Fernanda Beinotti

Physical activity attenuates neuropsychiatric disturbances and caregiver burden in patients with dementia

INTRODUCTION: A significant benefit from physical activity has recently been described in some patients who suffer from neurodegenerative diseases. OBJECTIVE: To assess the effects of physical activity on neuropsychiatric disturbances in demented patients and on the mental burden of their caregivers. METHODS: Assisted by a public geriatric psychiatry clinical unit, we studied 59 patients with dementia. Patients were divided into three groups according to their diagnosis and level of physical activity. Data were assessed through a semi-structured interview. Patients were evaluated with the Neuropsychiatric Inventory, the Mini-Sleep Questionnaire and the Baecke Questionnaire. The data were statistically analyzed using the Mann-Whitney U test and linear regression, with the level of significance set at 5%. RESULTS: Patients with Alzheimers or vascular dementia who engaged in physical activity had fewer neuropsychiatric symptoms than those who did not. When compared to the control group, the caregivers of patients with vascular dementia who engaged in physical activity had a reduced burden. CONCLUSION: The regular practice of physical activity seems to contribute to a reduction in neuropsychiatric symptoms in dementia patients and to attenuate the burden of the caregivers of those patients.

Effects of Horseback Riding Therapy on Quality of Life in Patients Post Stroke

Abstract Background: Persons with stroke commonly have serious sequelae requiring long-term medical treatment. They often experience distress, and thus improving quality of life (QOL) has been considered a therapeutic objective in addition to prolonging the patient’s life. Objective: The aim of this study was to analyze the impact of horseback riding therapy (HBRT) on the QOL of individuals with hemiparesis after stroke. Methods: In this single-blind, randomized, controlled trial, 24 poststroke patients were assigned to the experimental (n = 12) and control (n = 12) groups. The control group participated in a conventional physiotherapy program, whereas the experimental group participated in physiotherapy plus HBRT sessions for 16 weeks. The patients were evaluated by means of the Medical Outcomes Study 36-item Short-Form health survey (SF-36). Data analysis was applied through the use of descriptive and inferential statistics, with a 5% level of significance. Results: Significant improvement was observed in the total score of the SF-36 in the experimental group when compared with the control group. The combination of conventional physiotherapy and HBRT was associated with improvements in functional capacity (P = .02), physical aspects (P = .001), and mental health (P = .04) of the stroke patients. Conclusions: Supplementation of conventional physiotherapy with HBRT, applied in different contexts, may yield positive QOL outcomes for people with stroke. We recommend that further studies be carried out to clarify the benefits of HBRT applied singly.

Cognition and dual-task performance in older adults with Parkinson's and Alzheimer's disease.

Background Patients with neurodegenerative diseases usually experience significant functional deficits. Older adults with Parkinson’s disease (PD) and Alzheimer’s disease (AD) may suffer from both motor and cognitive impairments, making them especially vulnerable to poor dual-task performance. Objective To analyze the dual-task cost of walking in subjects with PD and AD exposed to motor and cognitive distracters. Methods A cross-sectional study was conducted involving 126 older adults comprising three groups: PD (n=43), AD (n=38), and control (n=45). The subjects were evaluated using the Timed Up and Go (TUG) test administered with motor and cognitive distracters. Mixed-design analysis of variance (ANOVA) with cognition as a covariant factor was used to test the possible main effects of dual-task on motion. A 5% threshold for significance was set, with a 95% confidence interval (CI). The partial eta square (n2p) analysis was included to estimate the magnitude of effect. Results Examining the effects for dual-task, ANOVA revealed the main effect for group×task interactions (F=13.09; P=0.001; n2p =0.178), for task (F=8.186; P=0.001; n2p =0.063) but not for group (F=2.954; P=0.056; n2p =0.047). Cognition applied as a covariant factor indicated interference on dual-tasks (F=30.43; P=0.001; n2p =0.201). Conclusion The findings of this study suggest that dual-task interference is a particularly noticeable problem in PD and AD, affecting subjects’ ability to appropriately adapt to environmental challenges.

Cognitive processes affect the gait of subjects with Parkinson’s and Alzheimer’s disease in dual tasks

Objective To investigate the relation between gait parameters and cognitive impairments in subjects with Parkinson’s disease (PD) and Alzheimer’s disease (AD) during the performance of dual tasks. Methods This was a cross-sectional study involving 126 subjects divided into three groups: Parkinson group (n = 43), Alzheimer group (n = 38), and control group (n = 45). The subjects were evaluated using the Timed Up and Go test administered with motor and cognitive distracters. Gait analyses consisted of cadence and speed measurements, with cognitive functions being assessed by the Brief Cognitive Screening Battery and the Clock Drawing Test. Statistical procedures included mixed-design analyses of variance to observe the gait patterns between groups and tasks and the linear regression model to investigate the influence of cognitive functions in this process. A 5% significant level was adopted. Results Regarding the subjects’ speed, the data show a significant difference between group vs task interaction (p = 0.009), with worse performance of subjects with PD in motor dual task and of subjects with AD in cognitive dual task. With respect to cadence, no statistical differences was seen between group vs task interaction (p = 0.105), showing low interference of the clinical conditions on such parameter. The linear regression model showed that up to 45.79%, of the variance in gait can be explained by the interference of cognitive processes. Conclusion Dual task activities affect gait pattern in subjects with PD and AD. Differences between groups reflect peculiarities of each disease and show a direct interference of cognitive processes on complex tasks.