition of multiple therapeutic benefits of exercise, little attention has been paid to its possible effects on cognition in people living with HIV. The purpose of the proposed pilot study is to compare the effects of a 12-week, randomly assigned, community-based yoga-mindfulness intervention on cognition, balance, walking, mental health and quality of life in 30 people \>35 years of age living with HIV in the Halifax area. Yoga is of particular interest because it encompasses not only the physical but also spiritual, emotional, and mental dimensions of life. As such, it has tremendous potential to help stave off some of the devastating consequences of HIV infection.
Interventions
OTHERYoga-mindfulness
Sample class: Warm-up (15 minutes) Standing poses (15 minutes) Balance poses (15 minutes) Abdominals & back bends (10 minutes) Cool-down (5 minutes) Seated meditation Alternate nostril breathing Bellows breath Shoulder/neck stretches Cat-cow Forward fold Sun salutations Warrior 1 Warrior 2 Triangle Extended side angle Reverse warrior High lunge with twist Tree pose Standing holding knee Modified warrior 3 (chair support) Half moon Bird-dog Side plank Bridge Cobra Sphinx Corpse pose Side-lying Seated om Every month, a smudging ceremony will take place with an Aboriginal Elder for 5-10 minutes at the start of the class.
Sponsors
Canadian Institutes of Health Research (CIHR)
Adria Quigley
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
Cognition, motor function (balance, walking speed), and affective (mental health, quality of life, medication adherence) evaluations will be administered at baseline and post-intervention (12 weeks) by a trained physiotherapist, blinded to the group assignment. The rationale for blinding the assessing physiotherapist is to reduce bias in scoring during the outcome assessment sessions.
Eligibility
Sex/Gender
ALL
Age
35 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Participant self-report of HIV diagnosis 2. Identified cognitive concerns on the C3Q (Communicating Cognitive Challenges in HIV Questionnaire) 3. Residence in the Halifax area 4. Capacity to provide informed consent 5. Aged 35 or older
Exclusion criteria
* If participants present with contraindications to exercise, they will be excluded from the study. If participants have participated in a yoga program within the past 6 months, they will be excluded.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| B-CAM (Brief Cognitive Ability Measure) | Will be assessed at baseline and 12 weeks. | Cognitive function will be measured using the Brief Cognitive Ability (B-CAM), a computerized cognitive test developed using Rasch Measurement Theory and Analysis that takes 30 minutes to administer. |
| C3Q (Communicating Cognitive Challenges in HIV Questionnaire) | Will be assessed during screening, baseline, and 12 weeks. | Self-reported cognition will be assessed using the C3Q (Communicating Cognitive Challenges in HIV Questionnaire). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Balance | Assessed at baseline and at 12 weeks. | Balance will be measured using the Community Balance and Mobility test (CB&M). |
| Feasibility (Post-participation questionnaire) | Assessed at 12 weeks. | Many domains of feasibility will be assessed using a post-intervention questionnaire with questions related to participant comfort, satisfaction, safety, attendance, and time commitment. |
| Walking Speed | Assessed at baseline and at 12 weeks. | Walking peed will be measured using the 10-meter walking test because it is a simple, well-recognized global health indicator that can predict survival probability. |
| Health-related Quality of Life | Assessed at baseline and at 12 weeks. | Quality of life will be assessed using MOS-HIV, consisting of 10 domains (health perceptions, physical/role/ social functioning, pain, mental health, vitality, health distress, cognitive function, QOL). |
| Medication Adherence | Assessed at baseline and at 12 weeks. | Participants will also be asked about Medication adherence (specifically antiretroviral) using the Simplified Medication Adherence Questionnaire (SMAQ). |
| Depression | Assessed at baseline and at 12 weeks. | Depression will be assessed using the Hospital Anxiety and Depression Scale, a self-report questionnaire. |
Countries
Canada
Outcome results
None listed