Trautwein Sandra, Barisch-Fritz Bettina, Scharpf Andrea, Bossers Willem, Meinzer Marcus, Steib Simon, Stein Thorsten, Bös Klaus, Stahn Alexander, Niessner Claudia, Altmann Stefan, Wittelsberger Rita, Woll Alexander
1Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany.
Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Eur Rev Aging Phys Act. 2019 Apr 13;16:5. doi: 10.1186/s11556-019-0212-7. eCollection 2019.
Recommendations for assessing motor performance in individuals with dementia (IWD) are rare, and most existing assessment tools previously applied in IWD were initially developed for healthy older adults. However, IWD and their healthy counterparts differ in motor and cognitive capabilities, which needs to be considered when designing studies for this population. This article aims to give recommendations for motor assessments for IWD and to promote standardisation based on a structured discussion of identified assessment tools used in previous trials.
Appropriateness and standardisation of previously applied motor assessments for IWD were intensively discussed using a qualitative approach during an expert panel. Furthermore, the use of external cues and walking aids, as well as psychometric properties were considered. Starting with a comprehensive overview of current research practice, the discussion was gradually specified and resulted in the elaboration of specific recommendations.
The superior discussion emphasised the need for tailoring motor assessments to specific characteristics of IWD and attaching importance to standardised assessment procedures. Specific recommendations include the use of sequential approaches, which incorporate a gradual increase of complexity from simple to more difficult tasks, a selection of motor assessments showing sufficient relative reliability and appropriateness for IWD, as well as allowing external cues and walking aids when restricted to repeated instructions and commonly used devices, respectively.
These are the first recommendations for assessing motor performance in IWD based on a comprehensive qualitative approach. Due to limited evidence, it was not possible to address all existing questions. It is therefore important to evaluate these recommendations in studies with IWD. Besides tailoring and evaluating available assessments, future research should focus on developing specific tools for IWD. Moreover, further progress in standardisation is necessary to enhance comparability between different trials. This article provides initial approaches for overcoming existing limitations in trials with IWD by giving recommendations and identifying future research questions, and therefore contributes to enhancing evidence regarding efficacy and effectiveness of physical activity interventions.
针对痴呆症患者运动能力评估的建议很少，而且大多数先前应用于痴呆症患者的现有评估工具最初是为健康老年人开发的。然而，痴呆症患者及其健康同龄人在运动和认知能力方面存在差异，在为这一人群设计研究时需要考虑到这一点。本文旨在为痴呆症患者的运动评估提供建议，并通过对先前试验中使用的已识别评估工具进行结构化讨论来促进标准化。
在专家小组中采用定性方法，深入讨论了先前应用于痴呆症患者的运动评估的适用性和标准化。此外，还考虑了外部提示和助行器的使用以及心理测量特性。从对当前研究实践的全面概述开始，讨论逐渐细化，最终形成了具体建议。
高级讨论强调了根据痴呆症患者的特定特征调整运动评估并重视标准化评估程序的必要性。具体建议包括使用循序渐进的方法，即从简单任务到更复杂任务逐渐增加难度，选择对痴呆症患者具有足够相对可靠性和适用性的运动评估，以及在分别限于重复指令和常用设备时允许使用外部提示和助行器。
这些是基于全面定性方法对痴呆症患者运动能力评估的首批建议。由于证据有限，无法解决所有现有问题。因此，在痴呆症患者的研究中评估这些建议很重要。除了调整和评估现有评估外，未来研究应专注于为痴呆症患者开发特定工具。此外，有必要在标准化方面取得进一步进展，以提高不同试验之间的可比性。本文通过提供建议和确定未来研究问题，为克服痴呆症患者试验中的现有局限性提供了初步方法，从而有助于增强关于体育活动干预效果和有效性的证据。
