11 research outputs found

    Effects of Physical Activity Training in Patients with Alzheimer’s Dementia: Results of a Pilot RCT Study

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    <div><p>Background</p><p>There is evidence that physical activity (PA) is of cognitive benefit to the ageing brain, but little is known on the effect in patients with Alzheimer’s disease (AD). The present pilot study assessed the effect of a home-based PA training on clinical symptoms, functional abilities, and caregiver burden after 12 and 24 weeks.</p><p>Methods</p><p>In an RCT thirty patients (aged 72.4±4.3 years) with AD (MMSE: 20.6±6.5 points) and their family caregivers were allocated to a home-based 12-week PA intervention program or the usual care group. The program changed between passive, motor-assisted or active resistive leg training and changes in direction on a movement trainer in order to combine physical and cognitive stimuli.</p><p>Results</p><p>Analysis of activities of daily living in the patients (ADCS ADL total score) revealed a significant group × time interaction effect (95% CI of the difference between both groups at T2: 5.01–10.51). The control group experienced decreases in ADL performance at week 12 and 24 whereas patients in the intervention group remained stable. Analyses of executive function and language ability revealed considerable effects for semantic word fluency with a group × time interaction (95% CI of the difference between both groups at T2: 0.18–4.02). Patients in the intervention group improved during the intervention and returned to initial performance at week 12 whereas the controls revealed continuous worsening. Analyses of reaction time, hand-eye quickness and attention revealed improvement only in the intervention group. Caregiver burden remained stable in the intervention group but worsened in the control group.</p><p>Conclusions</p><p>This study suggests that PA in a home-based setting might be an effective and intrinsically attractive way to promote PA training in AD and modulate caregiver burden. The results demonstrate transfer benefits to ADL, cognitive and physical skill in patients with AD.</p><p>Trial Registration</p><p>ClinicalTrials.gov <a href="https://clinicaltrials.gov/ct2/show/NCT02196545" target="_blank">NCT02196545</a></p></div

    a-e. Effects of physical activity on clinical performance.

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    <p>This figure shows the effects of physical activity on the patients when compared to the control group for the three time points (T0- baseline, T1–3 months later or after completion of the intervention and T2- 3 month follow-up). Activities of daily living (ADCS ADL total scores): patients in the control group experienced significant decreases in their performance over 12 weeks and at the 3 month follow-up whereas patients in the intervention group remained stable during the study period and follow-up (Fig 2a). Neuropsychiatric symptom profiles (NPI total scores): controls suffered a considerable increase in behavioural changes over 24 weeks whereas patients in the intervention group remained stable over 24 weeks (Fig 2b). Executive function and language ability: patients in the intervention group improved during the intervention period and returned to initial performance after completion but without revealing the continuous worsening over 24 weeks demonstrated in the controls (Fig 2c). Reaction time, hand-eye quickness and attention (FETZ-test or Ruler Drop Test): only patients in the intervention group improved their performance during the study period (Fig 2d). Caregiver burden (NPI): burden increased in the control group during the first 3 months whereas caregiver burden remained stable in the intervention group during the study period (Fig 2e).</p

    Relative increases in brain activity associated with personal familiarity.

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    <p>All activations are significant at p<0.05, corrected for multiple comparisons at the cluster level (with a height threshold of p<0.001, uncorrected at the voxel level). For each region of activation, the coordinates of the maximally activated voxels within the activation cluster are given in standard stereotactic MNI space. FF: familiar faces, UF: unfamiliar faces, FP: familiar places, UP: unfamiliar places; # indicates that this activation maximum is part of the same cluster.</p

    Demographic and neurocognitive characteristics.

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    1<p>age-adjusted z-values unless otherwise indicated.</p>2<p>effect size measure (Cohen's d).</p><p>BDI: Beck Depression Inventory; MMSE: Mini Mental State Examination; CVLT: California Verbal Learning Test; WMS-R: Wechsler Memory Scale – Revised; FAS: Controlled Oral Word Association Test, letters F,A,S; AAT: Aachen Aphasia Test.</p

    Within-group effect of personal familiarity irrespective of stimulus type.

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    <p>The figure shows brain areas with relative increase in neural activity for both subject groups when perceiving familiar>unfamiliar stimulus content irrespective of stimulus type. The local maxima are superimposed on a rendered standard single subject brain provided by SPM5. See <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0020030#pone-0020030-t003" target="_blank">Table 3</a> for exact coordinates. R = right, L = left, A = anterior, P = posterior.</p

    fMRI paradigm.

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    <p>This figure visualizes one experimental run of the fMRI paradigm. Three of these runs, each lasting 352 s, were performed. The order of the four conditions (FF, UF, FP, UP) was counterbalanced across the runs. Each block (35 s) of a condition consisted of a visual stimulus presented from five different angles (S1-5), a familiarity question (Q), and a response (“thank you”, R). FF = familiar face, UF = unfamiliar face, FP = familiar place, UP = unfamiliar place, B = baseline (fixation cross, 9 s).</p

    Interaction between age and familiarity.

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    <p>The figure shows an area (anterior cingulate cortex, −3, 39, 3) in which the young but not the elderly subjects showed reduced neural activity for unfamiliar versus familiar stimuli irrespective of stimulus type. Signal change at the local maximum is statistically significant at the voxel level (Psvc<0.05) in a ROI analysis based on the coordinates by <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0015790#pone.0015790-Sugiura3" target="_blank">[29]</a>. The local maximum is superimposed on a sagittal single subject brain section provided by SPM5. The histogram displays percentage BOLD signal change for the local maximum as a function of the experimental conditions (mean and 90% confidence interval). YF = young familiar, YU = young unfamiliar, EF = elderly familiar, EU = elderly unfamiliar.</p

    Demographic and clinical characteristics.

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    <p>MMSE, Mini Mental State Examination; CDR, Clinical Dementia Rating; WMS-R,</p><p>Wechsler Memory Scale – Revised; COWAT, Controlled Oral Word Association Test; CVLT, California Verbal Learning Test;</p><p>*p<0.05, 2-tailed.</p
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