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A controlled clinical trial on the effects of motor intervention on balance and cognition in institutionalized elderly patients with dementia

State University of Goiás, Department of Physical Therapy, gustavo_physio{at}yahoo.com.br

Merlyn Mércia Oliani

Dracena's Faculty, Department of Physical Education, Dracena

Sebastião Gobbi

State University of Sao Paulo, Department of Physical Education, Rio Claro

Florindo Stella

State University of Sao Paulo, Department of Education, Rio Claro

Lilian Teresa Bucken Gobbi

State University of Sao Paulo, Department of Physical Education, Rio Claro

Paulo Renato Canineu

Pontificie University of Sao Paulo, Department of Gerontology, Sorocaba, Brazil

Purpose: To analyse the effects of two interventions on the cognition and balance of institutionalized elderly people with mixed dementia.

Methods: Fifty-four participants were allocated into three groups. Group 1 was assisted by an interdisciplinary programme comprising physiotherapy, occupational therapy and physical education. A physiotherapist alone carried out the intervention in group 2. Group 3 was considered as control. Assessors were blinded to guarantee the absence of bias. Cognitive functions were analysed with the Mini-Mental State Examination and the Brief Cognitive Screening Battery. Balance was assessed with the Berg Balance Scale and the Timed Get-Up-and-Go Test. Multiple analysis of variance (MANOVA) was used to test possible main effects of the interventions.

Results: The results showed benefits on the balance of subjects in both groups 1 (F=3.9, P<0.05) and 2 (F=3.1, P<0.05), compared with group 3. MANOVA did not indicate benefits on the cognitive functions between groups 1 and 3 (F=1.1, P>0.05) and groups 2 and 3 (F=1.6, P>0.05). However, univariate analysis indicated some benefits of the interdisciplinary intervention on two specific domains measured by the Brief Cognitive Screening Battery (F=26.5, P<0.05; F=4.4, P<0.05).

Conclusion: Six months of multidisciplinary or physiotherapeutic intervention were able to improve a person's balance. Although global cognition did not improve through treatment, when the intervention was carried out on a multidisciplinary basis we observed an attenuation in the decline of global cognition on two specific cognitive domains. Exercises applied in different contexts may have positive outcomes for people with dementia.

Clinical Rehabilitation, Vol. 22, No. 7, 618-626 (2008)
DOI: 10.1177/0269215507086239


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