None listed
Conditions
Brief summary
Two hundred and fourteen participants with mild to moderate severity of Alzheimer’s disease will be recruited for the randomised controlled trial. Sixty-four age and gender matched (to first 64 people with Alzheimer’s dementia in the control group) healthy participants will be recruited for the longitudinal study. A series of laboratory and clinical measures will be used to investigate balance and mobility performances. All participants will undergo a full assessment process as the baseline, and will then be randomized to a control or an intervention group. The participants in the intervention group will undertake an individually tailored balance training at home programme of 6 months duration. This exercise programme will be based on the results of the balance assessment and conducted under the guidelines which is modified from the established “Otago” programme by a physiotherapist. For the control group, the participants will be provided six home visits by an occupational therapist. Both intervention group and control group will continue with their “usual care” programme as recommended by the Cognitive, Dementia and Memory Services (CDAMS). All participants will be re-assessed at the completion of the programme (after 6 months), and again in a further six months. Additionally, the first 64 participants of the control group with mild to moderate severity Alzheimer’s disease, and 64 age and gender matched healthy controls will be re-assessed on all measures again after 24 months to determine the longitudinal changes in balance performance and magnitude of balance dysfunction. This study will give improved understanding of the changes in balance performance associated with the progression of dementia and the degree of effectiveness of home based balance training in early stages of the disease on balance performance, risks of falls and quality of life in people with Alzheimer’s disease and their families.
Interventions
The intervention group will participate in a home based balance exercise programme, provided at home by an experienced physiotherapist. This exercise programme is modified from an existing home exercise programme “Otaogo programme” to suit people with memory difficulties, and will be tailored to the results of the balance and mobility assessments. The Otago programme has been shown in a number of studies of older people to reduce falls. The exercise programme will be structured to be performed a
The intervention group will participate in a home based balance exercise programme, provided at home by an experienced physiotherapist. This exercise programme is modified from an existing home exercise programme “Otaogo programme” to suit people with memory difficulties, and will be tailored to the results of the balance and mobility assessments. The Otago programme has been shown in a number of studies of older people to reduce falls. The exercise programme will be structured to be performed at least 5 times each week, and will have a focus on standing balance and strengthening exercise, as well as a graduated walking programme. The physiotherapist will provide six home visits over the six month period, to monitor, advise, and modify the programme as required. The frequency of home visits in this study is slightly increased on the successful Otago programme (4 visits), aiming to maximise safety with increased visits particularly in the first 6-8 weeks of the programme. An exercise booklet will be provided by the physiotherapist to each pariticipant to give illustrations and instructions for the participant to continue the exercise programme at home. In between visit, the physiotherapist will contact participant by telephone.
Sponsors
National Ageing Research Institute (NARI)
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
65 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Older people with recent diagnosis of Alzheimer's disease, of mild to moderate severity, independent mobility, no other serious neurological or othopaedic history that impacts on balance and mobility performance.
Exclusion criteria
Non-dementia diagnosis or dementia diagnosis other than Alzheimer's disease, Alzheimer's disease more than 12 months or severe dementia, limited mobility.
Outcome results
None listed