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Improved Functional Performance in Individuals With Dementia After a Moderate-Intensity Home-Based Exercise Program

A Randomized Controlled Trial

Dawson, Nicole, PT, PhD, GCS1; Judge, Katherine S., PhD2; Gerhart, Hayden, PhD3

Journal of Geriatric Physical Therapy: January/March 2019 - Volume 42 - Issue 1 - p 18–27
doi: 10.1519/JPT.0000000000000128
Research Reports

Background and Purpose: Individuals with dementia (IWDs) experience difficulties across cognitive and functional domains. Nonpharmacological interventions aimed at reducing disability are greatly needed. Exercise is a low-cost and easily implemented approach, but investigation has yielded mixed evidence to date. The purpose of the current study was to evaluate a novel and innovative moderate-intensity functional exercise intervention for IWDs, which was developed using principles from exercise science along with a Strength-Based Approach, consisting of 24 home-based sessions.

Methods: A randomized, controlled intervention trial with a 2-group pretest and posttest design was used with a sample of 23 community-dwelling IWDs (intervention group: n = 13; comparison group: n = 10). Average age of participants was 73.9 years (standard deviation, 9.1) with mild to moderate cognitive impairment (Mini-Mental State Examination, Mean = 20.8; standard deviation, 5.0).

Results and Discussion: A 99.0% attendance rate indicated high adherence to the moderate-intensity exercise program. Efficacy was examined using multiple linear regression. Group assignment significantly predicted performance in key outcome measures, with IWDs from the intervention group improving in lower extremity strength (B = 5.92, t = 3.26, P = .004), balance (B = 4.04, t = 4.13, P = .001), and fast gait speed (B = .32, t = 2.61, P = .02). These findings indicated IWDs are able to participate in and benefit from a moderate-intensity functional exercise program, consisting of strength and balance activities.

Conclusions: The current intervention used a Strength-Based Approach to facilitate implementation of exercise activities that could be completed by the sample. Therefore, integration of these techniques into mainstream clinical practice and research should be feasible with this patient population. Future research directions and implications of these findings also are discussed.

1Department of Health Professions, University of Central Florida, Orlando, Florida.

2Department of Psychology, Cleveland State University, Cleveland, Ohio.

3Department of Kinesiology, Health, and Sport Science, Indiana University of Pennsylvania, Indiana, Pennsylvania.

Address Correspondence to: Nicole Dawson, PT, PhD, GCS, Department of Health Professions, Doctor of Physical Therapy Program, 12805 Pegasus Dr, HPA I, Room 258A, Orlando, FL 32828 (

This study was support by the Dissertation Research Award (0010-1710-10DDDDAW) from Cleveland State University, Office of Research.

Some findings from this article were presented at the 2015 annual meeting of the Gerontological Society of America.

The authors declare no conflicts of interest.

Supplemental digital contents are available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

Robert Wellmon was the Decision Editor.

© 2019 Academy of Geriatric Physical Therapy, APTA
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