Feasibility of improving strength and functioning and decreasing the risk of falls in older adults with Alzheimer's dementia: a randomized controlled home-based exercise trial

Cezar, Natália Oiring de Castro; Ansai, Juliana Hotta; Oliveira, Marcos Paulo Braz de; Silva, Danielle Chagas Pereira da; Gomes, Wildja de Lima; Barreiros, Bruna Anzolin; Langelli, Tamiris de Cássia Oliva; Andrade, Larissa Pires de

doi:10.1016/j.archger.2021.104476

Cited by 18 publications

(13 citation statements)

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“…The medical diagnosis of AD was performed by geriatricians or neurologists based on the DSM-V [ 25 ]. The classification of AD stage was performed by the researchers based on the CDR, who have amply experience proved by previous studies [ 21 , 30 , 31 ]. This scale quantifies the severity of dementia and is composed of six domains: memory, orientation, judgment and problem solving, community affairs, home and hobbies and personal care.…”

Section: Methodsmentioning

confidence: 99%

“…Although the isokinetic dynamometer has been used of the evaluation of knee extensors and flexors in a physical intervention study involving older adults with AD [ 21 ], no previous reliability studies have been conducted involving the isokinetic dynamometer for this population. Moreover, older adults with AD may have difficulties understanding and following verbal commands [ 22 ], which could hinder the performance of the test and lower the reliability of the measure.…”

Section: Introductionmentioning

confidence: 99%

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Reproducibility of isokinetic measures of the knee and ankle muscle strength in community-dwelling older adults without and with Alzheimer’s disease

et al. 2022

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Background To interpret changes of muscle strength in older adults with Alzheimer’s disease (AD), determining the reliability of outcome measures is necessary. Therefore, the purpose of the present study was to investigate the relative and absolute intra-rater reliability of concentric isokinetic measures of the knee and ankle muscle strength in community-dwelling older adults without and with AD in the mild and moderate stages. Methods A methodological study was conducted. The participants were submitted to two isokinetic evaluations with an interval of three to seven days. The evaluations consisted of knee extension and flexion at 60°/s (five repetitions) and 180°/s (15 repetitions) and plantar flexion and dorsiflexion of the ankle at 30°/s (five repetitions). The measures of interest were peak torque, average peak torque and total work. The intraclass correlation coefficient two-way mixed model of a single-measure (ICC3,1), standard error of measurement (SEM) and minimal detectable change at the 95% confidence interval (MDC95) were calculated. The ICC3,1 was interpreted based on Munro’s classification. Standard error of measurement and MDC95 were analyzed in absolute and relative values (percentage of error [SEM%] and change [MDC95%]). Results A total of 62 older adults were included and allocated to the three groups: mild-AD (n = 22, 79.9 years, 15 female and seven male), moderate-AD (n = 20, 81.6 years, 15 female and five male) and without-AD (n = 20, 74.3 years, 10 female and seven male). The ICCs3,1 of the measures of knee were high/very high in the three groups (0.71–0.98). The ICCs3,1 of the measures of ankle were high/very high in the mild-AD group (0.78–0.92), moderate/high/very high in the moderate-AD group (0.63–0.93) and high/very high in the group without-AD (0.84–0.97). The measurements of knee extensors at 60°/s, knee extensors (peak torque and total work), with the exception of peak torque in the mild-AD group, and flexors (average peak torque) at 180°/s, and ankle dorsiflexors at 30°/s had the lowest of SEM% and MDC95% in the three groups. Conclusion Concentric isokinetic measures are reliable for the assessment of knee and ankle muscle strength in community-dwelling older adults without and with AD in the mild and moderate stages.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Reproducibility of isokinetic measures of the knee and ankle muscle strength in community-dwelling older adults without and with Alzheimer’s disease

et al. 2022

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“…The LAPESI telehealth protocol, inspired by a home‐based exercise program for patients with Alzheimer's disease (AD‐HOMEX), is a protocol designed by our research group for use in the home setting that has been tested in a registered clinical trial (RBR‐2mhvwv) (Cezar, Ansai & Andrade, 2021; Cezar et al., 2021; Cezar et al., 2021, 2021). It is important to point out that some adaptations were made to be carried out remotely, especially regarding the intervention time and safety precautions described ahead below.…”

Section: Methodsmentioning

confidence: 99%

Effects of telehealth on functional capacity, mental health and quality of life among older people with dementia: LAPESI telehealth protocol for a randomized controlled trial

Tsen

Andreatto

Aily

et al. 2022

Physiotherapy Res Intl

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Background Telehealth can be an alternative action at a distance that can help as a form of motor intervention, alleviating the deleterious effects arising from social distancing on functional capacity, mental health and quality of life among older people with dementia during the COVID‐19 pandemic. Purpose We aim to analyze the effects of a telehealth program on functional capacity, mental health and quality of life among older people with dementia and their caregivers. Methods seventy‐eight individuals with mild and moderate dementia and their caregivers will answer an anamnesis and be evaluated through Clinical Dementia Assessment Score. They will also be evaluated by blinded examiners in terms of functional capacity (Activities of Daily Living Questionnaire and World Health Organization Disability Assessment Schedule 2.0), mental health (Mini‐Mental State Examination, Clock Drawing Test, Verbal Fluency test and the Neuropsychiatric Inventor) and quality of life (Quality of Life in Alzheimer's Disease scale). Afterward, the volunteers will be randomized into the telehealth training group and the control group. The TR will perform systematic physical and cognitive exercises in 50‐min sessions three times a week with professional monitoring, while the CG will receive non‐systematized guidance, both for 12 weeks. Participants will be evaluated at baseline, immediately after the three‐month interventions and with a 12‐week follow‐ up. Discussion Technological approaches such as telehealth can be a viable alternative in home care service during times of pandemic. We expect that older people with dementia and their caregivers have high adherence to the telehealth program and improve their functional capacity, mental health and quality of life of older people with dementia. Telehealth is an alternative that can contribute to public policies and the development of effective intervention strategies that neutralize adverse outcomes. It can also be presented as an alternative to home care services, which could reduce demands for health resources.

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“…Studies have shown that resistance training increases lower body strength, agility, and balance in AD patients 13 , and continuous and interval aerobic training improves aerobic fitness and functional capacities in the elderly with AD, but not cognitive performance 14 . Recently, the effectiveness of multimodal exercise training (MET) such as aerobic endurance, flexibility, resistance, balance exercises 15 , strength and balance exercises 16 , and muscle endurance, balance, flexibility, and aerobic exercises 17 has been evaluated for the management of AD, showing encouraging results not only on physical parameters but also in terms of a decrease in the depression rate 17 . A review study by López-Ortiz et al 18 suggested that physical exercises) e.g., two or three weekly sessions of 30–60 min maintained for at least 2 months, combining both aerobic and muscle strengthening exercises) can improve some markers of cognitive function (at least for aerobic exercise) and physical function in patients with AD.…”

Section: Introductionmentioning

confidence: 99%

Effect of multimodal exercise training on physical fitness indices, cognitive status, and depressive symptoms in Alzheimer's disease

Haghighi,

Barzoei,

Kakhak

et al. 2023

Dement. neuropsychol.

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ABSTRACT. In Alzheimer's disease (AD) patients, low levels of physical fitness (PF) and cognitive status are associated with high rates of depression. However, this condition can be improved through physical training. Objective: The aim of the present study was to investigate the effect of multimodal exercise training (MET) on aerobic endurance, muscular strength, agility, dynamic balance, cognitive status, and depressive symptoms in men with mild-to-moderate AD. Methods: A total of 25 elderly men with a diagnosis of mild-to-moderate AD were randomly categorized into an MET or a control group. The subjects in the MET group participated in a 12-week, three sessions per week MET program that included resistance, balance, and aerobic exercises. While the participants in the control group did not perform any regular exercise training during this period. Patients’ cognitive status and depressive symptoms were assessed by Mini-Mental State Examination and the Geriatric Depression Scale-15 (GDS-15) questionnaires. PF indicators such as aerobic endurance, muscular strength, agility, and dynamic balance, as well as cognitive status and depressive symptoms, were taken from all the subjects before and after MET. Results: The participants in the MET group improved handgrip, upper and lower body strength, agility, dynamic balance, and depressive symptoms (p<0.05). The intervention had no significant effect on aerobic endurance and cognitive status (p>0.05). Conclusions: MET is an effective strategy to improve muscular strength, agility, dynamic balance, and depressive symptoms in men with mild-to-moderate AD. It is recommended for AD patients to engage in this type of exercise to reduce AD complications.

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Feasibility of improving strength and functioning and decreasing the risk of falls in older adults with Alzheimer's dementia: a randomized controlled home-based exercise trial

Cited by 18 publications

References 37 publications

Reproducibility of isokinetic measures of the knee and ankle muscle strength in community-dwelling older adults without and with Alzheimer’s disease

Reproducibility of isokinetic measures of the knee and ankle muscle strength in community-dwelling older adults without and with Alzheimer’s disease

Effects of telehealth on functional capacity, mental health and quality of life among older people with dementia: LAPESI telehealth protocol for a randomized controlled trial

Effect of multimodal exercise training on physical fitness indices, cognitive status, and depressive symptoms in Alzheimer's disease

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