痴呆症运动：一项可行性研究的方案，该研究测试针对中重度痴呆症长期护理居民的身体康复计划。

Dementia Moves: protocol for a feasibility study testing a physical rehabilitation program for long-term care residents with moderate to severe dementia.

作者信息

McArthur Caitlin, Alizadehsaravi Niousha, Affoo Rebecca, Cooke Karen, Douglas Natalie F, Earl Marie, Farlie Melanie K, Flynn Trudy, Ghanouni Parisa, Hunter Susan W, Grant Shannan M, Middleton Laura E, Moody Elaine, Smith Cheryl, Verlinden Linda, Weeks Lori E

机构信息

School of Physiotherapy, Dalhousie University, Halifax, NS, Canada.

School of Communication Sciences and Disorders, Dalhousie University, Halifax, NS, Canada.

出版信息

Pilot Feasibility Stud. 2025 Jul 26;11(1):104. doi: 10.1186/s40814-025-01685-7.

DOI:10.1186/s40814-025-01685-7

PMID:40713920

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12297742/

Abstract

BACKGROUND

Most long-term care (LTC) residents live with dementia and the proportion with more advanced cognitive impairment is increasing. Residents with dementia often have limited functional ability to complete their activities of daily living (ADLs) and are vulnerable to further functional decline. Multicomponent exercise can help prevent functional decline, but residents with dementia are less likely to receive it and have not often been included in previous intervention studies. The Dementia Moves intervention was designed to fill this gap. It is an individually tailored multicomponent group exercise program with an aerobic warm-up and a focus on moderate to high-intensity functional balance and strength training. We will measure the feasibility and effect of the Dementia Moves program on ADLs for LTC residents with moderate to severe dementia (Mini-Mental State Exam of 20 or less). We hypothesize the intervention will be feasible without modification if 16 individuals are recruited over 6 months, 65% of our sample is retained at 6 months and 75% of the completed exercises are performed at a moderate to high intensity.

METHODS

A pre-post study will be used to assess feasibility, safety (rates of falls and adverse events extracted from the electronic medical record), and change in ADLs at 3 and 6 months among LTC residents with moderate to severe dementia. There will be no control or comparison group. A physiotherapist, physiotherapy assistant and three volunteers will deliver the group-based exercise program to groups of four residents, three times per week, for 6 months. Assessments will be completed at 3 and 6 months. Feasibility outcomes include (1) recruitment over 6 months; (2) retention at 3- and 6-month follow-up; and adherence via (3) attendance and (4) proxy and self-reported ratings of exercise intensity. We will also assess fidelity of the intervention through program audits, and audio diaries and interviews to identify barriers and facilitators to implementation of the intervention.

DISCUSSION

The feasibility of the Dementia Moves intervention will be evaluated in LTC residents with dementia, and we will examine rates of falls and adverse events and change in ADLs. We will use the collected information to inform a definitive parallel cluster randomized controlled trial.

CLINICALTRIALS

gov: NCT06400108, May 3, 2024, Version 1. https://classic.

CLINICALTRIALS

gov/ct2/show/NCT06400108.

摘要

背景

大多数长期护理（LTC）机构的居民患有痴呆症，且认知功能障碍程度较高的居民比例正在增加。患有痴呆症的居民在完成日常生活活动（ADL）方面的功能能力往往有限，且容易出现进一步的功能衰退。多组分运动有助于预防功能衰退，但患有痴呆症的居民接受此类运动的可能性较小，且以往的干预研究中通常未将他们纳入。“痴呆症运动”干预措施旨在填补这一空白。它是一项针对个人量身定制的多组分团体运动计划，包括有氧热身运动，并侧重于中高强度的功能平衡和力量训练。我们将评估“痴呆症运动”计划对患有中度至重度痴呆症（简易精神状态检查表得分20分及以下）的长期护理机构居民的日常生活活动能力的可行性和效果。我们假设，如果在6个月内招募到16名参与者，6个月时样本保留率达到65%，且75%的已完成运动达到中高强度，那么该干预措施无需修改即可实施。

方法

将采用一项前后对照研究来评估患有中度至重度痴呆症的长期护理机构居民的可行性、安全性（从电子病历中提取跌倒和不良事件发生率）以及3个月和6个月时日常生活活动能力的变化。将不设对照组或比较组。一名物理治疗师、一名物理治疗助理和三名志愿者将为每组四名居民提供基于团体的运动计划，每周三次，为期6个月。评估将在3个月和6个月时完成。可行性结果包括：（1）6个月内的招募情况；（2）3个月和6个月随访时的保留率；以及通过（3）出勤率和（4）代理人及自我报告的运动强度评分来评估的依从性。我们还将通过项目审核、音频日记和访谈来评估干预措施的保真度，以确定实施干预的障碍和促进因素。