Dasselaar, E. (Edwin) (2016) Low intensity versus high intensity exercise in people with dementia: creating a contrast is feasible for strength training but not for walking. thesis, Human Movement Sciences.
Full text available on request.Abstract
Background: This is the first study that determined the dose-response relation of physical exercise in older people with dementia. One aspect of the dose of an activity is the intensity. In order to compare the cognitive and physical effects of different intensities, we need to know whether it is feasible for older people with dementia to perform activities on different intensities. Objective: To examine whether it is feasible for older people with dementia to participate in a Low Intensity (LI) and High Intensity (HI) alternated walking and strength exercise intervention and to test if the realized contrast in intensity between LI and HI was related to effects on physical and cognitive functioning. Method: The study design was a single blind, randomized control trial. Only the experimental group was selected for this study. During a 24-week intervention, alternated aerobic and strength exercises were performed. The first 12 weeks were performed on a LI, the second 12 weeks on a HI. These intensities were based on target criteria for Heart Rate (HR) and Rate of Perceived Exertion (RPE). Observed HR and RPE were assessed for each session as well as characteristics of compliance (respectively walking distance and speed; number of sets and repetitions). The experiences of the coaches regarding the intervention were inventoried by questionnaire. Cognitive and physical performance was measured with performance based tests at baseline, after 12 weeks and after 24 weeks 2 Results: Walking sessions: Observed HR was not different between LI and HI walking. Observed HR during LI walking appeared higher than the target HR for LI. Observed RPE was higher for HI versus LI walking. Observed RPE was within the range of the target RPE for both LI and HI walking. Participants from the negative contrast group (lower HR during HI versus LI walking) showed a higher walking speed and a larger walking distance in comparison with the other participants during the LI intervention. Strength training: The observed RPE was higher for HI versus LI. The observed RPE did not reach target RPE, but did also not differ from the lower limit of the target RPE. The number of performed sets and repetitions increased between HI versus LI. The results found for walking and strength training matched with the experiences of the coaches: The coaches had problems to stimulate participants to increase intensity after the LI. The coaches did not experience problems to create contrast between LI and HI for strength training. A higher contrast in HR between HI and LI walking was not related to a stronger cognitive or physical effect, except for MMSE scores. Participants with a negative contrast decreased in MMSE after the HI intervention, while the other participants improved or stabilized in MMSE score. Conclusion: Exercise at different intensities was feasible for strength training but not for walking training in older people with dementia. A higher contrast in walking intensity can probably obtained by reducing the intensity during LI walking. A higher sample size is needed to confirm this. Also the subjective type of the RPE scale should be regarded with attention. Medicine use (especially beta blockers) and physical pain experienced by the participant could should also taken into account during assessment of the LI and HI. Furthermore, HI didn’t improve physical functioning. There is an indication that HI influences global cognition.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Heuvelen, dr. M.J.G. van and Sanders, L.M.J. |
| Faculty: | Medical Sciences |
| Date Deposited: | 20 Apr 2022 10:22 |
| Last Modified: | 20 Apr 2022 10:22 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3128 |
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