Impact of physical exercise on independence in activities of daily living in People over 65 hospitalized in an acute psychiatric setting for moderate or severe dementia. A Randomised Controlled Study

Background: Several studies on the effect of physical exercise on activities of daily living (ADL) for people with dementia exist; yet data concerning the specific context of acute psychiatric hospitals remain scant. This... [ view full abstract ]

Background:
Several studies on the effect of physical exercise on activities of daily living (ADL) for people with dementia exist; yet data concerning the specific context of acute psychiatric hospitals remain scant. This study measured the effect of a physical exercise program on ADL scores in patients with moderate to severe dementia hospitalized in an acute psychiatric ward.
Method:
A multicenter clinical trial was conducted in five Swiss and Belgian psychiatric hospitals. Participants were randomly allocated to either an experimental group (EG) or a control group (CG). Members of the EG received 20 physical exercise sessions (strengthening, balance and walking) over a four week period, while members of the CG participated in social interaction sessions of equivalent duration and frequency, but without physical exercise. The effect of exercise on ADL was measured by comparing scores of the Barthel Index and the Functional Independence Measure in the EG and CG before and after the intervention.
Results:
Hundred and sixty patients completed the program. The mean ADL score of EG decreased slightly over time, whereas that of the CG significantly decreased compared to initial scores. Overall differences between groups were not significant; however, significant differences were found for mobility-related items.
Conclusion:
ADL scores in elderly with moderate to severe dementia deteriorate during acute psychiatric hospitalization. An exercise program delay the loss of mobility but does not have a significant impact on overall ADL scores.
Application to Practice:
In this specific area, clinicians should prefer focused interventions over comprehensive physical exercise sessions