Feasible Intervention through Simple Exercise for Risk of Falls in Dementia Patients: A Pilot Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants
2.2. Physical Exercise Intervention
2.3. Data Collection and Analysis Instruments
2.4. Data and Analysis
2.5. Ethical Considerations
3. Results
3.1. Participants’ Characteristics
3.2. Effects of Exercise Intervention on Functional Ability
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Talar, K.; Hernández-Belmonte, A.; Vetrovsky, T.; Steffl, M.; Kałamacka, E.; Courel-Ibáñez, J. Benefits of Resistance Training in Early and Late Stages of Frailty and Sarcopenia: A Systematic Review and Meta-Analysis of Randomized Controlled Studies. J. Clin. Med. 2021, 10, 1630. [Google Scholar] [CrossRef]
- Thomas, E.; Battaglia, G.; Patti, A.; Brusa, J.; Leonardi, V.; Palma, A.; Bellafiore, M. Physical activity programs for balance and fall prevention in elderly: A systematic review. Medicine 2019, 98, e16218. [Google Scholar] [CrossRef] [PubMed]
- Liu, C.J.; Latham, N.K. Progressive resistance strength training for improving physical function in older adults. Cochrane Database Syst. Rev. 2009, 2009, CD002759. [Google Scholar] [CrossRef] [PubMed]
- National Institute for Health and Care Excellence. Dementia: Assessment, Management and Support for People Living with Dementia and Their Carers; NICE Guideline: London, UK, 2018; p. 43. ISBN 978-1-4731-2978-8. [Google Scholar]
- Ljubenkov, P.A.; Geschwind, M.D. Dementia. Semin. Neurol. 2016, 36, 397–404. [Google Scholar] [CrossRef] [PubMed]
- Fernando, E.; Fraser, M.; Hendriksen, J.; Kim, C.H.; Muir-Hunter, S.W. Risk Factors Associated with Falls in Older Adults with Dementia: A Systematic Review. Physiother. Can. 2017, 69, 161–170. [Google Scholar] [CrossRef] [PubMed]
- Härlein, J.; Dassen, T.; Halfens, R.J.G.; Heinze, C. Fall risk factors in older people with dementia or cognitive impairment: A systematic review. J. Adv. Nurs. 2009, 65, 922–933. [Google Scholar] [CrossRef] [PubMed]
- Dolatabadi, E.; Van Ooteghem, K.; Taati, B.; Iaboni, A. Quantitative Mobility Assessment for Fall Risk Prediction in Dementia: A Systematic Review. Dement. Geriatr. Cogn. Disord. 2018, 45, 353–367. [Google Scholar] [CrossRef]
- Zhao, R.; Bu, W.; Chen, X. The efficacy and safety of exercise for prevention of fall-related injuries in older people with different health conditions, and differing intervention protocols: A meta-analysis of randomized controlled trials. BMC Geriatr. 2019, 19, 341. [Google Scholar] [CrossRef]
- Cadore, E.L.; Rodríguez-Mañas, L.; Sinclair, A.; Izquierdo, M. Effects of Different Exercise Interventions on Risk of Falls, Gait Ability, and Balance in Physically Frail Older Adults: A Systematic Review. Rejuvenation Res 2013, 16, 105–114. [Google Scholar] [CrossRef] [PubMed]
- Kegelmeyer, D.A.; Kloos, A.D.; Thomas, K.M.; Kostyk, S.K. Reliability and validity of the Tinetti Mobility Test for individuals with Parkinson disease. Phys. Ther. 2007, 87, 1369–1378. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Góme- Montes, J.F.; Curcio, C.L.; Alvarado, B.; Zunzunegui, M.V.; Guralnik, J. Validity and reliability of the Short Physical Performance Battery (SPPB): A pilot study on mobility in the Colombian Andes. Colomb. Med. 2013, 44, 165–171. [Google Scholar] [CrossRef]
- Mahoney, F.I.; Barthel, D.W. Functional evaluation: The Barthel Index. Md. State Med. J. 1965, 14, 61–65. [Google Scholar] [PubMed]
- Wesson, J.; Clemson, L.; Brodaty, H.; Lord, S.; Taylor, M.; Gitlin, L.; Close, J. A feasibility study and pilot randomised trial of a tailored prevention program to reduce falls in older people with mild dementia. BMC Geriatr. 2013, 13, 89. [Google Scholar] [CrossRef]
- Olsen, C.; Pedersen, I.; Bergland, A.; Enders-Slegers, M.J.; Ihlebæk, C. Effect of animal-assisted activity on balance and quality of life in home-dwelling persons with dementia. Geriatr. Nurs. 2016, 37, 284–291. [Google Scholar] [CrossRef] [PubMed]
- Taylor, M.E.; Wesson, J.; Sherrington, C.; Hill, K.D.; Kurrle, S.; Lord, S.R.; Brodaty, H.; Howard, K.; O’Rourke, S.D.; Clemson, L.; et al. Tailored Exercise and Home Hazard Reduction Program for Fall Prevention in Older People with Cognitive Impairment: The i-FOCIS Randomized Controlled Trial. J. Gerontol. Ser. A 2021, 76, 655–665. [Google Scholar] [CrossRef]
- Nyman, S.R.; Ingram, W.; Sanders, J.; Thomas, P.W.; Thomas, S.; Vassallo, M.; Raftery, J.; Bibi, I.; Barrado-Martín, Y. Randomised Controlled Trial Of The Effect Of Tai Chi On Postural Balance Of People with Dementia. Clin. Interv. Aging 2019, 14, 2017–2029. [Google Scholar] [CrossRef]
- Bossers, W.J.; van der Woude, L.H.; Boersma, F.; Hortobágyi, T.; Scherder, E.J.; van Heuvelen, M.J. A Nine-Week-Long Aerobic and Strength Training Program Improves Cognitive and Motor Function in Patients with Dementia: A Randomized, Controlled Trial. Am. J. Geriatr. Psychiatry 2015, 23, 1106–1116. [Google Scholar] [CrossRef]
- Öhman, H.; Savikko, N.; Strandberg, T.; Kautiainen, H.; Raivio, M.; Laakkonen, M.L.; Tilvis, R.; Pitkälä, K.H. Effects of Exercise on Functional Performance and Fall Rate in Subjects with Mild or Advanced Alzheimer’s Disease: Secondary Analyses of a Randomized Controlled Study. Dement. Geriatr. Cogn. Disord. 2016, 41, 233–241. [Google Scholar] [CrossRef] [PubMed]
- Perttila, N.M.; Öhman, H.; Strandberg, T.E.; Kautiainen, H.; Raivio, M.; Laakkonen, M.L.; Savikko, N.; Tilvis, R.S.; Pitkälä, K.H. Effect of Exercise on Drug-Related Falls Among Persons with Alzheimer’s Disease: A Secondary Analysis of the FINALEX Study. Drugs Aging 2018, 35, 1017–1023. [Google Scholar] [CrossRef] [PubMed]
- Lam, F.M.H.; Liao, L.R.; Kwok, T.C.R.; Pang, M.Y.C. Effects of adding whole-body vibration to routine day activity program on physical functioning in elderly with mild or moderate dementia: A randomized controlled trial. Int. J. Geriatr. Psychiatry 2018, 33, 21–30. [Google Scholar] [CrossRef]
- Schwenk, M.; Zieschang, T.; Englert, S.; Grewal, G.; Najafi, B.; Hauer, K. Improvements in gait characteristics after intensive resistance and functional training in people with dementia: A randomised controlled trial. BMC Geriatr. 2014, 12, 73. [Google Scholar] [CrossRef] [PubMed]
- Whitney, J.; Jackson, S.H.D.; Martin, F.C. Feasibility and efficacy of a multi-factorial intervention to prevent falls in older adults with cognitive impairment living in residential care (ProF-Cog). A feasibility and pilot cluster randomised controlled trial. BMC Geriatr. 2017, 17, 115. [Google Scholar] [CrossRef]
- Wiloth, S.; Werner, C.; Lemke, N.C.; Bauer, J.; Hauer, K. Motor-cognitive effects of a computerized game-based training method in people with dementia: A randomized controlled trial. Aging Ment. Health 2018, 22, 1124–1135. [Google Scholar] [CrossRef] [PubMed]
- Zieschang, T.; Schwenk, M.; Becker, C.; Uhlmann, L.; Oster, P.; Hauer, K. Falls and Physical Activity in Persons With Mild to Moderate Dementia Participating in an Intensive Motor Training: Randomized Controlled Trial. Alzheimer Dis. Assoc. Disord. 2017, 31, 307–314. [Google Scholar] [CrossRef]
- Williams, J.; Nyman, S. A secondary analysis of a randomised controlled trial to investigate the effect of Tai Chi on the instrumented timed up and go test in people with mild to moderate dementia. Aging Clin. Exp. Res. 2021, 33, 2175–2181. [Google Scholar] [CrossRef]
- Sanders, L.M.J.; Hortobágyi, T.; Karssemeijer, E.G.A.; van der Zee, E.A.; Scherder, E.J.A.; van Heuvelen, M.J.G. Effects of low-and high-intensity physical exercise on physical and cognitive function in older persons with dementia: A randomized controlled trial. Alzheimers Res. Ther. 2020, 12, 28. [Google Scholar] [CrossRef]
- Toots, A.; Wiklund, R.; Littbrand, H.; Nordin, E.; Nordström, P.; Lundin-Olsson, L.; Gustafson, Y.; Rosendahl, E. The Effects of Exercise on Falls in Older People With Dementia Living in Nursing Homes: A Randomized Controlled Trial. J. Am. Med. Dir. Assoc. 2019, 20, 835–842. [Google Scholar] [CrossRef] [PubMed]
- Gebhard, D.; Mess, F. Feasibility and Effectiveness of a Biography-Based Physical Activity Intervention in Institutionalized People With Dementia: Quantitative and Qualitative Results From a Randomized Controlled Trial. J. Aging Phys. Act. 2022, 30, 237–251. [Google Scholar] [CrossRef]
- Bull, F.C.; Al-Ansari, S.S.; Biddle, S.; Borodulin, K.; Buman, M.P.; Cardon, G.; Carty, C.; Chaput, J.P.; Chastin, S.; Chou, R.; et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br. J. Sports Med. 2020, 54, 1451–1462. [Google Scholar] [CrossRef]
Parameter | Group | Sex | Mean ± SD | p Value | Mean ± SD | p Value |
---|---|---|---|---|---|---|
Age (years) | IG | Men | 71.0 ± 8.4 | 0.38 | 74.2 ± 8.9 | 0.70 |
Women | 76.3 ± 9.3 | |||||
CG | Men | 76.0 ± 4.5 | 0.92 | 75.6 ± 7.4 | ||
Women | 75.4 ± 8.7 | |||||
BMI (Kg/m2) | IG | Men | 28.8 ± 3.3 | 0.41 | 30.4 ± 4.6 | 0.55 |
Women | 31.4 ± 5.3 | |||||
CG | Men | 31.4 ± 5.1 | 0.27 | 29.2 ± 3.9 | ||
Women | 28.2 ± 3.3 | |||||
Years since diagnosis | IG | Men | 1.8 ± 1.7 | 0.42 | 2.5 ± 2.2 | 0.07 |
Women | 3.0 ± 2.5 | |||||
CG | Men | 5.0 ± 2.0 | 0.50 | 4.3 ± 2 | ||
Women | 4.0 ± 2.1 | |||||
Barthel index score | IG | Men | 91.3 ± 7.5 | 0.88 | 89.5 ± 8.0 | 0.79 |
Women | 88.3 ± 8.8 | |||||
CG | Men | 93.3 ± 2.9 | 0.78 | 91.0 ± 5.16 | ||
Women | 90.0 ± 5.8 |
Test | Group | Pre-Intervention | Post-Intervention | Pre vs. Post | ||
---|---|---|---|---|---|---|
Mean ± SD | p Value | Mean ± SD | p Value | p Value | ||
TMT | IG | 26.9 ± 0.6 | 0.64 | 27.6 ± 0.5 | 0.28 | 0.03 |
CG | 27.0 ± 1.1 | 27.1 ± 0.8 | 0.32 | |||
SPPB | IG | 10.3 ± 1.0 | 0.87 | 11.8 ± 0.5 | 0.19 | 0.02 |
CG | 10.0 ± 2.1 | 11.3 ± 0.7 | 0.07 |
Parameter | Group | TMT | SPPB |
---|---|---|---|
Sex | IG | χ2 = 2.2, p = 0.33 | χ2 = 0.97, p = 0.91 |
CG | χ2 = 2.86, p = 0.24 | χ2 = 4.05, p = 0.54 | |
Age | IG | r = 0.16, p = 0.67 | r = −0.08, p = 0.83 |
CG | r = 0.18, p = 0.62 | r = 0.49, p = 0.15 | |
Years since diagnosis | IG | r = 0.44, p = 0.20 | r = 0.22, p = 0.53 |
CG | r = 0.50, p = 0.14 | r = 0.63, p = 0.05 |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
López-García, A.; Sánchez-Ruíz, M.E. Feasible Intervention through Simple Exercise for Risk of Falls in Dementia Patients: A Pilot Study. Int. J. Environ. Res. Public Health 2022, 19, 11854. https://doi.org/10.3390/ijerph191911854
López-García A, Sánchez-Ruíz ME. Feasible Intervention through Simple Exercise for Risk of Falls in Dementia Patients: A Pilot Study. International Journal of Environmental Research and Public Health. 2022; 19(19):11854. https://doi.org/10.3390/ijerph191911854
Chicago/Turabian StyleLópez-García, Ana, and Marta Encarnación Sánchez-Ruíz. 2022. "Feasible Intervention through Simple Exercise for Risk of Falls in Dementia Patients: A Pilot Study" International Journal of Environmental Research and Public Health 19, no. 19: 11854. https://doi.org/10.3390/ijerph191911854