Longhurst Jason, Phan Jason, Chen Elbert, Jackson Steven, Landers Merrill R
Department of Neurorehabilitation, Cleveland Clinic Lou Ruvo Center for Brain Health, 888 West Bonneville, Las Vegas, Nevada, USA 702-483-6032.
Department of Physical Therapy, University of Nevada, Las Vegas, USA.
Rehabil Res Pract. 2020 Nov 3;2020:8861004. doi: 10.1155/2020/8861004. eCollection 2020.
The purpose of this study was to determine if a pragmatic physical therapy (PT) program was associated with improved cognition, gait, and balance in individuals with cognitive impairment. This study investigated these associations for individuals with Alzheimer disease (AD), vascular dementia (VaD), dementia with Lewy bodies (DLB), and mild cognitive impairment (MCI) in order to better characterize outcomes to PT for each diagnostic group.
Data before and after one month of physical therapy were extracted from patient records (67 with AD, 34 with VaD, 35 with DLB, and 37 with MCI). The mean number of PT sessions over a month was 3.4 (±1.8). Outcomes covered the domains of gait, balance, and cognition with multiple outcomes used to measure different constructs within the balance and gait domains.
All groups showed improvements in balance and at least one gait outcome measure. Those with MCI improved in every measure of gait and balance performance. Lastly, cognition as measured by Montreal Cognitive Assessment improved in individuals in the AD, VaD, and MCI groups.
While this retrospective analysis is not appropriate for causal inference, results of one month of physical therapy were associated with decreases in gait, balance, and cognitive impairment in individuals with AD, VaD, DLB<, and MCI. . While physical therapy is not typically a primary treatment strategy for individuals with cognitive impairment, the results of this study are consistent with the literature that demonstrates improvement from physical therapy for other neurodegenerative diseases. Further clinical and research exploration for physical therapy as a primary treatment strategy in these populations is warranted.
本研究旨在确定一项实用的物理治疗（PT）计划是否与认知障碍患者的认知、步态和平衡改善相关。本研究调查了阿尔茨海默病（AD）、血管性痴呆（VaD）、路易体痴呆（DLB）和轻度认知障碍（MCI）患者的这些关联，以便更好地描述每个诊断组接受PT治疗的结果。
从患者记录中提取物理治疗前后一个月的数据（67例AD患者、34例VaD患者、35例DLB患者和37例MCI患者）。一个月内PT治疗的平均次数为3.4次（±1.8）。结果涵盖步态、平衡和认知领域，使用多个结果来测量平衡和步态领域内的不同结构。
所有组在平衡和至少一项步态结果测量方面均有改善。MCI组在步态和平衡表现的各项测量中均有改善。最后，AD、VaD和MCI组患者通过蒙特利尔认知评估测得的认知能力有所改善。
虽然这项回顾性分析不适用于因果推断，但一个月的物理治疗结果与AD、VaD、DLB和MCI患者的步态、平衡和认知障碍减轻相关。虽然物理治疗通常不是认知障碍患者的主要治疗策略，但本研究结果与文献一致，即表明物理治疗对其他神经退行性疾病有改善作用。有必要对物理治疗作为这些人群的主要治疗策略进行进一步的临床和研究探索。
