Safety and feasibility of a Dalcroze eurhythmics and a simple home exercise program among older adults with mild cognitive impairment (MCI) or mild dementia: the MOVE for your MIND pilot trial

Abstract

Background: Falls represent a major health problem for older adults with cognitive impairment, and the effects of exercise for fall reduction are understudied in this population. This pilot randomized controlled trial evaluated the feasibility, safety, and exploratory effectiveness of a Dalcroze eurhythmics program and a home exercise program designed for fall prevention in older adults with mild cognitive impairment (MCI) or early dementia. Methods: For this three-arm, single-blind, 12-month randomized controlled pilot trial, we recruited communitydwelling women and men age 65 years and older with MCI or early dementia through participating memory clinics in Zurich, Switzerland. Participants were randomly assigned to a Dalcroze eurhythmics group program, a simple home exercise program (SHEP), or a non-exercise control group. All participants received 800 IU of vitamin D 3 per day. The main objective of the study was to test the feasibility of recruitment and safety of the interventions. Additional outcomes included fall rate, gait performance, and cognitive function. Results: Over 12 months, 221 older adults were contacted and 159 (72%) were screened via telephone. Following screening, 12% (19/159) met the inclusion criteria and were willing to participate. One participant withdrew at the end of the baseline visit and 18 were randomized to Dalcroze eurhythmics (n = 7), SHEP (n = 5), or control (n = 6). Adherence was similarly low in the Dalcroze eurhythmics group (56%) and in the SHEP group (62%; p = 0.82). Regarding safety and pilot clinical endpoints, there were no differences between groups.

Duration and Efficiency of Combined versus Isolated Aerobic Training Interventions in Post-Stroke Cognition: A Systematic Review

“…The mean age of the participants in the reviewed studies was 61.91 years. Concerning sex, 27 included men and women in their sample [29‒31, 37, 40‒62], four had a sample composed only of men [38, 39, 63, 64], two composed only of women [65, 66], and one did not specify the gender in its sample [67]. Regarding the types of exercises targeted at the intervention groups, the combined rehabilitation training programs involved: dual-task gait training [45, 58, 62], aerobic and cognitive training [29, 40, 54, 59, 60, 66], aerobic activity and strength activity [44, 46], Tai Chi [41, 56], aerobic and endurance training [30, 50, 63, 64].…”

“…Regarding the type of rehabilitation training program, of the 23 studies that used combined rehabilitation training programs, 20 recorded cognitive improvements after completing the recommended exercise sessions [29, 30, 38, 40, 41, 44, 45, 47, 50‒52, 54, 56, 58‒63, 66], while three did not record cognitive improvements [46, 64, 65]. Concerning the 11 studies that followed an isolated rehabilitation training recovery program, seven reported cognitive improvements [31, 37, 42, 43, 53, 55, 67], and four reported no cognitive improvements [39, 48, 49, 57] (online suppl.…”

“…The isolated aerobic training programs involved: aerobic training [31,42,48,49], high-intensity training [37,39,53,57], and yoga training [43,67]. On the other hand, the control groups participated in programs involving singletask gait training with a treadmill [45,62], performing conventional exercises [29,31,38,39,42,43,46,48,49,55,63,64,67], daily routines [30,41,61,65], which included mobilization of upper and lower limbs, stretching and muscle strengthening with elastic bands and walking [51,52]. An overview of the study and participant characteristics is listed in Table 1.…”

“…Regarding the use of neuropsychological instruments at baseline, of the 23 studies that used a combined rehabilitation training program, only 13 assessed cognitive function as shown in online supplementary material 3, with cases using a single test [29,41,50,61,63,65], two tests [38,44,46,51,59,64], and three tests [52]. In the 11 studies using an isolated rehabilitation training program, 10 assessed cognitive function, either using a single test [37,48,53,57,67], two tests [39,49,55], three tests [31], or four tests [42].…”

“…One study included a passive control group, wherein the participants did not exercise or perform any other activity [61]. Further, ten combined rehabilitation training program studies used aerobic physical activity [29,40,45,46,54,58,59,62,65,66] and included an active control group based on usual care [29,46], relaxation or activity with games [54,66], single-task gait training with treadmill [45,62], standard overground FALLS [58], aerobic exercise training and cognitive training [59,60]; and resistance physical activity [30,50,63], wherein the control group used usual care [63], sham combined aerobic and resistance training [50], and daily routines [30]. Concerning the isolated rehabilitation training programs, ten used aerobic physical activity [31,37,39,42,43,48,49,53,57,67], and the control group used usual care [31,39,42,43,48,49 [37], lowintensity exercise…”