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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
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
  1. RCT - randomised controlled trial, CDR – Clinical Dementia Rating Scale, MMSE – Mini-mental state examination, FIM – functional independence measure, 6mwt – 6 min walking test, BI – Barthel Index