Table 2 Characteristics of included studies
From: Physical interventions for people with more advanced dementia – a scoping review
Burge [34] | Francese [30] | Kim [31] | Venturelli [33] | |
|---|---|---|---|---|
Year | 2017 | 1997 | 2016 | 2011 |
Country | Switzerland | USA | Korea | Italy |
Design | Multi-centre RCT | RCT | RCT | RCT |
Intervention group (N) | 136 | 6 | 19 | 12 |
Control group (N) | 134 | 5 | 19 | 12 |
Age | 81.7 (7.7) | Not reported | 81.9 ± 7.0 | 83 (6) |
Intervention group (mean SD) | ||||
Age | 81.1 (7.7) | Not reported | 80.9 ± 6.1 | 85 (5) |
Control group (mean SD) | ||||
Sex | 48.7 | Not reported | 13 (68.4) | Not reported |
Intervention group (N female,%) | ||||
Sex | 53.7 | Not reported | 12 (85.7) | Not reported |
Control group (N female,%) | ||||
Severity of dementia | CDR ≥ 2 | “Late stage” | Moderate to severe | MMSE 5 - 15 |
Type(s) of dementia | Alzheimer’s Lewy body Fronto-temporal Vascular Subcortical Mixed | Alzheimer’s | Alzheimer’s | Alzheimer’s |
Measurement of dementia | CDR ≥ 2 (moderate to severe dementia), MMSE | Not reported | MMSE | MMSE |
Measurement of physical ability | Barthel, FIM | Physical therapy assessment, Tinnetti | Exercise time, pedal rotation, total load, grip strength, Berg Balance Scale | 6mwt, Barthel Index, glycaemia |
Intervention | Usual care + exercise programme | Physical exercise programme | Physical exercise programme plus multicomponent cognitive programme | Walking |
Control | Social interaction | Singing | Multicomponent cognitive programme | Daily organised activities |
Materials | Demonstration by a therapist, music | Music, canes (for hand grips), bean bags, balls, weights + snack after 20 mins | TERASUERUGO - cycle ergometer | Walking log book |
Procedures | Strengthening, balance and walking accompanied by music | Exercise 20 mins each morning 3/wk. for 7 wks | 15 min of warm-up and stretching, 30 min of lower-limb aerobic exercise using a TERASUERUGO®, and 15 min of cool-down and relaxation. | Walking |
Who delivered | Physical therapists, occupational therapists, or psychomotor therapists | Primary investigator plus volunteer(s) | Physical therapist | Physiotherapist and caregiver |
Method of delivery | Groups of 4 | Small groups | Not reported | Individual |
Location of intervention | Acute psychiatric ward patients, but delivered off the ward | Dementia nursing facility | Long term care facility | Alzheimer’s care unit |
When/how much | 20 physical exercise sessions over 4 weeks lasting 30 mins each of moderate intensity | 20 min 3x week for 7 weeks | 60 min of supervised exercise sessions 5 times a week for 6 months | 30 min of moderate exercise (walking) 4 times a week; the program consisted of a simple aerobic walking activity. 24 weeks |
Tailoring | Individualised and graduated exercise programme | not reported | not reported | encouraged to walk at “fastest pace” |
Modifications | none reported | Not reported | not reported | not reported |
Check of fidelity | adherence | not reported | not reported | log books checked before and after walking session |
Actual fidelity | 81 completed out of 136 (most left hospital). 13.18/20 sessions | Not reported | not reported | 93.4% + 3.2% presence at the 96 scheduled training session. 1 person in walking group left due to stroke |
Outcomes measured | Effect on ADL | Depression, balance and physical ability (muscle strength, balance, ADL) | Cognition, grip strength, pedal power, total load, balance | Walking, ADL, cognition |
Outcome measures used | Barthel index, FIM | CADS, physical therapy score (PT muscle strength test), Tinnetti | MMSE, Berg scale, Borg scale, Grip strength | 6WT, BI, MMSE, glycaemia |
Results | No significant differences. ADL scores deteriorate during acute psychiatric hospitalization. An exercise program delays the loss of mobility but does not have a significant impact on overall ADL scores. | Significant difference between groups for Tinetti measurement in favour of intervention. | Exercise time, pedal rotation, total load, grip strength and BBS was significantly increased at 6 months | Significant difference between groups for 6WT and BI in favour of intervention. |
Long term follow-up | 2 week follow-up | None | 1,3 and 6 months | 6 months |