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Effects of a High-Intensity Functional Exercise Program on Dependence in Activities of Daily Living and Balance in Older Adults with Dementia

OBJECTIVES: To investigate the effects of a high-intensity functional exercise program on independence in activities of  daily living (ADLs) and balance in older people with dementia and whether exercise effects differed between dementia types. DESIGN: Cluster-randomized controlled trial: Umeå Demen...

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Autores principales: Toots, Annika, Littbrand, Håkan, Lindelöf, Nina, Wiklund, Robert, Holmberg, Henrik, Nordström, Peter, Lundin-Olsson, Lillemor, Gustafson, Yngve, Rosendahl, Erik
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons, Ltd 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4722852/
https://www.ncbi.nlm.nih.gov/pubmed/26782852
http://dx.doi.org/10.1111/jgs.13880
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author Toots, Annika
Littbrand, Håkan
Lindelöf, Nina
Wiklund, Robert
Holmberg, Henrik
Nordström, Peter
Lundin-Olsson, Lillemor
Gustafson, Yngve
Rosendahl, Erik
author_facet Toots, Annika
Littbrand, Håkan
Lindelöf, Nina
Wiklund, Robert
Holmberg, Henrik
Nordström, Peter
Lundin-Olsson, Lillemor
Gustafson, Yngve
Rosendahl, Erik
author_sort Toots, Annika
collection PubMed
description OBJECTIVES: To investigate the effects of a high-intensity functional exercise program on independence in activities of  daily living (ADLs) and balance in older people with dementia and whether exercise effects differed between dementia types. DESIGN: Cluster-randomized controlled trial: Umeå Dementia and Exercise (UMDEX) study. SETTING: Residential care facilities, Umeå, Sweden. PARTICIPANTS: Individuals aged 65 and older with a dementia diagnosis, a Mini-Mental State Examination score of 10 or greater, and dependence in ADLs (N = 186). INTERVENTION: Ninety-three participants each were allocated to the high-intensity functional exercise program, comprising lower limb strength and balance exercises, and 93 to a seated control activity. MEASUREMENTS: Blinded assessors measured ADL independence using the Functional Independence Measure (FIM) and Barthel Index (BI) and balance using the Berg Balance Scale (BBS) at baseline and 4 (directly after intervention completion) and 7 months. RESULTS: Linear mixed models showed no between-group effect on ADL independence at 4 (FIM=1.3, 95% confidence interval (CI)=−1.6–4.3; BI=0.6, 95% CI=−0.2–1.4) or 7 (FIM=0.8, 95% CI=−2.2–3.8; BI=0.6, 95% CI=−0.3–1.4) months. A significant between-group effect on balance favoring exercise was observed at 4 months (BBS=4.2, 95% CI=1.8–6.6). In interaction analyses, exercise effects differed significantly between dementia types. Positive between-group exercise effects were found in participants with non-Alzheimer's dementia according to the FIM at 7 months and BI and BBS at 4 and 7 months. CONCLUSION: In older people with mild to moderate dementia living in residential care facilities, a 4-month high-intensity functional exercise program appears to slow decline in ADL independence and improve balance, albeit only in participants with non-Alzheimer's dementia.
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spelling pubmed-47228522016-02-01 Effects of a High-Intensity Functional Exercise Program on Dependence in Activities of Daily Living and Balance in Older Adults with Dementia Toots, Annika Littbrand, Håkan Lindelöf, Nina Wiklund, Robert Holmberg, Henrik Nordström, Peter Lundin-Olsson, Lillemor Gustafson, Yngve Rosendahl, Erik J Am Geriatr Soc Clinical Investigations OBJECTIVES: To investigate the effects of a high-intensity functional exercise program on independence in activities of  daily living (ADLs) and balance in older people with dementia and whether exercise effects differed between dementia types. DESIGN: Cluster-randomized controlled trial: Umeå Dementia and Exercise (UMDEX) study. SETTING: Residential care facilities, Umeå, Sweden. PARTICIPANTS: Individuals aged 65 and older with a dementia diagnosis, a Mini-Mental State Examination score of 10 or greater, and dependence in ADLs (N = 186). INTERVENTION: Ninety-three participants each were allocated to the high-intensity functional exercise program, comprising lower limb strength and balance exercises, and 93 to a seated control activity. MEASUREMENTS: Blinded assessors measured ADL independence using the Functional Independence Measure (FIM) and Barthel Index (BI) and balance using the Berg Balance Scale (BBS) at baseline and 4 (directly after intervention completion) and 7 months. RESULTS: Linear mixed models showed no between-group effect on ADL independence at 4 (FIM=1.3, 95% confidence interval (CI)=−1.6–4.3; BI=0.6, 95% CI=−0.2–1.4) or 7 (FIM=0.8, 95% CI=−2.2–3.8; BI=0.6, 95% CI=−0.3–1.4) months. A significant between-group effect on balance favoring exercise was observed at 4 months (BBS=4.2, 95% CI=1.8–6.6). In interaction analyses, exercise effects differed significantly between dementia types. Positive between-group exercise effects were found in participants with non-Alzheimer's dementia according to the FIM at 7 months and BI and BBS at 4 and 7 months. CONCLUSION: In older people with mild to moderate dementia living in residential care facilities, a 4-month high-intensity functional exercise program appears to slow decline in ADL independence and improve balance, albeit only in participants with non-Alzheimer's dementia. John Wiley & Sons, Ltd 2016-01 2016-01-19 /pmc/articles/PMC4722852/ /pubmed/26782852 http://dx.doi.org/10.1111/jgs.13880 Text en © 2016 The Authors. The Journal of the American Geriatrics Society published by Wiley Periodicals, Inc. on behalf of The American Geriatrics Society. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
spellingShingle Clinical Investigations
Toots, Annika
Littbrand, Håkan
Lindelöf, Nina
Wiklund, Robert
Holmberg, Henrik
Nordström, Peter
Lundin-Olsson, Lillemor
Gustafson, Yngve
Rosendahl, Erik
Effects of a High-Intensity Functional Exercise Program on Dependence in Activities of Daily Living and Balance in Older Adults with Dementia
title Effects of a High-Intensity Functional Exercise Program on Dependence in Activities of Daily Living and Balance in Older Adults with Dementia
title_full Effects of a High-Intensity Functional Exercise Program on Dependence in Activities of Daily Living and Balance in Older Adults with Dementia
title_fullStr Effects of a High-Intensity Functional Exercise Program on Dependence in Activities of Daily Living and Balance in Older Adults with Dementia
title_full_unstemmed Effects of a High-Intensity Functional Exercise Program on Dependence in Activities of Daily Living and Balance in Older Adults with Dementia
title_short Effects of a High-Intensity Functional Exercise Program on Dependence in Activities of Daily Living and Balance in Older Adults with Dementia
title_sort effects of a high-intensity functional exercise program on dependence in activities of daily living and balance in older adults with dementia
topic Clinical Investigations
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4722852/
https://www.ncbi.nlm.nih.gov/pubmed/26782852
http://dx.doi.org/10.1111/jgs.13880
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