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Articles • Arq. Neuro-Psiquiatr. 72 (3) • Mar 2014 • https://doi.org/10.1590/0004-282X20130231 copy

Treadmill training as an augmentation treatment for Alzheimer’s disease: a pilot randomized controlled study

Treinamento na esteira como um tratamento adicional para a doença de Alzheimer: estudo piloto controlado randomizado

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective

To assess the effect of aerobic exercise on the cognition and functional capacity in Alzheimer’s disease (AD) patients.

Method

Elderly (n=20) with mild dementia (NINCDS-ADRDA/CDR1) were randomly assigned to an exercise group (EG) on a treadmill (30 minutes, twice a week and moderate intensity of 60% VO_2max) and control group (GC) 10 patients. The primary outcome measure was the cognitive function using Cambridge Cognitive Examination (CAMCOG). Specifics instruments were also applied to evaluate executive function, memory, attention and concentration, cognitive flexibility, inhibitory control and functional capacity.

Results

After 16 weeks, the EG showed improvement in cognition CAMCOG whereas the CG declined. Compared to the CG, the EG presented significant improvement on the functional capacity. The analysis of the effect size has shown a favorable response to the physical exercise in all dependent variables.

Conclusion

Walking on treadmill may be recommended as an augmentation treatment for patients with AD.

Alzheimer’s disease; aerobic exercise; physical training; cognitive function; functional capacity

	Control Group	Exercise Group
	(n=10)	(n=10)
	Mean (SD)	Mean (SD)	p-value
Age (years)^*	79 (74.7- 82.2)	78.5 (64- 81.2)	.44
Gender (% female)	50	60	.45
Education (years)	8.4 (4.0)	8.7 (4.7)	.88
MMSE (score)	19.9 (3.4)	20.4 (2.7)	.72
CAMCOG-CANDEX (score)	68.4 (12.2)	69.9 (10.8)	.77
CDR (score)	1	1
Duration of disease (years)	4.1 (2.1)	4.3 (2.8)	.34
Cornell Scale (score)	4 (3.1)	2.5 (2)	.48
VO_2máx (ml/kg/min)^*	23.3 (14-34.9)	23.3 (14- 26.2)	.57
Number of comorbidities^*	1 (0-2)	1 (0.75- 2.0)	.68
Number of falls*^†	0.5 (0-1)	0 (0-1)	.83

	Control Group (n=10)		Exercise group (n=10)
	Baseline	Delta	Baseline	Delta
	Mean (SD)	Mean (SD); CI (95%)	Mean (SD)	Mean (SD); CI (95%)	p-values
MMSE (score)	19.9 (3.4)	-2.10 (0.8); (-6 to 1)	20.4 (2.7)	0.30 (2.4); (-2 to 4)	0.05
CAMCOG (score)*	68.4 (12.2)	-6.10 (4.3); (-14 to 0)	69.9 (10.8)	6.10 (6.7); (-5 to 22)	0.00
CDT (score)	2.1 (1.5)	-1.10 (1.1); (-3 to 0)	2.1 (1.1)	-0.10 (1.1); (-2 to 2)	0.06
Verbal Fluency (score)^†	11 (8-12)	-1.0 (-2.2;-0.7); (-3 to 2)	10 (7-11)	0.5 (-2.2;2.5); (-4 to 5)	0.20
Trail Making A (sec)^†	117 (69-234)	6.5 (-11; 35); (-3 to 22)	130 (81-28)	-6.0 (-25;19); (-5 to 22)	0.36
Stroop Test (sec)	1.7 (0.8)	-0.35 (1.3); (-3 to 1)	2,2 (1,4)	0.81 (1.6); (-1 to 3.5)	0.10
Digit Span (score)	8.9 (3.4)	-1.90 (3.1); (-5 to 4)	8.4 (2.6)	-0.80 (1.9); (-5 to 6)	0.36
Forward digit-span (score)	4.8 (1.8)	-0.10 (1.40); (-2 to 2)	4.3 (1.6)	-0.50 (1.2); (-2 to 2)	0.52
Backward digit-span (score)	4.1 (1.9)	-0.90 (1.5); (-2 to 1)	4 (1.9)	-0.70 (0.9); (-4 to 1)	0.73
RAVLT (score)	20.2 (7.1)	-1.30 (3.5); (6 to 4)	20 (4.3)	-0.20 (4.2); (5 to 9)	0.53

	Control Group (n=10)		Exercise Group (n=10)
	Baseline	Delta	Baseline	Delta
	Mean (SD)	Mean (SD); CI (95%)	Mean (SD)	Mean (SD); CI (95%)	p-values
Berg Balance (score)*^†	53 (50; 54)	-2.5 (-3.7;0); (-8 to 2)	55 (52;56)	2 (2;3.5); (0 to 8)	0.00
Functional Reach (cm)*	19 (4.2)	-0.70 (4.3); (-10 to 6)	20 (4.3)	5.10 (2.9); (0 to 10)	0.00
TUGT (m/s)*^†	7 (5;9)	77 (0.75;15); (-19 to 29)	8 (6;9)	-101 (-19;-99); (-29 to 50)	0.00
TUGT MOD (m/s)	12 (3)	99 (28); (-50 to 60)	10 (2)	-61 (31); (-50 to 39)	0.24
STS (number of stands)	9 (3)	-0.5 (0.9); (-2 to 1)	9 (2)	1 (2.4); (-5 to 4)	0.08

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