Background

Multidirectional walking, including backward walking, is integral to daily activities, and seems particularly challenging in older age, and in people with pathology affecting postural control such as dementia.

Research Question

Does exercise influence backward walking speed in people with dementia, when tested using habitual walking aids and without, and do effects differ according to walking aid use?

Methods

This study included 141 women and 45 men (mean age 85 years) with dementia from the Umeå Dementia and Exercise (UMDEX), a cluster-randomized controlled trial study set in 16 nursing homes in Umeå, Sweden. Participants were randomized to a High-Intensity Functional Exercise (HIFE) program targeting lower limb strength-, balance and mobility exercise or to a seated attention control activity. Blinded assessors measured 2.4-meter usual backward walking speed, at baseline, 4 - (intervention completion) and 7-month follow-up; tested 1) with habitual walking aids allowed, and 2) without walking aids.

Results

Linear mixed models showed no between-group effect in either backward walking speed test at 4 or 7 months; test 1) 0.005 m/s, P = .788 and –0.006 m/s, P = .754 and test 2) 0.030 m/s, P = .231 and 0.015 m/s, P = .569, respectively. In interaction analyses, exercise effects differed significantly between participants who habitually walked unaided compared with those that used a walking aid at 7 months (0.094 m/s, P = .027).

Significance

In this study of older people with dementia living in nursing homes, the effects of exercise had no overall effects on backwards walking speed. Nevertheless, some benefit was indicated in participants who habitually walked unaided, which is promising and merits further investigation in future studies.

中文翻译：

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运动对痴呆症患者向后行走速度的影响：一项随机对照试验

背景

多方向步行，包括向后步行，是日常活动必不可少的，在老年人以及患有影响姿势控制（例如痴呆）的病理的人中，挑战尤其明显。

研究问题

在不使用习惯性助行器进行测试的情况下，运动是否会影响痴呆症患者的后向行走速度，效果是否因助行器的使用而有所不同？

方法

这项研究包括来自Umeå痴呆症和运动（UMDEX）的痴呆症的141名女性和45名男性（平均年龄85岁），这是一项在瑞典Umeå的16个疗养院进行的整群随机对照试验研究。参与者被随机分为针对下肢力量，平衡和活动性运动的高强度功能锻炼（HIFE）计划，或就座的注意力控制活动。盲人评估者在基线，4-（干预完成）和7个月的随访中测量了2.4米的通常后退速度。测试1）允许使用惯常助行器，以及2）不使用助行器。

结果

线性混合模型在4个月或7个月的向后步行速度测试中均未显示组间影响。测试1）0.005 m / s，P = .788和–0.006 m / s，P = .754和测试2）0.030 m / s，P = .231和0.015 m / s，P = .569。在互动分析中，习惯性无助行走的参与者与7个月使用助行器的参与者相比，锻炼效果差异显着（0.094 m / s，P = .027）。

意义

在这项针对居住在疗养院中的老年痴呆症患者的研究中，运动的影响对后退行走速度没有整体影响。尽管如此，习惯性走路的参与者仍能获得一些益处，这是有希望的，值得在以后的研究中进行进一步的研究。