ARTICLE INFO

Article Type

Short Cummiunication

Authors

Seifi   Z. (*1)
Baghdasarians   A. (2)






(*1) Clinical Psychology Department, Psychology & Educational Sciences Faculty, entral Tehran Branch, Islamic Azad University, Tehran, Iran
(2) Psychology Department, Psychology & Educational Sciences Faculty, Central Tehran Branch, Islamic Azad University, Tehran, Iran

Correspondence

Address: Clinical Psychology Department, Psychology & Educational Sciences Faculty, Central Tehran Branch, Islamic Azad University, Tehran, Iran
Phone: +98 (21) 26421696
Fax:
z.seifi2020@yahoo.co

Article History

Received:  September  2, 2017
Accepted:  April 30, 2019
ePublished:  July 6, 2019

BRIEF TEXT


Alzheimer's is one of the most common degenerative cerebrovascular diseases that is associated with cognitive impairment and is most commonly found in old age.

… [1]. Lack of physical activity is an important risk factor for cognitive decline in Alzheimer's disease (AD). In contrast, physical exercise can have a protective effect against cognitive decline in AD. Studies show that exercise has a significant effect on dementia in people living in different societies [4]. Increased physical activity increases brain activity, especially in the hippocampus (the center for memory and learning) leading to reducing the secondary effects of AD [5]. … [6].

The aim of this study was to investigate the effect of aerobic exercise program with fixed bicycle on cognitive abilities of patients with AD.

The present research was a quasi-experimental study with pre-test post-test design with control group.

The present research was performed on 14 patients with Alzheimer's with the mean age of 67 years as the members of the Alzheimer's Association of Iran in 2015.

14 patients with AD were selected by purposeful sampling method and were randomly divided into the experimental (n = 7) and control (n = 7) groups. Inclusion criteria included the ability to perform exercise confirmed by a cardiologist, suffering from AD for at least 6 months and the obtaining the consent from patients’ companion to perform exercise. Patients at severe stage or less than stage 6 and patients with musculoskeletal disorders who were unable to perform exercise were excluded.

The following tools were used to conduct the study: The Functional Assessment Staging Test (FAST): This is the most common system developed by Barry Reisberg in 1987 in New York University. … [7]. The FAST test used in this study was taken from the research of Mohammadian et al. [8]. … [9-10]. The Mini-Mental State Examination (MMSE): The MMSE questionnaire used in this study in Iran has been standardized by Seyedian et al. Cronbach's alpha coefficient for the whole test was 0.81. The Montreal Cognitive Assessment (MoCA): This scale developed by Nasruddin et al. in 2005, is a new cognitive assessment and measures a broader range of cognitive domains against brief examination of mental status. The MoCA scale used in Iran has been standardized by Sikarodi et al. [11]. Using demographic questionnaire and clinical interview based on statistical and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and considering the inclusion criteria, samples were measured and the severity of AD was assessed by MMSE and FAST and the rate of hippocampal atrophy was assessed based on MRI clinical imaging. Participants were evaluated for neuropsychological function using MMSE and MoCA tests before and after the 3-month exercise program. The control group was trained not to change their daily activities, while the experimental group participated in the exercise program. Exercise program was performed using a fixed bicycle twice a week for 45 min alternately in three stages of 15 min (15 min of exercise, 15 min of rest) for 3 months considering the intensity and threshold of patient tolerance. Each patient exercised on a fixed bicycle in each session considering his intensity and threshold tolerance in three 15-min sessions. After this period, the patient rested as much as the exercise length and through this interval, the next patient was subjected to exercise, and when the patient’s exercise time was finished, the previous patient was subjected to exercise related to the next step. After 48 h of exercise, both groups were reassessed for post-test scores by MMSE and MoCA tests. To evaluate the effect of aerobic exercise program on cognitive abilities of AD patients and to maintain the effect of pre-test scores on the experimental and control groups and to compare the post-test scores Univariate analysis of covariance was used. Data were analyzed by SPSS 22 software.

Five subjects were female and 9 were male. Based on the severity of the disease, 6 cases were in mild stage, 4 were in moderate stage and 4 were in relatively severe stage of the disease. The frequency of disease severity was similar in the two experimental and control groups, as in each group, 3 cases were in mild stage (FAST 4), 2 cases in moderate stage (FAST 5) and 2 subjects were in relatively severe stage (FAST 6A). In the pre-test phase, the mean score of cognitive abilities in the experimental group was 30.14 ±20.91 and in the control group 31.28 ±22.35, which there was no significant difference between two groups, but in the posttest, the mean score of cognitive abilities in the experimental group was 33.42 ± 14.61 and in the control group was 28.71 ±13.08 that this difference was significant in post-test by controlling for pre-test effect (p <0.01, F1 = 10.186). In addition, the obtained effect size of 0.481 indicated a significant effect of aerobic exercise program on cognitive abilities of patients with Alzheimer's disease.

In the study by Winchester et al. [1], the results showed that inactive patients had a significant decrease in MMSE scores and active patients were weak in reducing overall cognition. In the present study, the scores of the control patients were also lower, but the patients in the experimental group showed the MMSE scores for improved overall cognitive, which is not consistent with the findings of these studies. … [12]. Chapman et al. [5] found that the increased physical activity increases brain activity in the hippocampus leading to reducing the secondary effects of AD. Studies by Amini et al. [13] and Yousefi et al. [14] showed the effectiveness of aerobic exercise in the prevention and improvement of cognitive disorders in Alzheimer's patients, which is consistent with the findings of the present study.

In future studies, it is recommended to monitor the durability of therapeutic effects of aerobic exercise program intervention in patients with AD.

One of the limitations of the present study was the lack of follow-up for treatment results due to time limitation.

Attending at the aerobic exercise program is effective in improving the cognitive abilities of patients with Alzheimer's disease.

The authors are grateful to the officials of the Alzheimer's Association of Iran the head of the Sarem Hospital and Physiotherapy Department as well as all the patients who participated in this study.

None declared.

None declared.

None declared.


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