Recommendations for assessing motor performance in individuals with dementia: suggestions of an expert panel - a qualitative approach.

Dementia Exercise Motor assessments Motor performance Physical activity

Journal

European review of aging and physical activity : official journal of the European Group for Research into Elderly and Physical Activity
ISSN: 1813-7253
Titre abrégé: Eur Rev Aging Phys Act
Pays: Germany
ID NLM: 101284836

Informations de publication

Date de publication:
2019
Historique:
received: 19 12 2018
accepted: 31 03 2019
entrez: 25 4 2019
pubmed: 25 4 2019
medline: 25 4 2019
Statut: epublish

Résumé

Recommendations for assessing motor performance in individuals with dementia (IWD) are rare, and most existing assessment tools previously applied in IWD were initially developed for healthy older adults. However, IWD and their healthy counterparts differ in motor and cognitive capabilities, which needs to be considered when designing studies for this population. This article aims to give recommendations for motor assessments for IWD and to promote standardisation based on a structured discussion of identified assessment tools used in previous trials. Appropriateness and standardisation of previously applied motor assessments for IWD were intensively discussed using a qualitative approach during an expert panel. Furthermore, the use of external cues and walking aids, as well as psychometric properties were considered. Starting with a comprehensive overview of current research practice, the discussion was gradually specified and resulted in the elaboration of specific recommendations. The superior discussion emphasised the need for tailoring motor assessments to specific characteristics of IWD and attaching importance to standardised assessment procedures. Specific recommendations include the use of sequential approaches, which incorporate a gradual increase of complexity from simple to more difficult tasks, a selection of motor assessments showing sufficient relative reliability and appropriateness for IWD, as well as allowing external cues and walking aids when restricted to repeated instructions and commonly used devices, respectively. These are the first recommendations for assessing motor performance in IWD based on a comprehensive qualitative approach. Due to limited evidence, it was not possible to address all existing questions. It is therefore important to evaluate these recommendations in studies with IWD. Besides tailoring and evaluating available assessments, future research should focus on developing specific tools for IWD. Moreover, further progress in standardisation is necessary to enhance comparability between different trials. This article provides initial approaches for overcoming existing limitations in trials with IWD by giving recommendations and identifying future research questions, and therefore contributes to enhancing evidence regarding efficacy and effectiveness of physical activity interventions.

Sections du résumé

BACKGROUND BACKGROUND
Recommendations for assessing motor performance in individuals with dementia (IWD) are rare, and most existing assessment tools previously applied in IWD were initially developed for healthy older adults. However, IWD and their healthy counterparts differ in motor and cognitive capabilities, which needs to be considered when designing studies for this population. This article aims to give recommendations for motor assessments for IWD and to promote standardisation based on a structured discussion of identified assessment tools used in previous trials.
METHODS METHODS
Appropriateness and standardisation of previously applied motor assessments for IWD were intensively discussed using a qualitative approach during an expert panel. Furthermore, the use of external cues and walking aids, as well as psychometric properties were considered. Starting with a comprehensive overview of current research practice, the discussion was gradually specified and resulted in the elaboration of specific recommendations.
RESULTS RESULTS
The superior discussion emphasised the need for tailoring motor assessments to specific characteristics of IWD and attaching importance to standardised assessment procedures. Specific recommendations include the use of sequential approaches, which incorporate a gradual increase of complexity from simple to more difficult tasks, a selection of motor assessments showing sufficient relative reliability and appropriateness for IWD, as well as allowing external cues and walking aids when restricted to repeated instructions and commonly used devices, respectively.
CONCLUSIONS CONCLUSIONS
These are the first recommendations for assessing motor performance in IWD based on a comprehensive qualitative approach. Due to limited evidence, it was not possible to address all existing questions. It is therefore important to evaluate these recommendations in studies with IWD. Besides tailoring and evaluating available assessments, future research should focus on developing specific tools for IWD. Moreover, further progress in standardisation is necessary to enhance comparability between different trials. This article provides initial approaches for overcoming existing limitations in trials with IWD by giving recommendations and identifying future research questions, and therefore contributes to enhancing evidence regarding efficacy and effectiveness of physical activity interventions.

Identifiants

pubmed: 31015865
doi: 10.1186/s11556-019-0212-7
pii: 212
pmc: PMC6463628
doi:

Types de publication

Journal Article

Langues

eng

Pagination

5

Déclaration de conflit d'intérêts

ST, BB, ASC, WB, MM, and AW performed comprehensive research with IWD and are familiar in working with the target group. ST and WB intensively analysed literature towards research on motor assessments in IWD. WB, SS, TS, KB, CN, SA, and AW acquired expertise in developing and evaluating motor assessments for various populations. ST, BB, ASC, WB, MM, SS, KB, AST, RW, and AW were involved in ageing research. ST, BB, ASC, WB, MM, TS, AST, and AW studied the effects of exercise on cognition and brain plasticity.Not applicable.Not applicable.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Références

Brain. 1999 Mar;122 ( Pt 3):383-404
pubmed: 10094249
Res Q Exerc Sport. 1999 Jun;70(2):113-9
pubmed: 10380242
J Gerontol A Biol Sci Med Sci. 2000 Feb;55(2):M70-3
pubmed: 10737688
Phys Ther. 2000 Sep;80(9):896-903
pubmed: 10960937
Alzheimer Dis Assoc Disord. 2000 Oct-Dec;14(4):196-201
pubmed: 11186596
Alzheimer Dis Assoc Disord. 2002 Apr-Jun;16(2):81-7
pubmed: 12040303
Int Psychogeriatr. 2002 Mar;14(1):17-23
pubmed: 12094903
J Gerontol A Biol Sci Med Sci. 2002 Aug;57(8):M539-43
pubmed: 12145369
Phys Ther. 2002 Sep;82(9):866-79
pubmed: 12201801
Age Ageing. 2003 Jan;32(1):67-73
pubmed: 12540351
Med Biol Eng Comput. 2003 May;41(3):283-9
pubmed: 12803292
Respir Care. 2003 Aug;48(8):783-5
pubmed: 12890299
Z Gerontol Geriatr. 2004 Feb;37(1):27-32
pubmed: 14991293
Gerontology. 2004 May-Jun;50(3):121-6
pubmed: 15114032
J Gerontol A Biol Sci Med Sci. 2004 Nov;59(11):1207-12
pubmed: 15602077
J Am Geriatr Soc. 2005 Oct;53(10):1681-7
pubmed: 16181166
Neuroscience. 2006;137(2):385-92
pubmed: 16289889
Aging Clin Exp Res. 2006 Apr;18(2):174-6
pubmed: 16702791
Am J Phys Med Rehabil. 2006 Oct;85(10):847-57
pubmed: 16998433
J Neurol Neurosurg Psychiatry. 2007 Sep;78(9):929-35
pubmed: 17237140
J Am Geriatr Soc. 2007 Feb;55(2):158-65
pubmed: 17302650
J Am Geriatr Soc. 2007 Apr;55(4):632-4
pubmed: 17397453
Arch Phys Med Rehabil. 2007 May;88(5):604-9
pubmed: 17466729
Clin Rehabil. 2007 Nov;21(11):977-86
pubmed: 17984150
Gait Posture. 2008 Oct;28(3):392-6
pubmed: 18321707
Int J Sports Med. 2008 Oct;29(10):845-50
pubmed: 18401810
Am J Alzheimers Dis Other Demen. 2008 Aug-Sep;23(4):382-94
pubmed: 18453642
J Am Geriatr Soc. 2008 May;56(5):949-50
pubmed: 18454757
Clin Rehabil. 2008 Jul;22(7):618-26
pubmed: 18586813
Int Psychogeriatr. 2009 Feb;21(1):103-12
pubmed: 18925975
Phys Ther. 2009 Jun;89(6):569-79
pubmed: 19389792
PLoS One. 2009;4(5):e5521
pubmed: 19436724
J Am Geriatr Soc. 1991 Feb;39(2):142-8
pubmed: 1991946
Dement Geriatr Cogn Disord. 2010;29(2):109-14
pubmed: 20150731
Eur J Phys Rehabil Med. 2010 Jun;46(2):239-48
pubmed: 20485226
Gait Posture. 2010 Oct;32(4):436-45
pubmed: 20947353
J Rehabil Med. 2011 Apr;43(5):424-9
pubmed: 21448557
Int Psychogeriatr. 2011 Sep;23(7):1152-9
pubmed: 21489342
Am J Alzheimers Dis Other Demen. 2011 Aug;26(5):381-8
pubmed: 21852281
Mayo Clin Proc. 2011 Sep;86(9):876-84
pubmed: 21878600
Gait Posture. 2012 Jan;35(1):96-100
pubmed: 21940172
Am J Phys Med Rehabil. 2012 Jan;91(1):12-23
pubmed: 22157433
J Am Geriatr Soc. 2012 Jan;60(1):8-15
pubmed: 22211512
J Am Geriatr Soc. 1990 Oct;38(10):1105-12
pubmed: 2229864
J Gerontol. 1990 Nov;45(6):M192-7
pubmed: 2229941
Gait Posture. 2012 May;36(1):95-101
pubmed: 22386897
Age Ageing. 2012 Nov;41(6):712-21
pubmed: 22885845
Phys Ther. 2013 Jan;93(1):69-78
pubmed: 22976448
J Geriatr Phys Ther. 2013 Apr-Jun;36(2):78-86
pubmed: 22976811
J Am Geriatr Soc. 2012 Nov;60(11):2127-36
pubmed: 23110433
Rev Bras Fisioter. 2012 Nov-Dec;16(6):510-4
pubmed: 23175438
BMC Psychiatry. 2012 Nov 23;12:208
pubmed: 23176536
Dement Geriatr Cogn Dis Extra. 2012 Jan;2(1):589-609
pubmed: 23341825
Phys Ther. 2014 Feb;94(2):262-72
pubmed: 24092904
PLoS One. 2014 May 20;9(5):e97577
pubmed: 24844772
Int Psychogeriatr. 2014 Oct;26(10):1659-67
pubmed: 24989439
Am J Geriatr Psychiatry. 2015 Nov;23(11):1106-16
pubmed: 25648055
J Am Med Dir Assoc. 2016 Feb;17(2):104-16
pubmed: 26432622
J Am Geriatr Soc. 2016 Jun;64(6):1258-66
pubmed: 27321604
JBI Database System Rev Implement Rep. 2016 Aug;14(8):115-71
pubmed: 27635751
J Nutr Health Aging. 2016;20(9):952-957
pubmed: 27791226
JMIR Res Protoc. 2017 Mar 03;6(3):e35
pubmed: 28258048
Eur J Ageing. 2007 Feb 6;4(1):3-12
pubmed: 28794767
Age Ageing. 2018 Jan 1;47(1):34-41
pubmed: 28985262
J Geriatr Phys Ther. 2019 Jan/Mar;42(1):28-47
pubmed: 29210934
Dement Neuropsychol. 2008 Jul-Sep;2(3):233-240
pubmed: 29213577
J Physiol (Paris). 1988-1989;83(2):102-10
pubmed: 3251039
Arch Phys Med Rehabil. 1986 Jun;67(6):387-9
pubmed: 3487300
Q J Exp Psychol A. 1986 Nov;38(4):603-18
pubmed: 3809575
J Am Geriatr Soc. 1986 Feb;34(2):119-26
pubmed: 3944402
Am J Med. 1985 Jan;78(1):77-81
pubmed: 3966492
JAMA. 1968 Jan 15;203(3):201-4
pubmed: 5694044
J Gerontol A Biol Sci Med Sci. 1995 Nov;50(6):M291-7
pubmed: 7583799
Aging (Milano). 1994 Dec;6(6):410-9
pubmed: 7748914
J Gerontol. 1994 Mar;49(2):M85-94
pubmed: 8126356
J Gerontol A Biol Sci Med Sci. 1997 Jan;52(1):M52-5
pubmed: 9008669
Aging (Milano). 1997 Feb-Apr;9(1-2):95-8
pubmed: 9177591
J Am Geriatr Soc. 1998 Jun;46(6):758-61
pubmed: 9625194

Auteurs

Sandra Trautwein (S)

1Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany.

Bettina Barisch-Fritz (B)

1Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany.

Andrea Scharpf (A)

1Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany.

Willem Bossers (W)

Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

Marcus Meinzer (M)

3Centre for Clinical Research, University of Queensland, Brisbane, Australia.
4Department of Neurology, Greifswald University Medicine, Greifswald, Germany.

Simon Steib (S)

5Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.

Thorsten Stein (T)

1Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany.

Klaus Bös (K)

1Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany.

Alexander Stahn (A)

6Unit of Experimental Psychiatry, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA.
Institute of Physiology, Charité - Universitätsmedizin Berlin, a corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.

Claudia Niessner (C)

1Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany.

Stefan Altmann (S)

1Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany.

Rita Wittelsberger (R)

1Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany.

Alexander Woll (A)

1Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany.

Classifications MeSH