Passive exercise in a multisensory environment in order to manage adverse effects in physically inactive patients with dementia: a randomized controlled trial

Abstract

Background Since pharmacological treatments to manage dementia remain controversial, development of non-pharmacological alternatives to limit adverse effects of dementia is urgently needed. Passive exercise in a multisensory environment (Therapeutic Motion Simulation (TMSim, Whole Body Vibration (WBV) and a combination (TMSim + WBV)) is proposed to be such a non-pharmacological alternative. This study primarily aimed to investigate the effects of these different forms of passive exercise on Quality of Life (QoL) and Activities of Daily Living (ADLs) of inactive institutionalized patients with dementia. The secondary aim was to assess the effects on cognitive and physical function. Methods In this randomized controlled trial 120 inactive institutionalized persons with dementia (age 85.3 ± 6.8 years, 64.5% female, 59.2% walking aid/wheelchair users, mini mental state examination 12.9 ± 6.6) were assigned to TMSim, WBV, TMSim + WBV or a control group (regular care) The passive exercise groups followed a six-week intervention program consisting of four 4–12 minute sessions a week. QoL, ADLs (proxy-report questionnaires), cognitive and physical function (performance based tests) were measured at baseline, after 6 weeks of intervention, and 2 weeks after the intervention had ended. Results Outcome measures did not differ between groups at baseline. No consistent effects of passive exercise on QoL, ADLs, cognitive and physical function were observed after six weeks of intervention or during follow-up. Conclusion In the current setting passive exercise did not affect any of the outcomes measures. This may be due to the short intervention period, limited sensitivity to change of the assessment instruments in this specific vulnerable population or short lasting effects of the interventions. Future research into passive exercise should consider measuring acute and short term effects as well as longer intervention periods looking into alternative outcome measures (e.g. seated balance and behavioral and psychological symptoms of dementia).

Tactile Low Frequency Vibration in Dementia Management: A Scoping Review

“…In terms of design, there were three randomised controlled trials (Clements-Cortes et al, 2016;Lam et al, 2018;Heesterbeek et al, 2019a), two quasi-experimental studies (Clair and Bernstein, 1993;Kim and Lee, 2018), two case studies (Mercado and Mercado, 2006;Clements-Cortes et al, 2017a), and one qualitative research study (Clements-Cortes et al, 2017b). One grey literature source (preprint) was located (Heesterbeek et al, 2019b) but FIGURE 1 | Flow chart of n = 8 included studies with n = 6 excluded full-text articles for having limited detail on the intervention (n = 2), dementia not being the primary outcome or discussed in main text (n = 2), for being a study protocol (n = 1), and the same data set from a full-length included study (n = 1). was not included in the formal analysis.…”

“…In terms of design, there were three randomised controlled trials ( Clements-Cortes et al, 2016 ; Lam et al, 2018 ; Heesterbeek et al, 2019a ), two quasi-experimental studies ( Clair and Bernstein, 1993 ; Kim and Lee, 2018 ), two case studies ( Mercado and Mercado, 2006 ; Clements-Cortes et al, 2017a ), and one qualitative research study ( Clements-Cortes et al, 2017b ). One grey literature source (preprint) was located ( Heesterbeek et al, 2019b ) but was not included in the formal analysis. Conducted in the same setting as Heesterbeek et al (2019a) , results found no significant results of passive exercise on primary outcomes quality of life (QUALIDEM and EQ-5D-5L) nor activities of daily living (Barthel Index).…”