Does physical exercise improve ADL capacities in people over 65 years with moderate or severe dementia hospitalized in an acute psychiatric setting? A multisite randomized clinical trial.
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.



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, and two weeks later.



Hundred and sixty patients completed the program. Characteristics of participants of both groups were similar at the inception of the study. 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.



ADL scores in elderly with moderate to severe dementia deteriorate during acute psychiatric hospitalization. An exercise program delays the loss of mobility but does not have a significant impact on overall ADL scores.
Department of Physical Therapy,HES-SO University of Applied Sciences and Arts Western Switzerland,Geneva,Switzerland.
Elisabeth
E
Bürge
Institute of Social Sciences & NCCR LIVES,University of Lausanne,Lausanne,Switzerland.
André
A
Berchtold
Department of Nursing,HES-SO University of Applied Sciences and Arts Western Switzerland,Geneva,Switzerland.
Christine
C
Maupetit
Research Institute,HES-SO University of Applied Sciences and Arts Western Switzerland,Geneva,Switzerland.
Nathalie M-P
NM
Bourquin
Department of Psychiatry,Service of Old Age Psychiatry,Lausanne University Hospital,Lausanne,Switzerland.
Armin
A
von Gunten
Department of Psychiatry,Service of Old Age Psychiatry,Lausanne University Hospital,Lausanne,Switzerland.
Daniel
D
Ducraux
Department of Psychiatry and Psychotherapy for the elderly,Mental Health Network Fribourg (RFSM),Marsens,Switzerland.
Serge
S
Zumbach
Grand Hôpital de Charleroi,Charleroi,Belgium.
Anne
A
Peeters
Department of Occupational Therapy,HES-SO University of Applied Sciences and Arts Western Switzerland,Lausanne,Switzerland.
Nicolas
N
Kuhne
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000534:rehabilitation*; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D013557:Switzerland
activities of daily living (ADL); behavioral and psychological symptoms of dementia (BPSD); dementia; exercise; physical activity