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

Article type: Research Article

Authors: Padala, Kalpana P.^{a; b; *} | Padala, Prasad R.^{a; b; c} | Lensing, Shelly Y.^{a; d} | Dennis, Richard A.^{a; b} | Bopp, Melinda M.^a | Roberson, Paula K.^{a; d} | Sullivan, Dennis H.^{a; b}

Affiliations: [a] Geriatric Research Education and Clinical Center, Central Arkansas Veterans Healthcare System, Little Rock, AR, USA | [b] Department of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA | [c] Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA | [d] Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, AR, USA

Correspondence: [*] Correspondence to: Kalpana P. Padala, MD, MS, 2200 Fort Roots Drive (3J/NLR), North Little Rock, AR, 72114, USA. Tel.: +1 501 257 2044; Fax: +1 501 257 2501; E-mail: Kalpana.Padala@va.gov.

Abstract: Background/Objective:Balance problems are common in older adults with Alzheimer’s disease (AD). The objective was to study the effects of a Wii-Fit interactive video-game-led physical exercise program to a walking program on measures of balance in older adults with mild AD. Methods:A prospective randomized controlled parallel-group trial (Wii-Fit versus walking) was conducted in thirty community-dwelling older adults (73±6.2 years) with mild AD. Home-based exercises were performed under caregiver supervision for 8 weeks. Primary (Berg Balance Scale, BBS) and secondary outcomes (fear of falls and quality of life) were measured at baseline, 8 weeks (end of intervention), and 16 weeks (8-weeks post-intervention). Results:At 8 weeks, there was a significantly greater improvement (average inter-group difference [95% CI]) in the Wii-Fit group compared to the walking group in BBS (4.8 [3.3–6.2], p < 0.001), after adjusting for baseline. This improvement was sustained at 16 weeks (3.5 [2.0–5.0], p < 0.001). Analyses of the secondary outcome measures indicated that there was a significantly greater improvement in the Wii-Fit group compared to walking group in Activity-specific Balance Confidence scale (6.5 [3.6–9.4], p < 0.001) and Falls Efficacy Scale (–4.8 [–7.6 to –2.0], p = 0.002) at 8 weeks. However, this effect was not sustained at 16 weeks. Quality of life improved in both groups at 8 weeks; however, there were no inter-group differences (p = 0.445). Conclusion:Home-based, caregiver-supervised Wii-Fit exercises improve balance and may reduce fear of falling in community-dwelling older adults with mild AD.

Keywords: Alzheimer’s disease, balance, fear of falling, older adults

DOI: 10.3233/JAD-170120

Journal: Journal of Alzheimer's Disease, vol. 59, no. 2, pp. 565-574, 2017