Physical Training Improves Motor Performance in People with Dementia : A Randomized Controlled Trial

Abstract

Objectives:To determine whether a specific, standardized training regimen can improve muscle strength and physical functioning in people with dementia.Design:Double-blinded, randomized, controlled trial with 3-month intervention and 3-month follow-up period in 2006 to 2009.Setting:Outpatient geriatric rehabilitation.Participants:Individuals with confirmed mild to moderate dementia, no severe somatic or psychological disease, and ability to walk 10 m. Most participants were still living independently with or without supportive care.Intervention:Supervised, progressive resistance and functional group training for 3 months specifically developed for people with dementia (intervention, n = 62) compared with a low-intensity motor placebo activity (control, n = 60).Measurements:Primary outcome measures were one-repetition maximum in a leg press device for maximal strength and duration of the five-chair-stand test for functional performance. Secondary outcome measures were assessed for a number of established parameters for maximal strength, physical function, and physical activity.Results:Training significantly improved both primary outcomes (percentage change from baseline: maximal strength, intervention group (IG): +51.5 ± 41.5 kg vs control group (CG): –1.0 ± 28.9 kg, P < .001; functional performance, IG: –25.9 ± 15.1 seconds vs CG: +11.3 ± 60.4 seconds, P < .001). Secondary analysis confirmed effects for all strength and functional parameters. Training gains were partly sustained during follow-up. Low baseline performance on motor tasks but not cognitive impairment predicted positive training response. Physical activity increased significantly during the intervention (P < .001).Conclusion:The intensive, dementia-adjusted training was feasible and substantially improved motor performance in frail, older people with dementia and may represent a model for structured rehabilitation or outpatient training.