Exercise Training on Locomotion in Patients with Alzheimer’s Disease: A Feasibility Study

Article type: Research Article

Authors: Pedrinolla, Anna^{a; *} | Venturelli, Massimo^b | Fonte, Cristina^{b; c} | Munari, Daniele^{b; c} | Benetti, Maria Vittoria^b | Rudi, Doriana^b | Tamburin, Stefano^b | Muti, Ettore^d | Zanolla, Luisa^a | Smania, Nicola^{b; c} | Schena, Federico^b

Affiliations: [a] Department of Medicine, University of Verona, Verona, Italy | [b] Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy | [c] Neuromotor and Cognitive Rehabilitation Research Centre, University of Verona, Verona, Italy | [d] Mons. Mazzali Foundation, Mantua, Italy

Correspondence: [*] Correspondence to: Anna Pedrinolla, Via Felice Casorati 43, Verona, Italy. Tel.: +39 0458425147; E-mail: anna.pedrinolla@univr.it.

Abstract: Background:Although current literature has shown that patients with Alzheimer’s disease (AD) have worse locomotion compared with healthy counterparts, no studies have focused on the efficacy of exercise training in improving gait abnormalities including biomechanics and metabolic aspects, in this population. Objective:To verify the effectiveness of exercise training (ET) on gait parameters (i.e., speed, step and stride length, single and double support, and energy cost of walking (Cw)) in patients with AD with respect to a standard cognitive treatment (CT). Methods:In this study, we included a small portion of data belonging to a larger study (ClinicalTrials.gov number, NCT03034746). Patients with AD (Mini-Mental State Examination 22±5) were included in the study. Gait parameters and Cw were assessed at baseline and after 6 months (72 treatment sessions) of treatment. ET included 90 min of aerobic and strength training. CT included 90 min of cognitive stimuli. Results:The 16 patients assigned to ET exhibited significant improvement of Cw (–0.9±0.1 J/kg·m-1), while differences in gait parameters were negligible. The effect on gait parameters were undetectable in the 18 patients assigned to CT (–0.2±0.5 J/kg·m-1). Conclusions:Data from this study showed that ET program seems effective in improving Cw in patients with AD. Interestingly, the positive effect of ET on Cw was not coupled with ameliorations of patient’s gait parameters, suggesting that the gain of metabolic aspects of locomotion were the main factors responsible for this positive result.

Keywords: Dementia, energy cost of walking, physical activity, spatio-temporal gait parameters

DOI: 10.3233/JAD-170625

Journal: Journal of Alzheimer's Disease, vol. 61, no. 4, pp. 1599-1609, 2018