Historically, fitness and health practitioners have been reluctant to steer people with dementia into more intensive exercise programs. Researchers from the University of Arizona, Tucson, and the University of Heidelberg, in Germany, believed that customized, more intense exercise programs could significantly improve care even for older male and female inpatients with dementia. Their study findings indicate they may be right.
“Our recent findings suggest that an intensification of exercise training is feasible in patients with dementia if trainers use specific guidelines to promote exercise training and if a progressive high-intensity resistance and functional training program is developed according to established exercise guidelines for older adults,” said lead study author Michael Schwenk, PhD, research associate at the University of Arizona Interdisciplinary Consortium on Advanced Motion Performance, to IDEA Fitness Journal. “Low-functioning patients may benefit the most from the presented training program.”
According to Schwenk, “People with dementia have a threefold risk of falling compared to those without cognitive impairment. Exercise can be an important tool for maintaining everyday motor functions (such as walking), which are hallmarks of mobility-related quality of life and independence.”
Scwenk emphasized that “trainers should have a certificate assuring their knowledge about specific strategies for promoting exercise in the cognitively impaired.” He provided these practical guidelines:
- Speak slowly and clearly, repeating instructions several times.
- Make simple direct requests (“Mrs. Brown, please stand up”) rather than indirect requests (“Mrs. Brown, can you stand up for me?”).
- Use pictorial instructions (“nose over toes”) rather than directional instructions (“Lean forward”).
- To overcome initial reluctance, praise any response to exercise instructions, and encourage people to try again.
- Provide tactile and rhythmic cues to ensure correct execution of movements.
- Avoid carrying out unexpected moves on an unprepared patient, as they may cause distress.
- Encourage patients to give each task their maximum effort and to carry out tasks independently if possible.
- Focus a lot of attention on emotional aspects, such as reassurance and empathy toward each patient, as is described in dementia-care guidelines.
The study is available in the Journal of Alzheimer’s Disease (2014; doi: 10.3233/ JAD-130470).