Auswirkungen von körperlicher Aktivität auf demenzielle Erkrankungen

Scharpf, Andrea; Servay, Sandra; Wöll, Alexander

doi:10.1007/s12662-013-0295-7

Cited by 10 publications

(19 citation statements)

References 44 publications

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“…However, most studies applied a protocol consisting of two to three sessions per week for at least 12 weeks. This is in line with recommendations of recent systematic reviews and seems to be most effective in eliciting any effects on motor and cognitive performance in IWD [ 82 – 86 ]. Accordingly, our intervention had a duration of 16 weeks with a frequency of two sessions per week.…”

Section: Discussionsupporting

confidence: 89%

Effects of a 16-week multimodal exercise program on gait performance in individuals with dementia: a multicenter randomized controlled trial

et al. 2020

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Background There is a high prevalence of gait impairments in individuals with dementia (IWD). Gait impairments are associated with increased risk of falls, disability, and economic burden for health care systems. Only few studies have investigated the effectiveness of physical activity on gait performance in IWD, reporting promising but inconsistent results. Thus, this study aimed to investigate the effectiveness of a multimodal exercise program (MEP) on gait performance in IWD. Methods In this parallel-group randomized controlled trial, we enrolled 319 IWD of mild to moderate severity, living in care facilities, aged ≥ 65 years, and being able to walk at least 10 m. The control group ( n = 118) received conventional treatment, whereas the intervention group ( n = 201) additionally participated in a 16-week MEP specifically tailored to IWD. We examined the effects of the MEP on spatiotemporal gait parameters and dual task costs by using the gait analysis system GAITRite. Additionally, we compared characteristics between positive, non-, and negative responders, and investigated the impact of changes in underlying motor and cognitive performance in the intervention group by conducting multiple regression analyses. Results Two-factor analyses of variance with repeated measurements did not reveal any statistically significant time*group effects on either spatiotemporal gait parameters or dual task costs. Differences in baseline gait performance, mobility, lower limb strength, and severity of cognitive impairments were observed between positive, non-, and negative responders. Positive responders were characterized by lower motor performance compared to negative and non-responders, while non-responders showed better cognitive performance than negative responders. Changes in lower limb strength and function, mobility, executive function, attention, and working memory explained up to 39.4% of the variance of changes in gait performance. Conclusions The effectiveness of a standardized MEP on gait performance in IWD was limited, probably due to insufficient intensity and amount of specific walking tasks as well as the large heterogeneity of the sample. However, additional analyses revealed prerequisites of individual characteristics and impacts of changes in underlying motor and cognitive performance. Considering such factors may improve the effectiveness of a physical activity intervention among IWD. Trial registration DRKS00010538 (German Clinical Trial Register, date of registration: 01 June 2016, retrospectively registered, https://www.drks.de/drks_web/setLocale_EN.do ).

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Section: Discussionsupporting

confidence: 89%

Effects of a 16-week multimodal exercise program on gait performance in individuals with dementia: a multicenter randomized controlled trial

et al. 2020

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“…Because of its theoretical foundation and based on primary recommendations of the review by Scharpf et al [48], initial guidelines for designing physical activity interventions for IWD can be derived if results support efficiency.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of a 16-Week Multimodal Exercise Program on Individuals With Dementia: Study Protocol for a Multicenter Randomized Controlled Trial

Trautwein¹,

Scharpf²,

Barisch‐Fritz³

et al. 2017

JMIR Res Protoc

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BackgroundThe increasing prevalence of dementia in the next decades is accompanied by various societal and economic problems. Previous studies have suggested that physical activity positively affects motor and cognitive skills in individuals with dementia (IWD). However, there is insufficient evidence probably related to several methodological limitations. Moreover, to date adequate physical activity interventions specifically developed for IWD are lacking.ObjectiveThis study aims to investigate the effectiveness of a multimodal exercise program (MEP) on motor and cognitive skills in IWD in a high-quality multicenter trial.MethodsA multicenter randomized controlled trial with baseline and postassessments will be performed. It is planned to enroll 405 participants with dementia of mild to moderate stage, aged 65 years and older. The intervention group will participate in a 16-week ritualized MEP especially developed for IWD. The effectiveness of the MEP on the primary outcomes balance, mobility, and gait will be examined using a comprehensive test battery. Secondary outcomes are strength and function of lower limbs, activities of daily living, and cognition (overall cognition, language, processing speed, learning and memory, and visual spatial cognition).ResultsEnrollment for the study started in May 2015. It is planned to complete postassessments by the beginning of 2017. Results are expected to be available in the first half of 2017.ConclusionsThis study will contribute to enhancing evidence for the effects of physical activity on motor and cognitive skills in IWD. Compared to previous studies, this study is characterized by a dementia-specific intervention based on scientific knowledge, a combination of motor and cognitive tasks in the intervention, and high standards regarding methodology. Findings are highly relevant to influence the multiple motor and cognitive impairments of IWD who are often participating in limited physical activity.Trial RegistrationGerman Clinical Trials Register DRKS00010538; https://drks-neu.uniklinik-freiburg.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00010538 (Archived by WebCite at http://www.webcitation.org/6oVGMbbMD)

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“…In a first step, specific characteristics of IWD and derived demands for motor assessments were considered. Subsequently, these demands were applied to motor assessment tools used in previous trials, which were identified in randomised controlled trials initially analysed for a systematic review assessing effects of physical activity on motor and cognitive performance in IWD [ 32 ], supplemented by studies of Bossers et al [ 33 – 35 ] (see Table 2 ). Each tool was then rated whether it sufficiently considered specific characteristics of IWD or could be tailored to them.…”

Section: Methodsmentioning

confidence: 99%

“… Erlangen Test of Activities of Daily Living [ 64 ] Performance based activities of daily living [ 35 ] Assessment battery with five items (pouring a drink, spreading and cutting a sandwich, opening a small cupboard with a key, washing hands, and tying a bow on a present), which are rated according to correctly performed substeps (0–6 points). a Motor assessments displayed in Table 2 were identified in trials initially analysed for a review assessing effects of physical activity on motor and cognitive performance in IWD [ 32 ], supplemented by studies of Bossers et al [ 33 – 35 ] …”

Section: Methodsmentioning

confidence: 99%

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Recommendations for assessing motor performance in individuals with dementia: suggestions of an expert panel – a qualitative approach

Trautwein

Barisch‐Fritz

Scharpf

et al. 2019

Eur Rev Aging Phys Act

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Background Recommendations for assessing motor performance in individuals with dementia (IWD) are rare, and most existing assessment tools previously applied in IWD were initially developed for healthy older adults. However, IWD and their healthy counterparts differ in motor and cognitive capabilities, which needs to be considered when designing studies for this population. This article aims to give recommendations for motor assessments for IWD and to promote standardisation based on a structured discussion of identified assessment tools used in previous trials. Methods Appropriateness and standardisation of previously applied motor assessments for IWD were intensively discussed using a qualitative approach during an expert panel. Furthermore, the use of external cues and walking aids, as well as psychometric properties were considered. Starting with a comprehensive overview of current research practice, the discussion was gradually specified and resulted in the elaboration of specific recommendations. Results The superior discussion emphasised the need for tailoring motor assessments to specific characteristics of IWD and attaching importance to standardised assessment procedures. Specific recommendations include the use of sequential approaches, which incorporate a gradual increase of complexity from simple to more difficult tasks, a selection of motor assessments showing sufficient relative reliability and appropriateness for IWD, as well as allowing external cues and walking aids when restricted to repeated instructions and commonly used devices, respectively. Conclusions These are the first recommendations for assessing motor performance in IWD based on a comprehensive qualitative approach. Due to limited evidence, it was not possible to address all existing questions. It is therefore important to evaluate these recommendations in studies with IWD. Besides tailoring and evaluating available assessments, future research should focus on developing specific tools for IWD. Moreover, further progress in standardisation is necessary to enhance comparability between different trials. This article provides initial approaches for overcoming existing limitations in trials with IWD by giving recommendations and identifying future research questions, and therefore contributes to enhancing evidence regarding efficacy and effectiveness of physical activity interventions.

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Auswirkungen von körperlicher Aktivität auf demenzielle Erkrankungen

Cited by 10 publications

References 44 publications

Effects of a 16-week multimodal exercise program on gait performance in individuals with dementia: a multicenter randomized controlled trial

Effects of a 16-week multimodal exercise program on gait performance in individuals with dementia: a multicenter randomized controlled trial

Effectiveness of a 16-Week Multimodal Exercise Program on Individuals With Dementia: Study Protocol for a Multicenter Randomized Controlled Trial

Recommendations for assessing motor performance in individuals with dementia: suggestions of an expert panel – a qualitative approach

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