Can a 4 month twice a week program led by a physical therapist and consisting of high-intensity functional exercise program improve independence in activities of daily living (ADLs) and balance in older people with dementia? You bet.
A study conducted in Sweden at a residential care facilities, Umeå, with 93 individuals aged 65 and older with a dementia diagnosis, a Mini-Mental State Examination score of 10 or greater, and dependence in ADLs were allocated to the high-intensity functional exercise program, comprising lower limb strength and balance exercises, and 93 to a seated control activity.
Blinded assessors measured ADL independence using the Functional Independence Measure (FIM) and Barthel Index (BI) and balance using the Berg Balance Scale (BBS) at baseline and 4 (directly after intervention completion) and 7 months.
They found significant between-group effect on balance favoring exercise was observed at 4 months (BBS=4.2, 95% CI=1.8-6.6). They concluded that in older people with mild to moderate dementia living in residential care facilities, a 4-month high-intensity functional exercise program administered by a physical therapist appears to slow decline in ADL independence and improve balance.
The exercises had 5 components:
All exercises can be increased by higher steps, deeper squats, narrowing base, and weighted belts.
Toots A, Littbrand H, Lindelöf N, Wiklund R, Holmberg H, Nordström P, et al. Effects of a High-Intensity Functional Exercise Program on Dependence in Activities of Daily Living and Balance in Older Adults with Dementia. Am Geriatr Soc. 2016 Jan;64(1):55-64. doi: 10.1111/jgs.13880. Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/26782852. Full article available at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4722852/.