None listed
Conditions
Brief summary
Dementia is a clinical syndrome characterized by impaired cognitive functions and gradual deterioration of physical function. The objective of this study is to investigate the effect of exercise on cognitive and physical function in patients with Alzheimer’s disease and provide information on the appropriate types of exercise and its parameters to maintain and improve cognitive and physical function. The main study hypothesis is that exercise has an effect on cognitive and physical function of patients and that different exercise protocols have different effect size on cognitive and physical function. It is a randomized control trial. The intervention will include aerobic exercise and resistance exercise and three groups of patients: two intervention groups and one control group. The first intervention group will follow a combined aerobic and resistance exercise program and the second group resistance exercise only. Participants in the control group will continue their usual routine. The results are expected to further facilitate the design of individualized exercise programs for elderly with dementia in the community aiming at functionality improvement.
Interventions
The intervention will include aerobic exercise and resistance exercise. For this purpose, three teams will be created, two (2) intervention and one (1) control. The first intervention group will have a combined aerobic and resistance exercise program and the second resistance exercise only. Programs will be implemented with different duration and frequency for each type of exercise but with moderate intensity for both groups.
The intervention was planned according to studies and guidelines from
The intervention will include aerobic exercise and resistance exercise. For this purpose, three teams will be created, two (2) intervention and one (1) control. The first intervention group will have a combined aerobic and resistance exercise program and the second resistance exercise only. Programs will be implemented with different duration and frequency for each type of exercise but with moderate intensity for both groups. The intervention was planned according to studies and guidelines from the American Sports Medicine Association (ACSM) for exercise and prescribing, the American Society of Cardiology (AHA) and in accordance with the recommendations of the World Health Organization (WHO) for physical activity in the elderly. All participants will be evaluated at the center at the beginning and after the intervention. During the intervention period, patients in the intervention groups will not be allowed to participate in any other exercise program as well as patients in the control group will not be allowed to participate in any other form of intervention (exercise program) other than that provided in routine care. The intervention will include: Intervention group A (Combined aerobic and resistance exercise program) Aerobic Exercise The type of aerobic exercise in the present study will involve walking at moderate intensity. The frequency of aerobic exercise will be 5 days a week lasting 30 minutes. Moderate intensity is defined as 64-76% of the HRmax which is the most commonly used indicator for determining the intensity of aerobic exercise. The maximum heart rate is calculated according to the formula: HRmax= 220-age . Also, the exercise intensity should be verified and the Borg Rating of perceived Exertion (RPE) scale (subjective perception scale of fatigue on exercise) that has been used in studies of people with dementia, as a principal method for estimating exercise intensity during of sessions in combination with indicators such as sweating, skin color, respiratory rate and muscle fatigue. Caregivers will supervise all exercise sessions and physiotherapists once a week for the first 2 weeks and then once a month. Resistance Exercise The resistance exercise in the study will concern the main muscle groups of the body and will be performed with free weights at moderate intensity according to 50-69% of a maximum repetition (% 1-RM). The intervention will include 2 sets of 10 exercises with 8-12 repetitions. The frequency of resistance training will be 3 workouts per week (every 48 hours) for 40-45 minutes per session, with a break of 1-3 minutes between sets. The control of moderate intensity will be monitored based on the scale of subjective perception of fatigue in exercise (RPE) by both the physiotherapist and the caregiver at home. Intervention group B (Resistance exercise program) Intervention group B perform the same resistance exercise program as intervention group A. During the intervention both the aerobic exercise program and the resistance exercise program will be carried out with a gradual increase of the load. Also, both intervention programs will include warm-up and cool-down lasting 5-10 minutes respectively, which will involve active exercises for the head, limbs, torso and stretching. Caregivers will oversee all exercise sessions at home and physiotherapists will train resistance participants two (2) days out of three (3) at the Alzheimer's Maroussi day center . The training program and the RPE system were selected and designed so that they can be easily reproduced at home, promote an active lifestyle and after the end of the study. The schedule must be followed for 12 weeks. Strategies for monitoring and adhering to the intervention will be one (1) physiotherapist’s visit to the patient's home during the first two (2) weeks and then one (1) visit per month. One (1) phone call once a week for the first month and then one (1) phone call per month. Participants and their caregivers will complete an exercise diary form. The exercise program will also be given in printed form.
Sponsors
Vasileios Papatsimpas
Study design
Allocation
Randomised controlled trial
Primary purpose
Treatment
Eligibility
Sex/Gender
All
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Inclusion criteria: a) age 65 years and older b) diagnosis of mild Alzheimer’s dementia, as determined by the treating physician c) Mini-Mental State Examination (MMSE): 20-24/30 d) ability to move to the intervention place e) existence of a caregiver f) sufficient hearing and vision g) medical consent to participate in the exercise h) absence of any other exercise program i) without medication change for at least 2 months j) ability of consent k) have already been considered as capable for consent from the treating physician and the treatment team.
Exclusion criteria
Exclusion criteria: a) other dementia type b) neurological disease with severe motor and cognitive problems c) serious diseases where is inappropriate participation in exercise, in consultation with the treating physician such as severe psychiatric illnesses, uncontrolled blood pressure severe cardiorespiratory problems, severe musculoskeletal problems d) malignancy e) recent surgery (<12 months) f) severe vision/hearing problems g) alcoholism h) drug use
Outcome results
None listed