Department of Geriatric Research, Agaplesion Bethanien Hospital Heidelberg, Geriatric Center at the University of Heidelberg, Heidelberg, Germany.
Institute for the Study of Christian Social Service, University of Heidelberg, Heidelberg, Germany.
J Alzheimers Dis. 2017;60(1):107-120. doi: 10.3233/JAD-170258.
A complex motor skill highly relevant to mobility in everyday life (e.g., sit-to-stand [STS] transfer) has not yet been addressed in studies on motor learning in people with dementia (PwD).
To determine whether a dementia-specific motor learning exercise program enables PwD to learn compensatory STS maneuvers commonly taught in geriatric rehabilitation therapy to enhance patients' STS ability.
Ninety-seven patients with mild-to-moderate dementia (Mini-Mental State Examination: 21.9±2.9 points) participated in a double-blinded, randomized, placebo-controlled trial with 10-week intervention and 3-month follow-up period. The intervention group (IG, n = 51) underwent a motor learning exercise program on compensatory STS maneuvers specifically designed for PwD. The control group (CG, n = 46) performed a low-intensity motor placebo activity. Primary outcomes were scores of the Assessment of Compensatory Sit-to-stand Maneuvers in People with Dementia (ACSID), which covers the number of recalled and initiated, and of effectively performed compensatory STS maneuvers. Secondary outcomes included temporal and kinematic STS characteristics measured by a body-fixed motion sensor (BFS, DynaPort® Hybrid).
The IG significantly improved in all ACSID scores compared to the CG (p < 0.001). Secondary analysis confirmed learning effects for all BFS-based outcomes (p < 0.001-0.006). Learning gains were sustained during follow-up for most outcomes.
People with mild-to-moderate dementia can learn and retain compensatory STS maneuvers in response to a dementia-specific motor learning exercise program. This is the first study that demonstrated preserved motor learning abilities in PwD by using a motor skill highly relevant to everyday life.
日常生活中与移动高度相关的复杂运动技能(例如,坐站转移[STS])尚未在痴呆患者(PwD)的运动学习研究中得到解决。
确定针对痴呆症的运动学习练习计划是否使 PwD 能够学习在老年康复治疗中通常教授的代偿性 STS 动作,以增强患者的 STS 能力。
97 名轻度至中度痴呆患者(Mini-Mental State Examination:21.9±2.9 分)参加了一项为期 10 周的干预和 3 个月随访的双盲、随机、安慰剂对照试验。干预组(IG,n=51)接受了针对 PwD 专门设计的代偿性 STS 动作的运动学习练习计划。对照组(CG,n=46)进行了低强度的运动安慰剂活动。主要结局是评估痴呆症患者代偿性坐站动作的评估(ACSID)的得分,涵盖回忆和开始以及有效执行代偿性 STS 动作的次数。次要结局包括通过身体固定运动传感器(DynaPort® Hybrid)测量的 STS 时间和运动学特征。
与 CG 相比,IG 在所有 ACSID 评分中均显著改善(p<0.001)。二次分析证实了所有基于 BFS 的结果的学习效应(p<0.001-0.006)。在随访期间,大多数结果的学习增益都得到了维持。
轻度至中度痴呆患者可以学习并保留代偿性 STS 动作,以响应针对痴呆症的运动学习练习计划。这是第一项使用与日常生活高度相关的运动技能证明 PwD 保留运动学习能力的研究。