Gait performance in dementia: the effects of a 6-week resistance training program in an adult day-care setting

Background Age-related declines in balance and muscle power are largely responsible for the changes in the various components of gait performance among elderly people. But these can often be remedied with strength training. People with cognitive impairment frequently demonstrate impaired gait, putting them at increased risks for falls and serious injury. Objectives This paper reports on the effects of a six-week pilot study of moderate intensity strength training on the gait of elderly individuals with dementia who attend a day-care center. Methods Twenty-six adults (23 female, three male), age = 79.2 +/- 6.6 years, completed the study. Each subject completed a baseline assessment of lower extremity strength and gait. Gait was evaluated using free- and fast-gait speed over a 6-meter course, the Tinetti-Gait Assessment scale, the 'Timed-Up-and-Go', and the Gait Assessment Rating Scale (GARS). The intervention consisted of moderate-intensity progressive resistance lower extremity exercise using Theraband, for two to three sessions per week over the six weeks. Post-intervention assessment of strength and gait was repeated at the completion of the sixth week. Multiple paired t-tests were calculated for each outcome measure. Results The baseline assessment of gait suggests a high degree of frailty and risk for falls in the sample. Although post-intervention scores reflected improvement on all gait measures, the only statistically significant change observed was in fast-gait time. Conclusion A six-week resistance training program proved to be of insufficient duration, intensity or specificity to produce significant change in gait outcome measures, with the exception of fast speed gait. Copyright (C) 2002 John Wiley Sons, Ltd.