title: Sustainability of motor training effects in older people with dementia.
abstract: Evidence for sustainability of motor training effects in people with dementia is lacking. To examine whether the substantial improvements in motor performance achieved through a three-month specialized, standardized motor training were sustained, the participants of the randomized controlled trial were re-evaluated nine months after training had ceased. As part of a comprehensive study, participants with confirmed mild to moderate dementia underwent a progressive resistance and functional group training specifically developed for patients with dementia (intervention, n = 40) compared to a low-intensity motor placebo activity (control, n = 51). Primary and secondary outcome measures for maximal strength and function were measured before the start of the training (T1), directly after training ceased (T2), three months after training ceased (T3) and-the focus of this paper-nine months after training ceased (T4). Even after nine months without training, the gains in functional performance were sustained with significant group differences in the primary endpoint (five-chair-rise, relative change: IG: -8.54 ± 22.57 versus CG: +10.70 ± 45.89 s, p = 0.014, effect size ηp2 = 0.067). Other functional tests, such as walking speed and POMA (Tinetti), confirmed this result in the secondary analysis. Strength, as measured by the primary endpoint 1-Repetition Maximum (1RM) was still elevated (time effect for T1 versus T4: 148.68 ± 57.86 versus 172.79 ± 68.19 kg, p < 0.001, effect size ηp2 = 0.157), but between-group differences disappeared (relative change: maximal strength, IG: 22.75 ± 40.66 versus CG: 15.60 ± 39.26, p = 0.369). The study found that intensive dementia-specific motor training sustainably improved functional performance of patients with dementia nine months after cessation of training.
authors.affiliation: Agaplesion Bethanien Hospital, Center for Geriatric Medicine at the University of Heidelberg, Rohrbacher Street 149, Heidelberg, Germany. tzieschang@bethanien-heidelberg.de
authors.forename: Tania
authors.initials: T
authors.lastname: Zieschang
authors.forename: Michael
authors.initials: M
authors.lastname: Schwenk
authors.forename: Peter
authors.initials: P
authors.lastname: Oster
authors.forename: Klaus
authors.initials: K
authors.lastname: Hauer
mesh_terms: D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D003704:Dementia / Q000534:rehabilitation*; D004311:Double-Blind Method; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D009043:Motor Activity / Q000502:physiology*; D053580:Muscle Strength / Q000502:physiology; D012189:Retrospective Studies; D016896:Treatment Outcome