The effects of six months of exercise on single‐ and dual‐task gait and functional mobility relative to usual care alone among people living with dementia: A pilot randomized controlled trial
Bibliographic record
Abstract
Abstract Background Exercise may improve dual‐tasking and mobility impairments among people living with dementia (PWD), but more evidence is needed. The purpose of this pilot randomized controlled trial (RCT) was to determine the effect of six months of exercise on single‐ and dual‐task mobility compared to usual care alone in PWD. Method This assessor‐blinded RCT (1:1) included n = 21 PWD in the usual care and n = 21 PWD in the exercise group at two residential care facilities (Age = 82 years, 35% female, Montreal Cognitive Assessment (MoCA) = 10.2±5.9; NCT05488951). The physical therapist‐led adapted Otago Exercise Program involved 30 minutes of lower body strength and balance exercises and 30 minutes walking 3x/week for 6 months in groups of 5‐7. At baseline and 6 months, participants completed two trials of single‐ (walk 4m) and dual‐task gait (walk 4m while naming words), and single‐task timed‐up‐and‐go (TUG), and dual‐task TUG with a category task using APDM inertial sensors. We measured double limb support (%), gait speed (m/s), and stride length (m) for gait, and duration (s), turns angle (°), and turn velocity (m/s) for the TUG. Intent‐to‐treat (ITT) and per protocol (all usual care and exercisers with ≥2/3 adherence) analyses were performed. We controlled for age, race, sex, and the MoCA. Result In the ITT analysis, exercise provoked faster dual‐task gait speed (+0.03 m/s, p = 0.006), increased single‐task TUG turn velocity (+24.01 m/s, p = 0.001), decreased dual‐task TUG duration (‐11.54 s, p = 0.01), and increased dual‐task TUG turn velocity (+18.96 m/s, p<0.001). In the per Protocol analysis, both the exercise (‐22.04%, p = 0.007, n = 9) and usual care groups (‐18.90%, p<0.001, n = 21) decreased double limb support during single‐task gait. Additionally, only the exercise group increased stride length during dual‐task gait (+0.24 m, p = 0.007) and increased turn velocity during the single‐ (+28.27 m/s, p = 0.002) and dual‐task TUG (+17.75 m/s, p = 0.002). Conclusion Six months of exercise improved both single‐ and dual‐task mobility in PWD compared to usual care. Similar findings in both ITT and per protocol analyses indicate that exercising in any amount can improve dual‐task mobility in PWD. Our findings may inform therapeutic interventions for improving dual‐task mobility in PWD in residential care facilities.
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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 | 0.003 | 0.005 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.004 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
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".