Improvements in gait characteristics after intensive resistance and functional training in people with dementia: a randomised controlled trial

Persistent Link:
http://hdl.handle.net/10150/610031
Title:
Improvements in gait characteristics after intensive resistance and functional training in people with dementia: a randomised controlled trial
Author:
Schwenk, Michael; Zieschang, Tania; Englert, Stefan; Grewal, Gurtej; Najafi, Bijan; Hauer, Klaus
Affiliation:
Department of Geriatric Research, Bethanien-Hospital/ Geriatric Center at the University of Heidelberg, Heidelberg, Germany; Department of Surgery, Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), College of Medicine, University of Arizona, 1656 E Mabel Street, Tucson, Arizona 85724, USA; Arizona Center on Aging, University of Arizona, Tucson, USA; Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
Issue Date:
2014
Publisher:
BioMed Central
Citation:
Schwenk et al. BMC Geriatrics 2014, 14:73 http://www.biomedcentral.com/1471-2318/14/73
Journal:
BMC Geriatrics
Rights:
© 2014 Schwenk et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0)
Collection Information:
This item is part of the UA Faculty Publications collection. For more information this item or other items in the UA Campus Repository, contact the University of Arizona Libraries at repository@u.library.arizona.edu.
Abstract:
BACKGROUND:Preventing and rehabilitating gait disorders in people with dementia during early disease stage is of high importance for staying independent and ambulating safely. However, the evidence gathered in randomized controlled trials (RCTs) on the effectiveness of exercise training for improving spatio-temporal gait parameters in people with dementia is scarce. The aim of the present study was to determine whether a specific, standardized training regimen can improve gait characteristics in people with dementia.METHODS:Sixty-one individuals (mean age: 81.9years) with confirmed mild to moderate stage dementia took part in a 3-month double-blinded outpatient RCT. Subjects in the intervention group (IG) received supervised, progressive resistance and functional group training for 3months (2 times per week for two hours) specifically developed for people with dementia. Subjects in the control group (CG) conducted a low-intensity motor placebo activity program. Gait characteristics were measured before and after the intervention period using a computerized gait analysis system (GAITRite(R)).RESULTS:Adherence to the intervention was excellent, averaging 91.9% in the IG and 94.4% in the CG. The exercise training significantly improved gait speed (P < 0.001), cadence (P = 0.002), stride length (P = 0.008), stride time (P = 0.001), and double support (P = 0.001) in the IG compared to the CG. Effect sizes were large for all gait parameters that improved significantly (Cohen's d: 0.80-1.27). No improvements were found for step width (P = 0.999), step time variability (P = 0.425) and Walk-Ratio (P = 0.554). Interestingly, low baseline motor status, but not cognitive status, predicted positive training response (relative change in gait speed from baseline).CONCLUSION:The intensive, dementia-adjusted training was feasible and improved clinically meaningful gait variables in people with dementia. The exercise program may represent a model for preventing and rehabilitating gait deficits in the target group. Further research is required for improving specific gait characteristics such as gait variability in people with dementia.TRIAL REGISTRATION:ISRCTN49243245
EISSN:
1471-2318
DOI:
10.1186/1471-2318-14-73
Version:
Final published version
Additional Links:
http://www.biomedcentral.com/1471-2318/14/73

Full metadata record

DC FieldValue Language
dc.contributor.authorSchwenk, Michaelen
dc.contributor.authorZieschang, Taniaen
dc.contributor.authorEnglert, Stefanen
dc.contributor.authorGrewal, Gurtejen
dc.contributor.authorNajafi, Bijanen
dc.contributor.authorHauer, Klausen
dc.date.accessioned2016-05-20T08:56:57Z-
dc.date.available2016-05-20T08:56:57Z-
dc.date.issued2014en
dc.identifier.citationSchwenk et al. BMC Geriatrics 2014, 14:73 http://www.biomedcentral.com/1471-2318/14/73en
dc.identifier.doi10.1186/1471-2318-14-73en
dc.identifier.urihttp://hdl.handle.net/10150/610031-
dc.description.abstractBACKGROUND:Preventing and rehabilitating gait disorders in people with dementia during early disease stage is of high importance for staying independent and ambulating safely. However, the evidence gathered in randomized controlled trials (RCTs) on the effectiveness of exercise training for improving spatio-temporal gait parameters in people with dementia is scarce. The aim of the present study was to determine whether a specific, standardized training regimen can improve gait characteristics in people with dementia.METHODS:Sixty-one individuals (mean age: 81.9years) with confirmed mild to moderate stage dementia took part in a 3-month double-blinded outpatient RCT. Subjects in the intervention group (IG) received supervised, progressive resistance and functional group training for 3months (2 times per week for two hours) specifically developed for people with dementia. Subjects in the control group (CG) conducted a low-intensity motor placebo activity program. Gait characteristics were measured before and after the intervention period using a computerized gait analysis system (GAITRite(R)).RESULTS:Adherence to the intervention was excellent, averaging 91.9% in the IG and 94.4% in the CG. The exercise training significantly improved gait speed (P < 0.001), cadence (P = 0.002), stride length (P = 0.008), stride time (P = 0.001), and double support (P = 0.001) in the IG compared to the CG. Effect sizes were large for all gait parameters that improved significantly (Cohen's d: 0.80-1.27). No improvements were found for step width (P = 0.999), step time variability (P = 0.425) and Walk-Ratio (P = 0.554). Interestingly, low baseline motor status, but not cognitive status, predicted positive training response (relative change in gait speed from baseline).CONCLUSION:The intensive, dementia-adjusted training was feasible and improved clinically meaningful gait variables in people with dementia. The exercise program may represent a model for preventing and rehabilitating gait deficits in the target group. Further research is required for improving specific gait characteristics such as gait variability in people with dementia.TRIAL REGISTRATION:ISRCTN49243245en
dc.language.isoenen
dc.publisherBioMed Centralen
dc.relation.urlhttp://www.biomedcentral.com/1471-2318/14/73en
dc.rights© 2014 Schwenk et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0)en
dc.titleImprovements in gait characteristics after intensive resistance and functional training in people with dementia: a randomised controlled trialen
dc.typeArticleen
dc.identifier.eissn1471-2318en
dc.contributor.departmentDepartment of Geriatric Research, Bethanien-Hospital/ Geriatric Center at the University of Heidelberg, Heidelberg, Germanyen
dc.contributor.departmentDepartment of Surgery, Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), College of Medicine, University of Arizona, 1656 E Mabel Street, Tucson, Arizona 85724, USAen
dc.contributor.departmentArizona Center on Aging, University of Arizona, Tucson, USAen
dc.contributor.departmentInstitute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germanyen
dc.identifier.journalBMC Geriatricsen
dc.description.collectioninformationThis item is part of the UA Faculty Publications collection. For more information this item or other items in the UA Campus Repository, contact the University of Arizona Libraries at repository@u.library.arizona.edu.en
dc.eprint.versionFinal published versionen
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