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Progressive task-oriented circuit training for cognition, physical functioning and societal participation in individuals with dementia
Gbiri CAO, Amusa BF
Physiotherapy Research International 2020 Oct;25(4):e1866
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND AND OBJECTIVES: Dementia is commonly associated with cognitive deficit, functional decline and societal participation restriction across multiple domains of functioning. The decline impacts not only on the individual, but also on their informal caregivers, healthcare and the social system. This clinical random controlled study investigated the efficacy of 12-week progressive task-oriented circuit training on cognition, physical functioning and societal participation of individuals with dementia. METHODS: This study involved 31 individuals living with dementia recruited from a tertiary health institution in Lagos Nigeria. They were randomized into two groups: progressive task-oriented circuit training (involved in 12-week circuit training, two times a week for 70 min per session consisting of six workstations) and control group (training with conventional treatment and home programmes). They were assessed at baseline, mid-intervention and post-intervention using Mini-Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale-Cognition (ADAS-Cog), Bristol ADLs, Community integration Questionnaire, 6-min walk test. Data analysed using the independent-samples t tests, paired t tests, Friedman two-way analysis of variance and Mann-Whitney U test (p <= 0.05). RESULTS: Participants were aged 69.61 +/- 3.44 years. There was significant improvement from baseline to post-intervention in cognition (30.77 +/- 1.02 versus 28.77 +/- 3.30), physical functioning (28.19 +/- 3.90 versus 25.84 +/- 6.26) and societal participation (3.64 +/- 0.73 versus 5.59 +/- 2.76). However, the progressive task-oriented circuit training had more significant improvement than the control group within the group in cognition (p = 0.000), physical functioning (p = 0.000), and societal participation (p = 0.000). There was no statistical difference within the control group with cognition (p = 0.097), Physical functioning (p = 1.000). Meanwhile there was statistically significant effect between both groups on cognition, physical functioning and societal participation post-intervention (p < 0.005). CONCLUSION: Although both task-oriented circuit training and conventional treatment with home exercise programmes are efficacious, progressive task-oriented circuit training is more efficacious in enhancing and developing therapeutic strategies to train cognition, improve functional performance and societal participation in the rehabilitation of individuals with dementia.

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