Postural balance in Alzheimer's disease patients undergoing sensory pitfalls

Despite consensus regarding the interference of cognitive processes on the human balance, the impact that different sensory stimuli have on the stabilometric measures remains unclear. Here, we investigated changes in the postural balance of individuals with Alzheimer's disease (AD) and in healthy controls undergoing different proprioceptive and somesthetic pitfalls. We included 17 subjects submitted to eight sensorimotor dynamics with differences in the support bases, contact surfaces, and visual clues. The measurements used to assess participants balance were as follows: position of the body in space, range of instability, area of the support base, and velocity of postural control. From a total of 56 cross-sectional analyses, 21.42% pointed out differences between groups. Longitudinal analyses showed that tasks with proprioceptive and somesthetic pitfalls similarly impact imbalance in both groups. The current results suggest that AD subjects and healthy controls had different patterns submitted to balance, but suffered similar interference when undergoing proprioceptive and somesthetic challenges

Efeitos de uma terapia cognitivo-motora em idosos institucionalizados / Effects of a cognitive-motor therapy in institutionalized older subjects

As instituições de longa permanência representam uma alternativa no cuidado de idosos onde a família não consegue garantir uma assistência adequada. A aplicação de abordagens terapêuticas é fundamental para almejar índices adequados de saúde desta população. Nesta perspectiva, o objetivo desta pesquisa foi investigar os efeitos de três meses de exercícios com estimulação cognitivo-motora sobre as funções cognitivas, a mobilidade e a independência funcional de idosos institucionalizados. Sob um ensaio clínico controlado, 15 sujeitos foram alocados entre grupo experimental e controle. Para avaliação dos sujeitos, foram aplicados os seguintes instrumentos: Mini-Exame do Estado Mental, Teste de Fluência Verbal, Bateria de Avaliação Frontal e Teste do Desenho do Relógio para análise das funções cognitivas; Escala de Equilíbrio Funcional de Berg e Teste Timed Up and Go para verificação da mobilidade, e; Escala de Atividades da Vida Diária de Katz e Índice de Pfeffer para mensuração da independência funcional. O procedimento estatístico envolveu a aplicação de análises de medidas repetidas, sob significância de 5%. A verificação do tamanho do efeito se deu através do eta ao quadrado parcial (ƞ2Æ¿) e do poder estatístico. Quanto aos resultados, os achados vislumbram benefício promovido pelo exercício sobre índices de mobilidade (p=0,001; ƞ2Æ¿=0,678; poder=99,78%) e funcionalidade (p=0,047; ƞ2Æ¿=0,588; poder=66,44%), mas não sobre as funções cognitivas dos sujeitos (p=0.831; ƞ2Æ¿=0.138; power of 9.99%). A terapia cognitivo-motora apresentou eficácia sobre índices físicos, mas não evidenciou efeitos sobre as variáveis cognitivas.

Long-term care institutions represent an alternative to older subjects whose families cannot ensure proper needs. The application of therapeutic approaches is essential to target suitable health indices for this population. In this perspective, the aim of this study was to investigate the effects of three month cognitive-motor exercises on cognitive function, mobility and functional independence of institutionalized older adults. In a controlled clinical trial, 15 subjects were allocated into experimental and control group. Regarding the assessment of the subjects, the following instruments were applied: Mini-Mental State Examination, Verbal Fluency Test, Frontal Assessment Battery and Clock Drawing Test for analyzing cognitive functions; Berg Balance Scale and Timed Up and Go Test to verify mobility, and; Katz Daily Living Activities and Pfeffer Index for measurement of functional independence. The statistical procedures involved the application of the general linear model for repeated measures (multivariate and univariate analyses), with a 5% threshold for significance. The partial eta square (ƞ2ƿ) and power analyses were included to estimate the magnitude of effect. Regarding the results, the findings showed benefits promoted by the exercise on mobility (p = 0.001; ƞ2ƿ = 0.678; power of 99.78%) and functionality (p = 0.047; ƞ2ƿ = 0.588; power of 66.44%), but not on cognitive functions (p = 0.517; ƞ2ƿ = 0.257; power of 19.00%). Univariate analyzes reinforce this pattern and give the basis for asserting that the cognitive-motor exercise program has shown effectiveness on physical indices of institutionalized older subjects, showed no effects on cognitive variables.