Home-based multimodal exercise program in older people with Alzheimer disease: Randomized controlled trial protocol

Background At-home physical exercise may be an important intervention strategy for older people with Alzheimer disease (AD) due to the greater adherence and ease for the caregivers. Purpose Determine the effects home-based multimodal exercise program in older people with AD on muscle strength, balance, functioning, cognition, dual task performance, frailty, and physical activity level. Methods This is a trial with 40 older people with mild and moderate AD, randomized into intervention group (IG) and control group (CG). The participants will be evaluated by blinded examiners at baseline and after 16 weeks of training. The evaluations will investigate functioning (Timed Up and Go test, Direct Assessment of Functional Status, WHO Disability Assessment Schedule, Short Physical Performance Battery, and Activities of Daily Living Questionnaire), muscle strength (manual dynamometer and Sit-to-Stand test), frailty (FRAIL Scale and Edmonton Frail Scale), cognition (Addenbrooke's Cognitive Examination, Trail Making Test, Walking Trail-Making Test, and Frontal Assessment Battery), balance (force platform, Figure-of-Eight Walking Test, Functional Reach Test, Alternate Step Test, and Calf-Raise Senior), dual task (force platform), and physical activity level (Modified Baecke Questionnaire and Life-Space Assessment). The IG will perform 16 weeks of exercise at home that involve functioning, strength, balance, and aerobic endurance in 60-min sessions three times a week. The CG will not undergo any intervention. Conclusion Improvements in the aspects evaluated are expected in the IG compared to CG. The protocol will provide a theoretical basis for the creation of clinical interventions and health promotion measures for older people with AD.