El tratamiento fisioterapéutico ¿es efectivo en el mantenimiento físico y en la reducción del declive cognitivo de las demencias?

G. Christofoletti , M. Mércia Oliani , S. Gobbi , F. Stella , L.T. Bucken Gobbi , M del Rosario Sánchez Arias
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Abstract

Introduction

Dementia is a chronic and neurodegenerative disease responsible for a progressive decline of cognition and physical capacity.

Objective

To verify the effectiviness of three months of physiotherapy intervention on cognitive functions and balance of institutionilized elderly people with dementia.

Patients and methods

This study has comprised thirty subjects, divided in two groups: EG (experimental group) and CG (control group). EG was composed by 15 participants with mean age of 71,6 ± 8,5 years and scholarity of 4,7 ± 4,2 years. CG wasformed by 15 subjects with mean age of 78,5 ± 7,6 years and scholarity of2,2 ± 1,8years. The sample was evaluated by means ofthe following instruments: Mini-Mental State Examination, Semantic Verbal Fluency test, Clock Drawing test, Berg Balance Scale and Timed Get Up and Go test. The statistical procedures were done by means of Multivariate Analisis ofVariance (MANOVA), with significance of 5 % (p < 0,05).

Results

The results has shown a heterogeneity of both groups related to age (F = 0,2, p < 0,05) and scholarity (F = 2,6,p < 0,05). MANOVA pointed beneficts of physiotherapy on balance (F = 7,3, p < 0,01) but not on cognitive functions (F = 0,3, p > 0,05).

Conclusions

Three months of physiotherapy were effective to improuve physical capacity of institucionilized elderly people with dementia. Neverthless, it was not able to minimize cognitive decline commonly seen on dementia. The question if a prolonged intervention could propitiate cognitive beneficts remains, specially in a more homogeneous groups.

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物理治疗是否有效地维持身体和减少痴呆的认知下降?
痴呆是一种慢性和神经退行性疾病,导致认知和身体能力的逐渐下降。目的观察三个月物理治疗干预对住院老年痴呆患者认知功能和平衡能力的影响。患者和方法本研究共30例受试者,分为两组:EG(实验组)和CG(对照组)。EG由15名参与者组成,平均年龄71,6±8,5岁,年龄4,7±4,2岁。CG共15例,平均年龄78,5±7,6岁,年龄2,2±1.8岁。通过以下工具对样本进行评估:迷你心理状态测试、语义语言流畅性测试、时钟绘制测试、伯格平衡量表和定时起床和走测试。采用多元方差分析(MANOVA)进行统计处理,显著性为5% (p <0 05)。结果两组患者在年龄上存在异质性(F = 0,2, p <0.05)和学术水平(F = 2,6,p <0 05)。方差分析指出物理治疗对平衡的益处(F = 7,3, p <0.01),但对认知功能没有影响(F = 0,3, p >0 05)。结论3个月的物理治疗可有效提高机构老年痴呆患者的身体能力。然而,它并不能最大限度地减少痴呆症患者常见的认知能力下降。长期干预是否能带来认知方面的益处仍然是一个问题,特别是在一个更同质的群体中。
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