An Intensive Exercise Program Improves Motor Performances in Patients with Dementia: Translational Model of Geriatric Rehabilitation

Article type: Research Article

Authors: Schwenk, Michael^{a; b; *} | Dutzi, Ilona^c | Englert, Stefan^d | Micol, William^c | Najafi, Bijan^{a; b} | Mohler, Jane^{a; b} | Hauer, Klaus^c

Affiliations: [a] Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ, USA | [b] Arizona Center on Aging, University of Arizona, Tucson, AZ, USA | [c] Department of Geriatric Research, Bethanien-Hospital/Geriatric Centre at the University of Heidelberg, BW, Germany | [d] Institute of Medical Biometry and Informatics, University of Heidelberg, BW, Germany

Correspondence: [*] Correspondence to: Michael Schwenk, PhD, Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Department of Surgery, College of Medicine, University of Arizona, 1656 E Mabel Street, Tucson, AZ 85724, USA. Tel.: +1 520 626 9989; Fax: +1 520 626-8140; E-mail: mschwenk@surgery.arizona.edu.

Abstract: Background:Translation of intensive exercise programs developed specifically for patients with dementia into clinical settings is lacking. Objective:To determine if a progressive resistance and functional training program, previously evaluated in dementia outpatients, can be implemented in a geriatric inpatient setting in order to improve motor performances in patients with dementia. Methods:Eligible patients in one ward of a German geriatric hospital were assigned to the intervention group (IG, n = 74) and received intensive exercise training specifically designed for patients with dementia. Patients in the second ward were observed as a control group (CG, n = 74). All patients received usual care treatment. Primary endpoints were maximal lower extremity strength measured by a leg-press device and duration of the 5-chair-stand test for functional performance. Secondary outcomes included a number of parameters for strength and function. Results:The rehabilitation period averaged 18.1 ± 6.8 days. The IG significantly improved in both primary endpoints (change: maximal strength, IG: +51.9 ± 42.3% versus CG: +13.5 ± 51.8%, p < 0.001; functional performance, IG: −19.2 ± 22.3% versus CG: −3.8 ± 32.2% s, p = 0.037). Secondary outcomes confirmed effects for strength and some, but not all, functional parameters. Interestingly, low baseline motor status, but not cognitive status, predicted positive training response. Conclusion:An intensive exercise program can be implemented in a geriatric rehabilitation setting to improve motor performances in patients with dementia. Results suggest that an intensification of training is feasible in the target group and substantially increases the benefits in comparison to receiving usual care exercise only.

Keywords: Cognitive impairment, dementia, exercise, geriatrics, rehabilitation, resistance training

DOI: 10.3233/JAD-130470

Journal: Journal of Alzheimer's Disease, vol. 39, no. 3, pp. 487-498, 2014