Physical exercise improves strength, balance, mobility, and endurance in people with cognitive impairment and dementia: a systematic review

Freddy MH Lam, Mei Zhen Huang, Lin Rong Liao, Raymond CK Chung, Timothy CY Kwok, Marco Yiu Chung Pang

Research output: Journal article publicationJournal articleAcademic researchpeer-review

70 Citations (Scopus)

Abstract

Question Does physical exercise training improve physical function and quality of life in people with cognitive impairment and dementia? Which training protocols improve physical function and quality of life? How do cognitive impairment and other patient characteristics influence the outcomes of exercise training? Design Systematic review with meta-analysis of randomised trials. Participants People with mild cognitive impairment or dementia as the primary diagnosis. Intervention Physical exercise. Outcome measures Strength, flexibility, gait, balance, mobility, walking endurance, dual-task ability, activities of daily living, quality of life, and falls. Results Forty-three clinical trials (n = 3988) were included. According to the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) system, the meta-analyses revealed strong evidence in support of using supervised exercise training to improve the results of 30-second sit-to-stand test (MD 2.1 repetitions, 95% CI 0.3 to 3.9), step length (MD 5 cm, 95% CI 2 to 8), Berg Balance Scale (MD 3.6 points, 95% CI 0.3 to 7.0), functional reach (3.9 cm, 95% CI 2.2 to 5.5), Timed Up and Go test (–1 second, 95% CI –2 to 0), walking speed (0.13 m/s, 95% CI 0.03 to 0.24), and 6-minute walk test (50 m, 95% CI 18 to 81) in individuals with mild cognitive impairment or dementia. Weak evidence supported the use of exercise in improving flexibility and Barthel Index performance. Weak evidence suggested that non-specific exercise did not improve dual-tasking ability or activity level. Strong evidence indicated that exercise did not improve quality of life in this population. The effect of exercise on falls remained inconclusive. Poorer physical function was a determinant of better response to exercise training, but cognitive performance did not have an impact. Conclusion People with various levels of cognitive impairment can benefit from supervised multi-modal exercise for about 60 minutes a day, 2 to 3 days a week to improve physical function. [Lam FMH, Huang MZ, Liao LR, Chung RCK, Kwok TCY, Pang MYC (2018) Physical exercise improves strength, balance, mobility, and endurance in people with cognitive impairment and dementia: a systematic review. Journal of Physiotherapy 64: 4–15]

Original languageEnglish
Pages (from-to)4-15
Number of pages12
JournalJournal of Physiotherapy
Volume64
Issue number1
DOIs
Publication statusPublished - 1 Jan 2018

Keywords

  • Dementia
  • Exercise
  • Mild cognitive impairment
  • Physical fitness
  • Quality of life

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation

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