Page 37 - Petelin, Ana. 2021. Ed. Zdravje starostnikov / Health of the Elderly. Proceedings. Koper: University of Primorska Press.
P. 37
ance and walking (Marques et Queiros, 2018), which can lead to mobility the effect of physiotherapy on the mobility of patients with cognitive impairment 35
limitations (Cruz-Jentoft et al., 2019) and to a higher incidence of falls (Yeung et
al., 2019). These problems often lead to hospitalisation of older adults, which is
an additional risk factor for reduced mobility in the elderly (Surkan et Gibson,
2018) especially in people with cognitive decline (Hartley et al, 2017).
In addition to cognitive decline, reduced mobility is one of the main risk
factors for falls among the elderly (Terrosso et al., 2014). The risk of falling is al-
most three times higher in older adults with moderate to severely reduced mo-
bility compared to those without any restraints (Musich et al., 2018), while in
older adults with dementia, the risk of falling is two times higher than in the el-
derly with intact cognition (Allali et al., 2017). Both reduced mobility and cog-
nitive decline lead to a decrease in an individual’s independence in performing
activities of daily living (ADLs) (Heiland et al. 2016; Mograbi et al., 2017) and
increase mortality (Frith et al., 2015; Bergland et al., 2017).
Previous research shows a positive effect of exercise on cognitive abili-
ties, maintaining mobility and independence in performing ADLs in people
with dementia (Liu et al., 2020). Furthermore, therapeutic exercise improves
strength, balance, walking, and endurance in people with mild cognitive im-
pairment (Lam et al., 2018), which shows the relevance of including people with
cognitive impairment in physiotherapy treatment. In addition, a higher fre-
quency of physiotherapy treatments during hospitalisation shortens the length
of stay, improves functional status and increases independence with ADLs up-
on discharge (Hartley et al., 2016).
However, the effect of physiotherapy treatment on people with cognitive
impairment remains insufficiently researched. The aim of our research is to in-
vestigate the effect of a 14-day physiotherapy treatment on the mobility of hos-
pitalised patients with cognitive decline.
Methods
A retrospective quantitative pilot research was conducted. The research includ-
ed patients admitted to Gerontopsychiatric Unit of the University Psychiat-
ric Clinic Ljubljana between October 2020 and April 2021. Inclusion criteria
were age 60 and above, cognitive decline confirmed by Mini Mental State Ex-
am (MMSE) and inclusion to physiotherapy treatment. The exclusion criteria
were exacerbation of a chronic disease and acute health deterioration.
The De Morton Mobility Index (DEMMI) was used to assess mobility. It
is a standardised measuring instrument used to assess 15 items, including mo-
bility in bed, mobility on a chair, static balance, dynamic balance and walk-
ing. Eleven items were evaluated with a 2-point scale, and the remaining four
with a 3-point scale. The maximum that an individual could have achieved is 19
raw points that were converted into interval-level DEMMI points. Minimum
of 0 points means complete dependence while 100 points means complete in-
dependence in mobility (de Morton et al., 2008). Braun et al. (2018) confirmed
limitations (Cruz-Jentoft et al., 2019) and to a higher incidence of falls (Yeung et
al., 2019). These problems often lead to hospitalisation of older adults, which is
an additional risk factor for reduced mobility in the elderly (Surkan et Gibson,
2018) especially in people with cognitive decline (Hartley et al, 2017).
In addition to cognitive decline, reduced mobility is one of the main risk
factors for falls among the elderly (Terrosso et al., 2014). The risk of falling is al-
most three times higher in older adults with moderate to severely reduced mo-
bility compared to those without any restraints (Musich et al., 2018), while in
older adults with dementia, the risk of falling is two times higher than in the el-
derly with intact cognition (Allali et al., 2017). Both reduced mobility and cog-
nitive decline lead to a decrease in an individual’s independence in performing
activities of daily living (ADLs) (Heiland et al. 2016; Mograbi et al., 2017) and
increase mortality (Frith et al., 2015; Bergland et al., 2017).
Previous research shows a positive effect of exercise on cognitive abili-
ties, maintaining mobility and independence in performing ADLs in people
with dementia (Liu et al., 2020). Furthermore, therapeutic exercise improves
strength, balance, walking, and endurance in people with mild cognitive im-
pairment (Lam et al., 2018), which shows the relevance of including people with
cognitive impairment in physiotherapy treatment. In addition, a higher fre-
quency of physiotherapy treatments during hospitalisation shortens the length
of stay, improves functional status and increases independence with ADLs up-
on discharge (Hartley et al., 2016).
However, the effect of physiotherapy treatment on people with cognitive
impairment remains insufficiently researched. The aim of our research is to in-
vestigate the effect of a 14-day physiotherapy treatment on the mobility of hos-
pitalised patients with cognitive decline.
Methods
A retrospective quantitative pilot research was conducted. The research includ-
ed patients admitted to Gerontopsychiatric Unit of the University Psychiat-
ric Clinic Ljubljana between October 2020 and April 2021. Inclusion criteria
were age 60 and above, cognitive decline confirmed by Mini Mental State Ex-
am (MMSE) and inclusion to physiotherapy treatment. The exclusion criteria
were exacerbation of a chronic disease and acute health deterioration.
The De Morton Mobility Index (DEMMI) was used to assess mobility. It
is a standardised measuring instrument used to assess 15 items, including mo-
bility in bed, mobility on a chair, static balance, dynamic balance and walk-
ing. Eleven items were evaluated with a 2-point scale, and the remaining four
with a 3-point scale. The maximum that an individual could have achieved is 19
raw points that were converted into interval-level DEMMI points. Minimum
of 0 points means complete dependence while 100 points means complete in-
dependence in mobility (de Morton et al., 2008). Braun et al. (2018) confirmed
