Home-Based Exercise Program Improves Balance and Fear of Falling in Community-Dwelling Older Adults with Mild Alzheimer’s Disease: A Pilot Study

Padala, Kalpana P.; Padala, Prasad R.; Lensing, Shelly; Dennis, Richard A.; Bopp, Melinda M.; Roberson, Paula K.; Sullivan, Dennis H.

doi:10.3233/jad-170120

Cited by 81 publications

(111 citation statements)

References 38 publications

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“…The 13 studies with lower ROB were conducted in the United Kingdom, 26,30,[37][38][39] United States, 29,31 Netherlands, 34,56 Finland, 27,28,33 Germany, 32,36 Denmark, 25 and France. 35 .…”

Section: Description Of Lower Rob Studiesmentioning

confidence: 99%

“…35 . They evaluated functional ability using informant or self-report scales that measured patient performance and dependency on others to perform ADLs, [25][26][27][28][29][30][31][32][33][35][36][37][38][39]56 activity-specific goal setting, 56 and physical role function. 34 We divided the included studies into four groups: physical exercise therapies, OT interventions, multicomponent interventions, and cognitionoriented or reminiscence therapies.…”

Section: Description Of Lower Rob Studiesmentioning

confidence: 99%

“…26 The third RCT was a small pilot study (n = 30), comparing an in-home Wii fit video game-led exercise programme (involving yoga, strength, aerobics, balance, and dual-task exercise) for 20 minutes, 5 days a week for 8 weeks and a walking-based control in people with mild dementia. 29 The intervention was supervised by family carers.…”

Section: Only One Of Thementioning

confidence: 99%

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Effects of nonpharmacological interventions on functioning of people living with dementia at home: A systematic review of randomised controlled trials

Scott

Cooper

Leverton

et al. 2019

Int J Geriat Psychiatry

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Objective Slowing functional decline could enable people living with dementia to live for longer and more independently in their own homes. We aimed to update previous syntheses examining the effectiveness of nonpharmacological interventions in reducing functional decline (activities of daily living, activity‐specific physical functioning, or function‐specific goal attainment) in people living in their own homes with dementia. Methods We systematically searched electronic databases from January 2012 to May 2018; two researchers independently rated risk of bias of randomised controlled trials (RCTs) fitting predetermined inclusion criteria using a checklist; we narratively synthesised findings, prioritising studies judged to have a lower risk of bias. Results Twenty‐nine papers (describing 26 RCTs) met eligibility criteria, of which we judged 13 RCTs to have a lower risk of bias. Study interventions were evaluated in four groups: physical exercise, occupational, multicomponent, and cognition‐oriented interventions. Four out of 13 RCTs reported functional ability as a primary outcome. In studies judged to have a lower risk of bias, in‐home tailored exercise, individualised cognitive rehabilitation, and in‐home activities‐focussed occupational therapy significantly reduced functional decline relative to control groups in individual studies. There was consistent evidence from studies at low risk of bias that group‐based exercise and reminiscence therapies were ineffective at reducing functional decline. Conclusion We found no replicated evidence of intervention effectiveness in decreasing functional decline. Interventions associated with slower functional decline in individual trials have been individually delivered and tailored to the needs of the person with dementia. This is consistent with previous findings. Future intervention trials should prioritise these approaches.

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Section: Description Of Lower Rob Studiesmentioning

confidence: 99%

Section: Description Of Lower Rob Studiesmentioning

confidence: 99%

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Effects of nonpharmacological interventions on functioning of people living with dementia at home: A systematic review of randomised controlled trials

Scott

Cooper

Leverton

et al. 2019

Int J Geriat Psychiatry

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“…So, we can consider exercise as a useful tool to improve functional capacities as mobility, gait, balance and strength, executive functions, and thus decrease falls. [ 7 , 24 , 36 , 52 – 58 ] Moreover, we must consider that exercise or planned physical activity is a helpful plan for maintaining optimal bone health regulating bone metabolism, [ 41 , 59 , 60 ] although its mechanism to improve bone health is not exactly clear yet. However, it has been accepted that increasing muscle mass and mechanical stress in bones results in increasing or preventing the loss of BMD.…”

Section: Introductionmentioning

confidence: 99%

Short and medium-term effects of a multicomponent physical exercise program with a Mediterranean diet on bone mineral density, gait, balance, and fall risk for patients with Alzheimer disease

et al. 2020

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Introduction: Reduced bone mineral density and increased risk of falls are related with Alzheimer disease, and these increase likelihood of bone osteoporotic fractures causing serious complications such as disability, fear of falling, loss autonomy, decreased quality of life, and anticipated mortality in elderly patients. Gait and balance disturb are 2 factors to favor falls in elderly, and in patients with cognitive impairment, the risk of falls increases to double. Exercise and Mediterranean diet produce beneficial effects for aging, cognitive decline, and are widely recommended to reduce the effects of osteoporosis, fall risk, and related fragility fractures. The primary objective of this study is to evaluate the short and medium-term effects during 6 months, of a multicomponent physical exercise program with a Mediterranean diet on bone mineral density, fall risk, balance, and gait by a controlled clinical trial in patients with Alzheimer disease. Methods: The study is a 6-month, randomized controlled parallel-group, single-blinded clinical trial. Institutionalized patients with Alzheimer disease will be included. The intervention group will perform a multicomponent physical exercise program in reduced groups, with a frequency of 3 sessions per week, associated with a Mediterranean diet. This program includes strength, balance, and aerobic resistance exercises, and in the main part of the session, also ludic exercises to improve agility, coordination, and balance. The control group will receive usual care. The outcomes to assess are the change of physical functions, such as gait and balance, and the change of bone mineral density by calcaneal quantitative ultrasound, during the study follow-up at 1, 3, and 6 months. This clinical trial will generate more and new evidence on the effects of a multicomponent physical exercise program and Mediterranean diet in patients with Alzheimer disease on risk of falls and osteoporotic fractures, the relation of these with bone mineral density, gait and balance, and the correlations between them. Ethics and dissemination: This study protocol has been approved by the Ethics Committee of the University of Salamanca. The results will be published in peer-reviewed journals and disseminated in national and international conferences, to the participants and their families, and the general public through the associations of people with AD. Trial registration ID: ClínicalTrials.gov ID: NCT04439097.

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“…Exergaming is expected to be a joyful activity in itself for people with dementia and, thus, a feasible way to motivate them to engage in physical activities in a safe manner [36][37][38][39]. International studies which included people living with dementia show some promising effects of exergaming, for example that it can improve physical [40,41], cognitive [38,40] and emotional functioning [41].…”

Section: Introductionmentioning

confidence: 99%

The (cost-) effectiveness of exergaming in people living with dementia and their informal caregivers: protocol for a randomized controlled trial

et al. 2019

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Background: Physical activity is linked to benefits such as increased physical fitness, cognition, emotional and social functioning, general health and well-being in older people. Some evidence suggests that this also applies to people living with dementia. However, it can be harder for them to perform physical activities, due to several barriers, such as issues with orientation and balance problems. A relatively new type of physical activity called exergaming may help them overcome these barriers. Exergaming is "physical exercise interactively combined with cognitive stimulation in a gaming environment". The aim of our study is to evaluate the effectiveness and cost-effectiveness of exergaming compared to regular activities in people living with dementia, who attend day-care centres. Additionally, we want to investigate whether the exergaming activity for the person living with dementia, also (indirectly) affects the informal caregiver, as well as which facilitators and barriers to implementation of exergames for this target group exist. Methods: A cluster Randomized Controlled Trial (RCT), with economic and process evaluations alongside will be carried out. In the Netherlands, 24 day-care centres are randomized in the experimental or control group. The study group will consist of 224 dyads (community-dwelling participants with dementia and their informal caregivers), who are interviewed at baseline, and at 3 and 6 months of follow-up. The participant with dementia has to visit the day-care centre for at least two days per week, have a diagnosis of mild to moderate dementia and have an informal caregiver present, who is willing to participate. Societal cost data will be collected during interviews, using healthcare utilization diaries, and from day-care centres. The process evaluation will only involve the experimental group, and will include an online survey, qualitative interviews and focus groups. Discussion: This study will contribute to the evidence base that more effective exercise among people with dementia will result in positive effects on their wellbeing and quality of life. This will motivate people with dementia to be physically active. We also envision that there might be a positive effect on the burden of care experienced by their informal caregivers.

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Home-Based Exercise Program Improves Balance and Fear of Falling in Community-Dwelling Older Adults with Mild Alzheimer’s Disease: A Pilot Study

Abstract: Home-based, caregiver-supervised Wii-Fit exercises improve balance and may reduce fear of falling in community-dwelling older adults with mild AD.

Cited by 81 publications

References 38 publications

Effects of nonpharmacological interventions on functioning of people living with dementia at home: A systematic review of randomised controlled trials

Effects of nonpharmacological interventions on functioning of people living with dementia at home: A systematic review of randomised controlled trials

Short and medium-term effects of a multicomponent physical exercise program with a Mediterranean diet on bone mineral density, gait, balance, and fall risk for patients with Alzheimer disease

The (cost-) effectiveness of exergaming in people living with dementia and their informal caregivers: protocol for a randomized controlled trial

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