| Popis: |
Individuals with dementia (IWDs) can experience difficulties due to the neurodegenerative pathology across cognitive and functional domains. These challenges may result in functional limitations and disability that can burden the individual, caregivers, and society. Interventions aimed at improving these outcomes may lessen secondary ramifications experienced due to the dementia. Exercise could be an excellent adjunct or alternative to available interventions; however, there is limited and mixed evidence in the current body of literature regarding the use of exercise with IWDs. Limitations in the current research warrant further study to determine the effects of exercise with IWDs. The aims of the current study was to 1) develop a moderate-intensity home-based functional exercise program for IWDs adapted from the HIFE protocol (Littbrand et al., 2006); 2) evaluate the acceptability and feasibility of this intervention; and 3) to test the efficacy on multiple outcomes. A randomized-controlled intervention trial with a two-group pre-test and post-test design was used to evaluate a home-based moderate-intensity functional exercise program for IWDs. The intervention, developed using principles from exercise science along with a Strength-Based Approach, consisted of 24 sessions (twice weekly for 12 weeks) of a moderate-intensity strength and balance program that was delivered in the participant’s home by a trained exercise practitioner. The sample consisted of 23 IWDs with mild to moderate cognitive impairment (intervention group: n=13, comparison group: n=10). Overall, data indicated a high level of acceptability and feasibility of the current intervention for both participants and the exercise practitioner with a 99.04% treatment adherence. Excellent fidelity to the protocol was demonstrated as well as good tolerance to the moderate-intensity program as determined by low occurrence of adverse events (6.7% of total sessions). Efficacy was examined using multiple linear regression. Group assignment significantly predicted performance in key outcome measures. IWDs in the intervention group demonstrated significant improvements in lower-extremity strength (t=3.26, p=.004), balance (t=4.13, p=.001), and fast gait speed (t=2.61, p=.02). These findings indicate that IWDs are able to participate and benefit from a moderate-intensity functional strength and balance program. Clinical implications and future directions of research are thoroughly discussion further. |
