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Effects of physical activity training in patients with Alzheimer's dementia: results of a pilot RCT study.

Holthoff VA, Marschner K, Scharf M, Steding J, Meyer S, Koch R, Donix M - PLoS ONE (2015)

Bottom Line: Analysis of activities of daily living in the patients (ADCS ADL total score) revealed a significant group × time interaction effect (95% CI of the difference between both groups at T2: 5.01-10.51).This study suggests that PA in a home-based setting might be an effective and intrinsically attractive way to promote PA training in AD and modulate caregiver burden.The results demonstrate transfer benefits to ADL, cognitive and physical skill in patients with AD.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychiatry and Psychotherapy, Division of Old Age Psychiatry and Cognitive Neuropsychiatry, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, 01307, Dresden, Germany; DZNE, German Center for Neurodegenerative Diseases, Dresden, Germany.

ABSTRACT

Background: There is evidence that physical activity (PA) is of cognitive benefit to the ageing brain, but little is known on the effect in patients with Alzheimer's disease (AD). The present pilot study assessed the effect of a home-based PA training on clinical symptoms, functional abilities, and caregiver burden after 12 and 24 weeks.

Methods: In an RCT thirty patients (aged 72.4±4.3 years) with AD (MMSE: 20.6±6.5 points) and their family caregivers were allocated to a home-based 12-week PA intervention program or the usual care group. The program changed between passive, motor-assisted or active resistive leg training and changes in direction on a movement trainer in order to combine physical and cognitive stimuli.

Results: Analysis of activities of daily living in the patients (ADCS ADL total score) revealed a significant group × time interaction effect (95% CI of the difference between both groups at T2: 5.01-10.51). The control group experienced decreases in ADL performance at week 12 and 24 whereas patients in the intervention group remained stable. Analyses of executive function and language ability revealed considerable effects for semantic word fluency with a group × time interaction (95% CI of the difference between both groups at T2: 0.18-4.02). Patients in the intervention group improved during the intervention and returned to initial performance at week 12 whereas the controls revealed continuous worsening. Analyses of reaction time, hand-eye quickness and attention revealed improvement only in the intervention group. Caregiver burden remained stable in the intervention group but worsened in the control group.

Conclusions: This study suggests that PA in a home-based setting might be an effective and intrinsically attractive way to promote PA training in AD and modulate caregiver burden. The results demonstrate transfer benefits to ADL, cognitive and physical skill in patients with AD.

Trial registration: ClinicalTrials.gov NCT02196545.

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Related in: MedlinePlus

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Mentions: Thirty patients with AD were randomized to either the intervention (n = 15) or control group (n = 15). A total of 64 patients were eligible and contacted by the physicians of the memory disorder clinic of the university hospital. 32 patients and caregivers declined participation as they doubted that the patients would adhere to the study protocol as often as required or because they wanted to travel freely during the three months to follow. Two patients were excluded as they had progressed to severe dementia since first screening for the study (Fig 1). The restricted availability of the movement trainers and the allocation to each participant for a period of 3 months made the recruitment period last from August 2011 to July 2013.


Effects of physical activity training in patients with Alzheimer's dementia: results of a pilot RCT study.

Holthoff VA, Marschner K, Scharf M, Steding J, Meyer S, Koch R, Donix M - PLoS ONE (2015)

Consort Flow Chart.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4401690&req=5

pone.0121478.g001: Consort Flow Chart.
Mentions: Thirty patients with AD were randomized to either the intervention (n = 15) or control group (n = 15). A total of 64 patients were eligible and contacted by the physicians of the memory disorder clinic of the university hospital. 32 patients and caregivers declined participation as they doubted that the patients would adhere to the study protocol as often as required or because they wanted to travel freely during the three months to follow. Two patients were excluded as they had progressed to severe dementia since first screening for the study (Fig 1). The restricted availability of the movement trainers and the allocation to each participant for a period of 3 months made the recruitment period last from August 2011 to July 2013.

Bottom Line: Analysis of activities of daily living in the patients (ADCS ADL total score) revealed a significant group × time interaction effect (95% CI of the difference between both groups at T2: 5.01-10.51).This study suggests that PA in a home-based setting might be an effective and intrinsically attractive way to promote PA training in AD and modulate caregiver burden.The results demonstrate transfer benefits to ADL, cognitive and physical skill in patients with AD.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychiatry and Psychotherapy, Division of Old Age Psychiatry and Cognitive Neuropsychiatry, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, 01307, Dresden, Germany; DZNE, German Center for Neurodegenerative Diseases, Dresden, Germany.

ABSTRACT

Background: There is evidence that physical activity (PA) is of cognitive benefit to the ageing brain, but little is known on the effect in patients with Alzheimer's disease (AD). The present pilot study assessed the effect of a home-based PA training on clinical symptoms, functional abilities, and caregiver burden after 12 and 24 weeks.

Methods: In an RCT thirty patients (aged 72.4±4.3 years) with AD (MMSE: 20.6±6.5 points) and their family caregivers were allocated to a home-based 12-week PA intervention program or the usual care group. The program changed between passive, motor-assisted or active resistive leg training and changes in direction on a movement trainer in order to combine physical and cognitive stimuli.

Results: Analysis of activities of daily living in the patients (ADCS ADL total score) revealed a significant group × time interaction effect (95% CI of the difference between both groups at T2: 5.01-10.51). The control group experienced decreases in ADL performance at week 12 and 24 whereas patients in the intervention group remained stable. Analyses of executive function and language ability revealed considerable effects for semantic word fluency with a group × time interaction (95% CI of the difference between both groups at T2: 0.18-4.02). Patients in the intervention group improved during the intervention and returned to initial performance at week 12 whereas the controls revealed continuous worsening. Analyses of reaction time, hand-eye quickness and attention revealed improvement only in the intervention group. Caregiver burden remained stable in the intervention group but worsened in the control group.

Conclusions: This study suggests that PA in a home-based setting might be an effective and intrinsically attractive way to promote PA training in AD and modulate caregiver burden. The results demonstrate transfer benefits to ADL, cognitive and physical skill in patients with AD.

Trial registration: ClinicalTrials.gov NCT02196545.

Show MeSH
Related in: MedlinePlus