A Scoping Review of Physical Performance Outcome Measures Used in Exercise Interventions for Older Adults With Alzheimer Disease and Related Dementias

McGough, Ellen L.; Lin, Shih‐Yin; Belza, Basia; Becofsky, Katie; Jones, Dina L.; Liu, Minhui; Wilcox, Sara; Logsdon, Rebecca G.

doi:10.1519/jpt.0000000000000159

Cited by 29 publications

(45 citation statements)

References 85 publications

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“…The few available investigations also focusing on recommendations of motor assessments in IWD analysed assessments used in previous trials from a quantitative perspective, and did not deal with standardisation of assessment procedures or tailoring assessments to specific characteristics of IWD. For the most part, the assessments recommended in this paper coincide with these recommendations (see Bossers et al [ 19 ] and McGough et al [ 31 ]).…”

Section: Discussionmentioning

confidence: 58%

“…Unfortunately, there is currently a lack of recommendations or guidelines on how to assess motor performance in IWD. In two of the few studies addressing this issue, Bossers et al [ 19 ] and McGough et al [ 31 ] performed a systematic and scoping review, respectively, and recommended using the Berg Balance Scale, the Performance Oriented Mobility Assessment, the Timed Up & Go Test (TUG), short distance walk tests (WT), sit-to-stand (STS) tests, isometric strength assessments, and the 6-min WT for IWD in mild to moderate stages of the disease. Both research groups derived their recommendations based on frequency of use and observed outcome effect sizes in previous trials.…”

Section: Introductionmentioning

confidence: 99%

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Recommendations for assessing motor performance in individuals with dementia: suggestions of an expert panel – a qualitative approach

Trautwein

Barisch‐Fritz

Scharpf

et al. 2019

Eur Rev Aging Phys Act

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Background Recommendations for assessing motor performance in individuals with dementia (IWD) are rare, and most existing assessment tools previously applied in IWD were initially developed for healthy older adults. However, IWD and their healthy counterparts differ in motor and cognitive capabilities, which needs to be considered when designing studies for this population. This article aims to give recommendations for motor assessments for IWD and to promote standardisation based on a structured discussion of identified assessment tools used in previous trials. Methods Appropriateness and standardisation of previously applied motor assessments for IWD were intensively discussed using a qualitative approach during an expert panel. Furthermore, the use of external cues and walking aids, as well as psychometric properties were considered. Starting with a comprehensive overview of current research practice, the discussion was gradually specified and resulted in the elaboration of specific recommendations. Results The superior discussion emphasised the need for tailoring motor assessments to specific characteristics of IWD and attaching importance to standardised assessment procedures. Specific recommendations include the use of sequential approaches, which incorporate a gradual increase of complexity from simple to more difficult tasks, a selection of motor assessments showing sufficient relative reliability and appropriateness for IWD, as well as allowing external cues and walking aids when restricted to repeated instructions and commonly used devices, respectively. Conclusions These are the first recommendations for assessing motor performance in IWD based on a comprehensive qualitative approach. Due to limited evidence, it was not possible to address all existing questions. It is therefore important to evaluate these recommendations in studies with IWD. Besides tailoring and evaluating available assessments, future research should focus on developing specific tools for IWD. Moreover, further progress in standardisation is necessary to enhance comparability between different trials. This article provides initial approaches for overcoming existing limitations in trials with IWD by giving recommendations and identifying future research questions, and therefore contributes to enhancing evidence regarding efficacy and effectiveness of physical activity interventions.

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Section: Discussionmentioning

confidence: 58%

Section: Introductionmentioning

confidence: 99%

Recommendations for assessing motor performance in individuals with dementia: suggestions of an expert panel – a qualitative approach

Trautwein

Barisch‐Fritz

Scharpf

et al. 2019

Eur Rev Aging Phys Act

View full text Add to dashboard Cite

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“…Additionally to elaborating recommendations, this article emphasises the need for tailoring and standardising motor assessments for IWD [22]. Moreover, three systematic reviews [7, 13, 23] and one scoping review [24] examined frequency of use, sensitivity to change, and psychometric properties. Bossers et al [13] and McGough et al [24] identified eight frequently applied, sensitive assessments, showing good to excellent relative test-retest reliability.…”

Section: Introductionmentioning

confidence: 99%

Recommended motor assessments based on psychometric properties in individuals with dementia: a systematic review

Trautwein

Maurus

Barisch‐Fritz

et al. 2019

Eur Rev Aging Phys Act

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BackgroundMotor assessments are important to determine effectiveness of physical activity in individuals with dementia (IWD). However, inappropriate and non-standardised assessments without sound psychometric properties have been used. This systematic review aims to examine psychometric properties of motor assessments in IWD combined with frequency of use and effect sizes and to provide recommendations based on observed findings.We performed a two-stage systematic literature search using Pubmed, Web of Science, Cochrane Library, ALOIS, and Scopus (inception - July/September 2018, English and German). The first search purposed to identify motor assessments used in randomised controlled trials assessing effectiveness of physical activity in IWD and to display their frequency of use and effect sizes. The second search focused on psychometric properties considering influence of severity and aetiology of dementia and cueing on test-retest reliability. Two reviewers independently extracted and analysed findings of eligible studies in a narrative synthesis.ResultsLiterature searches identified 46 randomised controlled trials and 21 psychometric property studies. While insufficient information was available for validity, we observed sufficient inter-rater and relative test-retest reliability but unacceptable absolute test-retest reliability for most assessments. Combining these findings with frequency of use and effect sizes, we recommend Functional Reach Test, Groningen Meander Walking Test (time), Berg Balance Scale, Performance Oriented Mobility Assessment, Timed Up & Go Test, instrumented gait analysis (spatiotemporal parameters), Sit-to-Stand assessments (repetitions> 1), and 6-min walk test. It is important to consider that severity and aetiology of dementia and cueing influenced test-retest reliability of some assessments.ConclusionThis review establishes an important foundation for future investigations. Sufficient relative reliability supports the conclusiveness of recommended assessments at group level, while unacceptable absolute reliability advices caution in assessing intra-individual changes. Moreover, influences on test-retest reliability suggest tailoring assessments and instructions to IWD and applying cueing only where it is inevitable. Considering heterogeneity of included studies and insufficient examination in various areas, these recommendations are not comprehensive. Further research, especially on validity and influences on test-retest reliability, as well as standardisation and development of tailored assessments for IWD is crucial.This systematic review was registered in PROSPERO (CRD42018105399).

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“…Exercise as a therapeutic intervention (or clinical exercise) is the application of the body of knowledge of sports science involving physiological, metabolic, and structural responses and prescribing principles to short-and long-term PA with clinical relevance to the management of health conditions. 19,20 Clinical exercise is becoming extremely relevant as a new efficacious therapeutic intervention in multiple medical fields. Besides helping in disease management, clinical exercise also improves physical fitness and is associated with other general health benefits, including the improvement of cardio-and cerebrovascular health, reduction of osteoporosis and age-related sarcopenia, improvement in psychological and autonomic disorders, and as having a general anti-inflammatory effect.…”

Section: Exercise As a Therapeutic Interventionmentioning

confidence: 99%

Physical Activity, Exercise, and Physiotherapy in Parkinson's Disease: Defining the Concepts

Bouça‐Machado

Rosário

Caldeira

et al. 2019

Movement Disord Clin Pract

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Background Background: Exercise is gaining extreme relevancy as a new therapeutic intervention for Parkinson's disease (PD). However, the frequent misuse of the concepts exercise, physiotherapy, and physical activity limits the possibility of summarizing research findings. This review aims to clarify these concepts and summarize the evidence on exercise in PD. Methods Methods: We critically appraised physical activity-related concepts and conducted a systematic review of clinical trials evaluating exercise interventions in PD. Additionally, we discussed the implications for PD clinical practice and research. ResultsResults: Exercise is a subset of physical activity, and a major component of physiotherapy for PD management, having as the main goal to improve physical fitness. The appraisal of the 83 identified clinical trials found high variability in exercise interventions. Multimodal exercise was the most studied, and 60 minutes, two times/week for 12 weeks, the most reported prescription parameters. Conclusion Conclusion: The best available evidence recommends increasing physical activity levels in PD. Exercise and physiotherapy programs seem the most efficacious strategies to achieve this goal. As a result of the heterogeneity in the type and manner exercise is prescribed, it is not possible to propose strong recommendations for exercise in PD. We believe that, in addition to the clarification of concepts here presented, a collaborative and rigorous work of different areas of knowledge is needed.

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A Scoping Review of Physical Performance Outcome Measures Used in Exercise Interventions for Older Adults With Alzheimer Disease and Related Dementias

Abstract: The results of this review will aid clinicians and researchers in selecting reliable measures to evaluate physical performance outcomes in response to exercise interventions in older adults with ADRD.

Cited by 29 publications

References 85 publications

Recommendations for assessing motor performance in individuals with dementia: suggestions of an expert panel – a qualitative approach

Recommendations for assessing motor performance in individuals with dementia: suggestions of an expert panel – a qualitative approach

Recommended motor assessments based on psychometric properties in individuals with dementia: a systematic review

Physical Activity, Exercise, and Physiotherapy in Parkinson's Disease: Defining the Concepts

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