2012-2013 ARDRAF Project

Balance Training Program Designed for Individuals with Alzheimer’s Disease: The Effect on Balance and Falls

VCoA-at-VCU*The Virginia Center on Aging which administers the Alzheimer’s and Related Diseases Research Award Fund for the Commonwealth of Virginia, provides seed money to researchers in Virginia to stimulate innovative research into biomedical and psychosocial aspects of dementia, including cell biology, caregiving, and animal modeling.


 

Balance Training Program Designed for Individuals with Alzheimer’s Disease: The Effect on Balance and Falls

Julie D. Ries, PhD, PT

Marymount University

This is an expansion of two pilot studies in which small-group balance interventions were successful in improving balance in individuals with AD. The program uniquely integrates motor learning strategies and communication tactics demonstrated to be successful with this population. Balance activities are functional and concrete. Thirty participants will be recruited from three adult day center programs. Subjects will have a probable AD diagnosis, be medically stable, and ambulatory with or without an assistive device. Background data includes medical, personal, and fall history, as well as scores on the Mini Mental Status Exam and the Functional Assessment Staging Tool. Twice a week for 12 weeks, subjects will be supervised by physical therapists as they participate in a 45-minute, functionally-based balance training program at their day care center. Outcome measures include the Berg Balance Scale, Timed Up and Go test, and Gait Speed. Fall data will be gathered three months following the program. Pilot studies showed that, although individuals did not recall participating in exercise programs, balance performance significantly improved, demonstrating “motor memory” of the training. An intervention that improves balance and decreases falls could positively impact quality of life and decrease healthcare costs for individuals with AD.

(Dr. Ries may be contacted at 703/284-5983; jries@marymount.edu)

 

REPORT:

Individuals with Alzheimer’s disease (IwAD) experience more frequent and more serious falls than their age-matched peers. Balance training is effective in improving balance and decreasing falls in cognitively intact older adults. This study was developed to analyze the effects of a balance training program designed specifically for IwAD, with specific guidelines for communication/interaction and deliberate structure of training sessions. Thirty participants with AD were recruited from three adult day-center programs; twenty-two of them completed at least one post-test session. Balance and mobility tests were administered immediately before and after the three-month program and again three months later.  Balance training sessions were 45 minutes, twice per week and were characterized by functional, relevant activities, with considerable repetition, and with sessions consistently formatted with blocks of  time dedicated to different tasks. Participants were up on their feet the majority of each session and were individually challenged as much as possible. Although most IwAD did not remember participating in the program week to week, or recognize the researchers after the three-month program, they demonstrated statistically significant improvements in balance. This finding suggests that their bodies had a “motor memory” of the training even if participants did not have a cognitive memory of it. Balance deteriorated after termination of the program, although participants did maintain some improvement three months after the training. Fewer participants experienced falls the six months following program initiation (n = 5) than the six months prior to initiation (n = 9). This upright and intensive balance training program shows promise for improving balance and potentially decreasing falls in IwAD.

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