A program of physical activity improves gait impairment in people with Alzheimer's disease

Abstract

-Aim:This study aimed to identify the effects of aging and Alzheimer's disease (AD) on gait parameters after a four-month period and to investigate the effects of a four-month program of physical activity, with emphasis on the cognitive components of gait during single and dual task, in people with AD. Methods: Twenty-three people with AD, divided into the Training Group (TG; n=12; aged 79.17±7.62 years) and the Control Group (CG; n=11; aged 77.00±5.57 years), and eleven healthy older adults (Healthy Group -HG; aged 75.82±4.83 years) were included in this study. TG participated in a physical activity program for four months. The CG and HG were instructed not to participate in any kind of regular physical activity in this period. The physical activity program includes motor activities and cognitive tasks simultaneously. The participants attended a 1-h session three times a week. The kinematic parameters of gait were analyzed under two conditions, before and after a physical activity program: single and dual task. Deltas for all dependent variables between pre and post training were calculated. The deltas were compared using two-way ANOVAs with group (TG x CG and CG x HG) and task (single x dual task) as factors, with repeated measures for task. Results: After the training period, the TG improved stride length, duration, velocity and cadence compared to the CG. Conclusion: Physical activity with emphasis on cognitive components promotes better reallocation of attention while walking in people with AD, improving attentional focus on the gait and thus resulting in a safer locomotive pattern.

Interventions to Improve Gait in Older Adults with Cognitive Impairment: A Systematic Review

“…There were 9 studies in this category, including 6 RCTs, 2 non‐RCTs, and 1 pre‐/post period controlled trial (Table ). Sample sizes ranged from 23 to 78 and mean age from 65.9 to 88.1.…”

“…The percentage of female and male participants was fairly equal across the studies. Participants were recruited from a variety of settings, including aged care facilities, the community, outpatients, and volunteer databases . Participants in 5 studies were diagnosed with dementia or AD, and the other 4 studies included participants with MCI.…”

“…Control groups received usual care, health promotion education, motor placebo training, balance training, or memory training. One study had low risk of bias, 6 had moderate risk, and 2 had high risk …”

“…All of these studies included strength and balance training. One study also included functional mobility training (daily walking) and executive function exercises, 2 included physical exercises and cognitive tasks, and 2 included dual‐task gait training (walking and talking, walking while creating a poem or performing arithmetic tasks). Walking (functional mobility) was a common component of these 4 studies but was lacking in 3 of the 4 studies that showed no effect on gait.…”

“…Five studies 17,55,58,61,62 found that their combined exercise and cognitive intervention was associated with significant improvement in gait speed, stride length, or TUG test results. All of these studies included strength and balance training.…”