Walking Aids Moderate Exercise Effects on Gait Speed in People With Dementia: A Randomized Controlled Trial.
OBJECTIVE
To investigate the effects of exercise on gait speed, when tested using walking aids and without, and whether effects differed according to amount of support in the test.


METHODS
A cluster-randomized controlled trial.


METHODS
The Umeå Dementia and Exercise (UMDEX) study was set in 16 nursing homes in Umeå, Sweden.


METHODS
One hundred forty-one women and 45 men (mean age 85 years) with dementia, of whom 145 (78%) habitually used walking aids.


METHODS
Participants were randomized to the high-intensity functional exercise program or a seated attention control activity.


METHODS
Blinded assessors measured 4-m usual gait speed with walking aids if any gait speed (GS), and without walking aids and with minimum amount of support, at baseline, 4 months (on intervention completion), and 7 months.


RESULTS
Linear mixed models showed no between-group effect in either gait speed test at 4 or 7 months. In interaction analyses exercise effects differed significantly between participants who walked unsupported compared with when walking aids or minimum support was used. Positive between-group exercise effects on gait speed (m/s) were found in subgroups that walked unsupported at 4 and 7 months (GS: 0.07, P = .009 and 0.13, P < .001; and GS test without walking aids: 0.05, P = .011 and 0.07, P = .029, respectively).


CONCLUSIONS
In people with dementia living in nursing homes exercise had positive effects on gait when tested unsupported compared with when walking aids or minimum support was used. The study suggests that the use of walking aids in gait speed tests may conceal exercise effects.
Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden; Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden. Electronic address: annika.toots@umu.se.
Annika
A
Toots
Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden; Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden.
Håkan
H
Littbrand
Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
Henrik
H
Holmberg
Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden.
Peter
P
Nordström
Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.
Lillemor
L
Lundin-Olsson
Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden.
Yngve
Y
Gustafson
Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden; Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden.
Erik
E
Rosendahl
D000368:Aged; D000369:Aged, 80 and over; D016000:Cluster Analysis; D003704:Dementia; D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D009735:Nursing Homes; D012656:Self-Help Devices; D013548:Sweden; D016138:Walking; D000072797:Walking Speed
Alzheimer disease; Frail elderly; Mobility limitations; Rehabilitation; Residential facilities