The aim of this study was to examine and compare the effects of balance exercises versus strengthening exercises on gait and cognitive parameters in older adults with early-stage dementia. A total of 35 older adults with early-stage dementia were included in the study, and it was completed with 32 participants. The participants were divided into two groups and followed for 8 weeks. Group I received strengthening exercises, while Group II received balance exercises. After recording the demographic and clinical characteristics of all participants, gait was evaluated using the Berg Balance Scale (BBS), spatiotemporal gait parameters, and the Timed Up and Go (TUG) test; cognitive parameters were assessed with the Montreal Cognitive Assessment (MoCA) and the Dynamic Lowenstein Occupational Therapy Cognitive Assessment - Geriatric Version (DLOTCA-G); muscle strength was measured using Activforce-2; and quality of life was evaluated using the WHOQOL-OLD (World Health Organization Quality of Life - Older Adults Module).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
32
In the strengthening exercises, the amount of weight was determined based on 40 to 60 percent of the one-repetition maximum. Each exercise was performed in two sets of six to eight repetitions. The exercise sessions lasted approximately 40 minutes and included a 10-minute warm-up, 20 minutes of strengthening exercises, and a 10-minute cool-down period. To perform the strengthening exercises, resistance bands (Theraband), dumbbells, weighted balls, sandbags, and a resistance bicycle were used. The exercises were performed for both the upper and lower extremities. For the upper extremities, shoulder abduction, elbow extension, and shoulder extension exercises were performed using a theraband; elbow flexion, shoulder flexion, and elbow extension exercises were performed using dumbbells; and shoulder abduction exercises were performed using a weighted ball. For the lower extremities, knee extension, hip extension, and hip abduction exercises were performed using a resistance bicycle.
Each session was carried out over approximately 40 minutes, consisting of a 10-minute warm-up, 20 minutes of balance exercises, and a 10-minute cool-down period. The exercises were individually planned based on the participant's performance. To perform the balance exercises, supportive equipment such as balance discs and Pilates balls, as well as environments such as soft surfaces and stairs, were used. The balance exercises applied during the intervention included standing on a balance disc with weight shifting, walking on a soft surface, tandem walking, walking while stepping over obstacles, and cross-step walking. Additionally, seated balance activities, standing trunk rotations using a Pilates ball, sit-to-stand exercises from a chair, and stair climbing exercises were also performed as part of the program.
Istanbul University-Cerrahpaşa, Faculty of Health Sciences
Istanbul, Turkey (Türkiye)
Change from Baseline in Balance Performance Assessed by the Berg Balance Scale After 8 Weeks of Treatment
It is scored from 0 to 56, with higher scores indicating better balance performance.
Time frame: 8 Weeks
Change from Baseline in Gait Parameters Assessed by Temporal-Spatial Variables After 8 Weeks of Treatment
Within the scope of the Temporal-Spatial Variables Method, step length, double step length, step width, and the number of steps taken per minute were evaluated. Increases in step length and double step length, a decrease in step width, and an increase in the number of steps per minute were associated with improvements in gait.
Time frame: 8 Weeks
Change from Baseline in Gait Performance Assessed by the Timed Up and Go Test After 8 Weeks of Treatment
The Timed Up and Go Test is performed by measuring, in seconds, the time it takes for an individual to stand up from a chair, walk 3 meters, turn around, walk back, and sit down again. A shorter time indicates better gait performance.
Time frame: 8 Weeks
Change from Baseline in Cognitive Function as Measured by the Montreal Cognitive Assessment (MoCA) After 8 Weeks of Treatment
Cognitive function in the Montreal Cognitive Assessment (MoCA) is scored between 0 and 30, with higher scores indicating better cognitive performance.
Time frame: 8 Weeks
Change from Baseline in Cognitive Function as Measured by the Dynamic Loewenstein Occupational Therapy Cognitive Assessment - Geriatric Version (DLOTCA-G) After 8 Weeks of Treatment
The Dynamic Loewenstein Occupational Therapy Cognitive Assessment - Geriatric Version (DLOTCA-G) is a cognitive assessment tool scored between 17 and 119. Higher scores indicate better cognitive functioning.
Time frame: 8 Weeks
Change from Baseline in Muscle Strength as Measured by the Activforce 2 Dynamometer After 8 Weeks of Treatment
Activforce-2 is a digital dynamometer used for the objective measurement of muscle strength. In this study, muscle strength of the Biceps, Triceps, Middle Deltoid, Quadriceps, Hamstrings, Gluteal muscles, and Gastrocnemius was assessed using the Activforce-2 device.
Time frame: 8 Weeks
Change from Baseline in Quality of Life as Measured by the World Health Organization Quality of Life - Older Adults Module (WHOQOL-OLD) Questionnaire After 8 Weeks of Treatment
The World Health Organization Quality of Life - Older Adults Module (WHOQOL-OLD) is an assessment scale scored between 24 and 120. However, since higher scores in certain items may reflect lower quality of life, it is important to evaluate the individual item scores rather than relying solely on the total score.
Time frame: 8 Weeks
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