Effect Of Occupational therapy Training On Balance and Cognitive In Older Adults with Mild Cognitive Impairment
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Abstract
Background: Older adults with MCI are at an increased risk of falls and other mobility issues due toimpaired cognitive function, which can affect balance and gait. As the population ages, findingeffective interventions to mitigate these risks and improve quality of life is crucial. Occupationaltherapy has been recognized as a beneficial approach to enhance both cognitive and physicalfunctionsinvarious populations,includingolderadults.
Studydesign: Randomizedcontrolledtrial
Aim: To assess the impact of occupational therapy training on balance and cognition in older adultswithmildcognitiveimpairment.
Objective:Toevaluateoutcomeofoccupationaltherapytrainingonbalanceand cognitioninolderadultswithmildcognitiveimpairment.
Participants: The participants were recruited on the basis of exclusion and inclusion criteria. Theparticipantsweredividedintwogroup controlgroup andexperimentalgroup20participantsineachgrouptotal40participants were includedinthestudy.
Methods:A randomized control trial was conducted on 40 patients with mild cognitive impairment(MCI) at AGAN OLD AGE HOME, Noida. The total sample was randomly divided into two equalgroups. Experimental group (N = 20) and a control group (N = 20). The control group was provideddual task training and the experimental group was administered with occupational therapy program which include physical training,cognitive training and physical&cognitive training.
Result: Montreal Cognitive Study (MOCA) pre and post in resulted that the pre mean of MOCA(17.80) accompanied by standard error (0.869) and subsequently post mean value of MOCAincreased (24.75) standard error (0.580) and standard deviation( 2.593) which indicate progress ofpostmean value (24.75)indicatingan improvementtoalevelofcognitivefunction.
Tinetti performance oriented mobility assessment (POMA) pre and post resulted that the pre mean ofPOMA GAIT(7.15) POMA BAL(10.75) accompanied by standard error (0.494),(0.814) andsubsequently post mean value decrease (13.00),(8.75)standard deviation (1.682),(3.340) whichindicate progress of post mean vale(13.00),(8.75) signifying that increased in balance & Gait amongolderadults.
Conclusion: Considering all aspect of social life my study show effectiveness of occupational therapy training programe give insight to maintain productive aging which will closely related with cogntion and balance.This study show significantly improvement in cognition and balance.
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References
De Souto Barreto P, Rolland Y, Vellas B, et al: Association of long-term exercise training with risk of falls, fractures, hospitalizations, and mortality in older adults:A systematic review and meta-analysis.JAMAInternMed179(3):394-405,2018.
Konda PR, Sharma PK, Gandhi AR, Ganguly E. Correlates of Cognitive Impairment amongIndianUrbanElders.JGerontolGeriatrRes.2018;7(6):489.doi:10.4172/2167-7182.1000489.Epub2018Nov6.
MohanD,IypeT,VargheseS,UshaA,MohanM.Across-sectional study to assess prevalence and factors associated with mild cognitive impairment among older adults in anurban area of Kerala,SouthIndia.BMJ Open.2019Mar20;9(3):e025473.
OsobaMY,RaoAK,AgrawalSK,LalwaniAK.Balance and gait in the elderly:A contemporary review.Laryngoscope InvestigOtolaryngol.2019Feb4;4(1):143-153.
Shin BM,Han SJ, Jung JH,Kim JE,Fregni F. Effect of mild cognitive impairment on balance.J NeurolSci.2011Jun15;305(1-2):121-5.
Chalise, Hom Nath. (2019). Aging: Basic Concept. American Journal of Biomedical Science&Research.
BorsonS. Cognition, aging, and disabilities: conceptual lissues .Phys Med Rehabil ClinN Am.2010May;21(2):375-82.
Harvey PD.Domains of cognition and their assessment.Dialogues Clin Neuro sci.2019Sep;21(3):227-237.
Sanford AM. Mild Cognitive Impairment. Clin Geriatr Med.2017Aug;33(3):325-337.
Pollock AS,Durward BR,Rowe PJ,Paul JP.What is balance?ClinRehabil.2000Aug;14(4):402-6.
Xiao T, Yang L, Smith L, Loprinzi PD, Veronese N, Yao J, Zhang Z, Yu JJ. Correlation Between Cognition and Balance Among Middle-Aged and Older Adults Observed Through a Tai Chi Intervention Program.FrontPsychol.2020Apr6;11:668.
Azhdar M, Mirzakhani N, Irani A, Akbarzadeh Baghban A, Daryabor A, Sangi S et al. TheEffect of Balance Training on Cognitive and Occupational Performance of the Elderly. J BabolUnivMedSci2022;24(1):41-49
Chantanachai T, Taylor ME, Lord SR, Menant J, Delbaere K,Sachdev PS, Kochan NA,Brodaty H, Sturnieks DL. Risk factors for falls in community-dwelling older people with mild cognitive impairment: a prospectiveone-yearstudy.PeerJ.2022 May30;10:e13484.
Turunen KM, Tirkkonen A, Savikangas T, Hänninen T, Alen M, Fielding RA, Kivipelto M,Stigsdotter Neely A, Törmäkangas T, Sipilä S. Effects of Physical and Cognitive Training on Falls and Concern About Falling in Older Adults : Results From a Randomized Controlled .Trial.J GerontolABiolSciMedSci.2022Jul5;77(7):1430-1437.
Freiberger E,HäberleL,Spirduso WW,Zijlstra GA.Long-term effects of three multi component exercise interventions on physical performance and fall-related psychological outcomes in community dwelling older adults: a randomized controlled trial. J Am GeriatrSoc.2012Mar;60(3):437-46.
LipardoDS,TsangWW.Effects of combined physical and cognitive training on fall prevention and risk reduction in older persons with mild cognitive impairment: a randomized controlled study.ClinRehabil.2020Jun;34(6):773-782.
Langoni CDS, Resende TL, Barcellos AB, Cecchele B, Knob MS, Silva TDN, da Rosa JN,DiogoTS,FilhoIGDS,SchwankeCHA.EffectofExerciseonCognition,Conditioning,MuscleEndurance,andBalanceinOlderAdultsWithMildCognitiveImpairment:ARandomized ControlledTrial.JGeriatrPhysTher.2019 Apr/Jun;42(2):E15-E22.
Law LLF, Mok VCT, Yau MMK. Effects of functional tasks exercise on cognitive functions of older adults with mild cognitive impairment: a randomized controlled pilot trial. AlzheimersResTher.2019Dec4;11(1):98.
Bajwa RK, Goldberg SE, Van der Wardt V, Burgon C, Di Lorito C, Godfrey M, Dunlop M,Logan P, Masud T, Gladman J, Smith H, Hood-Moore V, Booth V, Das Nair R, Pollock K,Vedhara K, Edwards RT, Jones C, Hoare Z, Brand A, Harwood RH. A randomised controlledtrial of an exercise intervention promoting activity, independence and stability in older adultswith mild cognitive impairment and early dementia (PrAISED) - A Protocol. Trials. 2019 Dec30;20(1):815.
Sipilä S, Tirkkonen A, Hänninen T, Laukkanen P, Alen M, Fielding RA, KivipeltoM,KokkoK,KulmalaJ,RantanenT,SihvonenSE,SillanpääE,Stigsdotter-NeelyA,Törmäkangas T. Promoting safe walking among older people: the effects of a physical andcognitive training intervention vs. physical training alone on mobility and falls among older community-dwelling men and women (the PASSWORD study): design and methods of a randomized controlledtrial.BMC Geriatr.2018Sep15;18(1):215.
Montero-Odasso M, Almeida QJ, Burhan AM, Camicioli R, Doyon J, Fraser S, Li K, Liu-AmbroseT,MiddletonL,Muir-HunterS,McIlroyW,MoraisJA,Pieruccini-FariaF,Shoemaker K, Speechley M, Vasudev A, Zou GY, Berryman N, Lussier M, Vanderhaeghe L,Bherer L. SYNERGIC TRIAL (SYNchronizing Exercises, Remedies in Gait and Cognition) a multi-Centre randomized controlled double blind trial to improve gait and cognition in mild cognitive impairment.BMCGeriatr.2018Apr16;18(1):93.
Tyrovolas S, Koyanagi A, Lara E, Santini ZI, Haro JM. Mild cognitive impairmentis associated with falls among older adults:Findings from the Irish Longitudinal Study on Ageing(TILDA).ExpGerontol.2016Mar;75:42-7.
Lee YY, Wu CY, Teng CH, Hsu WC, Chang KC, Chen P. Evolving methods to combinecognitive and physical training for individuals with mild cognitive impairment: study protocol for a randomized controlled study.Trials.2016Oct28;17(1):526.
Hagovská M, Olekszyová Z. Impact of the combination of cognitive and balance training ongait, fear and risk of falling and quality of life in seniors with mild cognitive impairment.GeriatrGerontolInt.2016Sep;16(9):1043-50.
Tangen GG, Engedal K, Bergland A, Moger TA, Mengshoel AM. Relationships betweenbalanceandcognitioninpatientswithsubjectivecognitiveimpairment,mildcognitiveimpairment,andAlzheimerdisease.PhysTher.2014Aug;94(8):1123-34.doi:10.2522/ptj.20130298.Epub2014Apr24.
Gschwind YJ, Kressig RW, Lacroix A, Muehlbauer T, Pfenninger B, Granacher U. A bestpracticefallpreventionexerciseprogramtoimprovebalance,strength/power,andpsychosocialhealthinolderadults:studyprotocolforarandomizedcontrolledtrial.BMCGeriatr.2013Oct9;13:105.
Gschwind YJ, Kressig RW, Lacroix A, Muehlbauer T, Pfenninger B, Granacher U. A best practice fall prevention exercise program to improve balance,strength/power,and psychosocial health in older adults: study protocol for a randomized controlled trial.BMCGeriatr.2013Oct9;13:105.
Doi T, Makizako H, Shimada H, Yoshida D, Tsutsumimoto K, Sawa R, Misu S, Suzuki T.Effects of multi component exercise on spatial-temporal gait parameters among the elderly with amnestic mild cognitive impairment (aMCI): preliminary results from a randomized controlledtrial(RCT).ArchGerontolGeriatr.2013Jan-Feb;56(1):104-8.
Suzuki T, Shimada H, Makizako H, Doi T, Yoshida D, Ito K, Shimokata H, Washimi Y,EndoH,KatoT.Arandomizedcontrolledtrialofmulticomponentexerciseinolder adults with mild cognitive impairment.PLoSOne.2013Apr9;8(4):e61483.
Makizako H, Doi T, Shimada H, Yoshida D, Tsutsumimoto K, Uemura K, Suzuki T. Does a multi component exercise program improve dual-task performance in amnestic mild cognitive impairment?Arandomized controlled trial.Aging Clin Exp Res.2012 Dec;24(6):640-6.
Scura D, Munakomi S. Tinetti Gait and Balance Test. [Updated 2022 Nov 20]. In: StatPearls[Internet].TreasureIsland(FL):StatPearls Publishing;2023Jan-.
DautzenbergG,LijmerJ,BeekmanA .Diagnostic accuracy of the Montreal Cognitive Assessment (MoCA) for cognitive screening in old age psychiatry: Determining cutoff scoresinclinicalpractice.Avoidingspectrumbiascausedbyhealthycontrols.IntJGeriatrPsychiatry.2020Mar;35(3):261-269.