Mobility and dementia: Is physiotherapy treatment during respite care effective?

Background. Mobility problems experienced by elderly people with a dementia are associated with falls, fractures and admission to long-term care. A ho spital respite care admission is therefore often seen as an opportunity to provide physiotherapy treatment. Aim. To find whether elderly people with a dementia and a mobility problem show a greater improvement in mobility skills if given physiotherapy treatm ent than if given non-physical activities intervention during a hospital re spite admission. Method. A controlled randomized multicentre trial with independent blinded assessment. The Southampton Mobility Assessment (mobility score) and Two Mi nute Walking Test (distance walked) were undertaken at the beginning and en d of the study admission and beginning of the next respite admission. Follo wing the first assessment, participants were randomized to either physiothe rapy or activities. Results. Eighty-one participants, from 12 clinical centres, with a mean age of 81.9 years and CAFE I/O score of 2. During the study admission there wa s a non-significant trend for a lower reduction in mobility score of the ph ysiotherapy group (Mann-Whitney; p = 0.614) and a non-significant trend for greater decrease in distance walked in the activities group (t-test; p = 0 .325). Discussion. The results of this trial do not support the positive changes d emonstrated elsewhere. However, changes in respite care curing the early st ages of this trial may have produced differences between the sample for thi s trial and that for the pilot study. This trial was therefore underpowered . Conclusion. This trial suggests that future research needs to change the fo cus from clinical settings to presentations. (C) 1999 John Wiley & Sons, Lt d.