Home-Based Exercise Training When You Can’T Leave The House: Promoting Physical Activity In Alzheimer’s Caregivers

PURPOSE: To establish the feasibility of a remotely administered at-home high-intensity interval training (HIIT) intervention in insufficiently active Alzheimer’s Disease (AD) caregivers and to test the hypothesis that exercise will improve fitness and psychological outcomes. METHODS: 9 Alzheimer’s caregivers were randomized to a 6-week, 4 days/week HIIT program (E) or usual care (U). E sessions included 5-minutes of warm up, 5-minutes of cool down and, 8 to 12-minutes of HIIT (20 sec at 85% followed by 40 sec at 65% of maximal predicted heart rate (MPHR)) on a manual treadmill. Before and after the intervention participants completed psychological questionnaires (Carers-DEMentia Quality of Life (C-DEMQOL), Caregiver Burden Inventory (CBI), Zarit Burden Inventory (ZBI), Spielberger Trait Anxiety (STAI), Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index (PSQI)) and a submaximal graded step test (STEP) to volitional fatigue. Total energy expenditure (Kilocalories; EEtot) was estimated on the STEP. The Student’s t-test was used to compare the change scores between E and U. Change scores are reported as means (range) and effect sizes as Cohen’s d. RESULTS: Participants in the E group (5) completed 88.3 ± 12.6% of the HIIT sessions. Large, statistically significant effects favoring E were observed for EEtot [(E: 12.80 (8.3, 17.3); U: 3.62 (-0.3, 12.4)); p = 0.02; d = 2]; and C-DEMQOL [(E: 10.4 (6, 16); U: -.07 (-6, 9)); p = 0.02; d = 1.98]. Non-significant, large effect sizes were seen for CBI [(E: -7.8 (-26, 10); U: 3 (-6, 7)); p = 0.168; d = -1.03]; ZBI [(E: -0.8 (-6, 3); U: 3.75 (2, 7)); p = 0.056; d = -1.53]; STAI [(E: -4 (-10, 6); U: 3.75 (-1, 7)); p = 0.08; d = -1.37] and PSQI [(E: -0.4 (-3, 4); U: 2 (0, 5)); p = 0.211; d = -0.92]. Small, nonsignificant effect sizes were shown for BDI [(E: -2.6 (-11, 7); U: -4.5 (-7, -)); p = 0.635; d = 0.33]. CONCLUSIONS: We have demonstrated the feasibility of an entirely home-based exercise intervention in AD caregivers with limited ability to leave the home. Although the small sample size makes statistical significance testing unreliable, results of this small pilot trial showed large effect sizes for energy expenditure and most of the psychological variables. These promising findings support the need for an adequately powered trial. Internal funding