We aimed to determine the short- and medium-term effects of a multimodal physical exercise program (MPEP) on bone health status, fall risk, balance, and gait in patients with Alzheimer’s disease. A single-blinded, controlled clinical trial was performed where 72 subjects were allocated in a 3:1 ratio to an intervention group (IG; n = 53) and control group (CG; n = 19), where the IG’s subjects were admitted to live in a State Reference Center of Alzheimer’s disease, which offers the targeted exercise program, while the CG’s subjects resided in independent living. A multidisciplinary health team assessed all patients before allocation, and dependent outcomes were again assessed at one, three, and six months. During the study, falls were recorded, and in all evaluations, bone mineral density was measured using a calcaneal quantitative ultrasound densitometer; balance and gait were measured using the performance-oriented mobility assessment (POMA), the timed up and go test (TUG), the one-leg balance test (OLB), and the functional reach test (FR). There were no differences between groups at baseline for all outcome measures. The prevalence of falls was significantly lower in the IG (15.09%) than in the CG (42.11%) (χ² = 5.904; p = 0.015). We also found that there was a significant time*group interaction, with a post hoc Šidák test finding significant differences of improved physical function, especially in gait, for the IG, as assessed by POMA-Total, POMA-Gait, and TUG with a large effect size (ƞ²p = 0.185–0.201). In balance, we found significant differences between groups, regardless of time, and a medium effect size as assessed by POMA-Balance and the OLB (ƞ²p = 0.091–0.104). Clinically relevant effects were observed, although without significant differences in bone health, with a slowing of bone loss. These results show that a multimodal physical exercise program reduces fall risk and produces an improvement in gait, balance, and bone mineral density in the short and medium term in institutionalized patients with Alzheimer’s disease.

中文翻译：

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为期6个月的多模式体育锻炼计划对阿尔茨海默氏病患者骨矿物质密度，跌倒风险，平衡和步态的影响：一项对照临床试验

我们旨在确定多模式体育锻炼计划（MPEP）对阿尔茨海默氏病患者的骨骼健康状况，跌倒风险，平衡能力和步态的短期和中期影响。进行了单盲对照临床试验，其中以3：1的比例将72位受试者分配到干预组（IG; n = 53）和对照组（CG; n= 19），其中IG的受试者被允许住在阿尔茨海默氏病国家参考中心，该中心提供有针对性的锻炼计划，而CG的受试者则生活在独立生活中。一个多学科的医疗团队在分配之前对所有患者进行了评估，并在1、3和6个月时再次评估了依从性结局。在研究过程中，记录了跌倒，并且在所有评估中，均使用跟骨定量超声密度计测量了骨矿物质密度。平衡和步态使用面向性能的移动性评估（POMA），定时走步测试（TUG），单腿平衡测试（OLB）和功能触及测试（FR）进行测量。所有结果指标在基线时两组之间没有差异。IG的跌倒发生率（15.09％）明显低于CG的跌倒发生率（42。² = 5.904；p = 0.015）。我们还发现，存在显着的时间*群体互动，事后Šidák测试发现IG的改善的生理功能（尤其是步态）有显着差异，如POMA-Total，POMA-Gait和TUG评估的那样。大的效果大小（ƞ ² p = 0.185-0.201）。在平衡时，我们发现两组之间不分时间和介质作用大小显著差异，通过POMA-余额和OLB所评估（ƞ ²p = 0.091–0.104）。观察到了与临床相关的作用，尽管在骨骼健康方面没有显着差异，但减慢了骨质流失。这些结果表明，多模式体育锻炼计划可在短期和中期改善机构性阿尔茨海默氏病患者的跌倒风险并改善步态，平衡和骨矿物质密度。