The impact of the 6‐month adapted Otago Exercise Program on clinical measures of physical function relative to usual care alone in people living with dementia in residential care facilities: A pilot randomized controlled trial
Bibliographic record
Abstract
Abstract Background Dementia compromises physical function, posing risks for falls. People living with dementia (PWD) have been historically excluded from intervention trials due to researchers’ eligibility criteria. Exercise shows potential in enhancing physical function, but more evidence is needed. This pilot randomized controlled trial aimed to assess whether the adapted Otago Exercise Program improves physical function relative to usual care alone in PWD. Method 42 PWD (Montreal Cognitive Assessment<19/30) were randomized (1:1) into the exercise (n = 21) or usual care (n = 21) group at two residential care facilities [NCT05488951]. The adapted Otago Exercise Program was a physical therapist‐led strength, balance, and walking program for 1 hour, 3x/week for 6 months in groups of 5‐7 participants. Physical function was evaluated by the short physical performance battery (balance, gait speed, and chair stands), timed‐up‐and‐go (TUG), and strength at baseline and 6 months. Gait speed (m/s) was measured over 4m. The single‐task TUG involved getting up, walking 3m, walking back, and sitting down (s); the dual‐task TUG involved simultaneously performing a category task. We used dynamometers to measure leg and grip strength (kg). We performed intent‐to‐treat (ITT; n = 42) and per protocol (n = 21 usual care and n = 9 exercisers with 2/3 adherence) generalized mixed models, controlling for age, race, sex, and the MoCA. Result For the ITT analysis, left leg strength increased in the exercise group (baseline = 13.4kg; follow‐up = 16.7kg) and decreased in the usual care group (baseline = 14.4kg; follow‐up = 13.7kg; p = 0.03). Exercise provoked faster dual‐task gait speed (baseline = 0.4m/s; follow‐up = 0.5m/s; p<0.01) and decreased TUG dual‐task duration (baseline = 37.3s; follow‐up = 27.6s; p = 0.01) with no change following usual care. The per protocol analysis showed no differences. Conclusion The improvements in strength, gait speed, and functional mobility in the exercise group, plus the decline in strength in the usual care group suggest that exercise may prevent decline and improve physical function among PWD. There were no differences in the per protocol analysis, however, this could be due to our small sample of only n = 9 participants with ≥2/3 exercise adherence. Our results suggest that implementing any level of exercise into care plans may improve physical function in PWD, but further research should confirm these preliminary findings.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.003 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".