Objective To describe the comparative efficacy of drug and non-drug interventions for reducing symptoms of depression in people with dementia who experience depression as a neuropsychiatric symptom of dementia or have a diagnosis of a major depressive disorder. Design Systematic review and meta-analysis. Data sources Medline, Embase, the Cochrane Library, CINAHL, PsycINFO, and grey literature between inception and 15 October 2020. Eligibility criteria for study selection Randomised trials comparing drug or non-drug interventions with usual care or any other intervention targeting symptoms of depression in people with dementia. Main outcome measures Pairs of reviewers screened studies, abstracted aggregate level data, and appraised risk of bias with the Cochrane risk of bias tool, which facilitated the derivation of standardised mean differences and back transformed mean differences (on the Cornell scale for depression in dementia) from bayesian random effects network meta-analyses and pairwise meta-analyses. Results Of 22 138 citations screened, 256 studies (28 483 people with dementia) were included. Missing data posed the greatest risk to review findings. In the network meta-analysis of studies including people with dementia without a diagnosis of a major depressive disorder who were experiencing symptoms of depression (213 studies; 25 177 people with dementia; between study variance 0.23), seven interventions were associated with a greater reduction in symptoms of depression compared with usual care: cognitive stimulation (mean difference −2.93, 95% credible interval −4.35 to −1.52), cognitive stimulation combined with a cholinesterase inhibitor (−11.39, −18.38 to −3.93), massage and touch therapy (−9.03, −12.28 to −5.88), multidisciplinary care (−1.98, −3.80 to −0.16), occupational therapy (−2.59, −4.70 to −0.40), exercise combined with social interaction and cognitive stimulation (−12.37, −19.01 to −5.36), and reminiscence therapy (−2.30, −3.68 to −0.93). Except for massage and touch therapy, cognitive stimulation combined with a cholinesterase inhibitor, and cognitive stimulation combined with exercise and social interaction, which were more efficacious than some drug interventions, no statistically significant difference was found in the comparative efficacy of drug and non-drug interventions for reducing symptoms of depression in people with dementia without a diagnosis of a major depressive disorder. Clinical and methodological heterogeneity precluded network meta-analysis of studies comparing the efficacy of interventions specifically for reducing symptoms of depression in people with dementia and a major depressive disorder (22 studies; 1829 patients). Conclusions In this systematic review, non-drug interventions were found to be more efficacious than drug interventions for reducing symptoms of depression in people with dementia without a major depressive disorder. Systematic review registration PROSPERO CRD42017050130.

https://www.bmj.com/content/bmj/372/bmj.n532.full.pdf

Comparative efficacy of interventions for reducing symptoms of depression in people with dementia: systematic review and network meta-analysis.

The Handbook Of Alzheimer's Disease And Other Dementias (Softcover) - Libros de Medicina - Neurogeriatria - 29,02

The Handbook Of Alzheimer's Disease And Other Dementias (Softcover)

Gymnastics athletes are exposed to a high risk of injury, but also of developing musculoskeletal pain. These data are still little investigated in the available scientific literature. An online survey was distributed to 79 professional athletes who practiced artistic and rhythmic gymnastics. The survey collected demographic and anthropometric data, information about the sport practice, the training sessions, the prevalence of musculoskeletal pain gymnastics-related, and lifestyle habits. Musculoskeletal pain had a high prevalence, involving 65 of 79 athletes (82.3%). A significant correlation was found between musculoskeletal pain and the duration of sports practice, both for general pain (p = 0.041) and for specific districts: right wrist pain (p = 0.031), left wrist pain (p = 0.028), right shoulder (p = 0.039), left hip (p = 0.031), right thigh (p = 0.031), and left knee (p = 0.005). Another statistical association was found between right wrist pain and BMI (p = 0.001), and hip pain and BMI (p = 0.030). Hours spent in a sitting position were also correlated with the incidence of pain (p = 0.045). Wrist pain and right shoulder pain had a statistically significant association with the age of the athletes (right wrist pain: p = 0.038; left wrist pain: p = 0.004; right shoulder pain: p = 0.035). The more the gymnasts practice this sport, the more likely they are to develop musculoskeletal pain. Increased age and a higher BMI, as well as daily prolonged sitting position, seem to be potential risk factors for the onset of musculoskeletal pain. Future studies could plan training strategies aimed at preventing musculoskeletal pain associated with gymnastics, in order to promote its further spread.

Musculoskeletal Pain in Gymnasts: A Retrospective Analysis on a Cohort of Professional Athletes

Background: Although a knee valgus position is related to the increase in injury risk in volleyball players, there is a lack of studies on the relationship between knee valgus and vertical jump (VJ) performance. Hence, the aim of this study was to investigate the effects of a postural exercise program on VJ height in young female volleyball players with knee valgus. Methods: This pilot study included 19 young female volleyball players divided into the following groups: the Valgus Experimental Group (VEG); the Valgus Control Group (VCG); and the Neutral Control Group (NCG). All three groups carried out the same volleyball training program. In addition, only the VEG underwent a 3-month postural exercise program of 30–45 min/session, twice/week. VJ performance was measured through the Sargent test before (T0), at 6 weeks (T1), and at 12 weeks (T2). Results: A significant effect from T0 to T1 (p = 0.0017) and from T0 to T2 (p = 0.0001) was found in the VEG. No significant differences were found over time in the VCG and in the NCG. Conclusion: An integrated postural exercise program might lead to a more balanced muscle efficiency inducing athletes to obtain a higher VJ performance.

/pdf/effects-of-a-postural-exercise-program-on-vertical-jump-12y19mwk.pdf

Effects of a Postural Exercise Program on Vertical Jump Height in Young Female Volleyball Players with Knee Valgus

This review aims to systematically review the effects of physical exercise on the cognitive performance of patients with Alzheimer's disease (AD) and its mechanisms of action. Databases such as Web of Science, PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials were searched until December 2021. A randomized controlled trial (RCT) to assess the effect of an exercise intervention (compared with no exercise) on patients with AD. The measures included cognitive function [Mini-Mental State Examination (MMSE), Alzheimer's Disease assessment scale-cognitive (ADAS-Cog), Montreal cognitive assessment scale (MoCA) and Executive Function (EF)]. The methodological quality of the included literature was assessed using the Physiotherapy Evidence Database (PEDro) scale. Twenty-two studies (n = 1647, mean age: 77.1 ± 6.3 years) were included in the systematic review, sixteen of which were included in the meta-analysis. A systematic review and meta-analysis revealed that physical exercise positively affects cognitive performance in older patients with AD. However, the positive effects of the intervention should be interpreted with caution considering the differences in methodological quality, type, frequency, and duration of exercise in the included studies. Future studies should consider the design rigor and specification of RCT protocols.

/pdf/effect-of-physical-exercise-on-cognitive-function-of-f17r6e9p.pdf

Effect of Physical Exercise on Cognitive Function of Alzheimer's Disease Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trial

Background:Several recent studies have examined the positive effects of physical exercise and equilibrium on individuals with neurodegenerative diseases.Objectives:In this sense, this study based o...

https://journals.sagepub.com/doi/pdf/10.1177/1533317519867824

An Experimental Pilot Study of Global Postural Reeducation Concerning the Cognitive Approach of Patients With Alzheimer's Disease

INTRODUCTION The classical gymnastics has always given great importance to exercises of -rachis extension and abduction of the arms during deep inhalation to acquire a greater -thoracic capacity. OBJECTIVE The aim of this study is to organize the concentration and the self-limited capacity of patients with Alzheimer's disease (AD) thanks to the physical and -respiratory exercise modalities of global postural reeducation. DESIGN A randomized controlled trial was conducted. SETTING Nursing homes. PARTICIPANTS Patients with probable AD diagnosis. INTERVENTION The global postural reeducation method (GPR) was implemented for a total of 72 treatment sessionswith a frequency of 3 times a week, for 24 weeks consecutively. MAIN OUTCOME MEASURES The Neuropsychiatric Inventory, Mini Mental State Examination, Geriatric Depression Scale, Quality of Life in Alzheimer's Disease and Tinetti Scale and respiratory rate frequency (RSP/F) were applied. RESULTS Ninety elderly people participated in this study, precisely 50 women and 40 men aged 67-92 years (mean age = 81.17, SD = 5.24). The therapy had a significant effect on the difference between groups in all the outcomes (p 0.05). CONCLUSION This study demonstrated a very good tolerance rate on behalf of the significant results achieved.

Why Not a Global Postural Reeducation as an Alternative Therapy Applied to Alzheimer's Patients in Nursing Homes? A Pioneer Randomized Controlled Trial.

Context One of the main reasons why athletes with a high physical condition suffer from low back pain disease is because they often participate in sports that involve disc compression movements during flexion, lifting loads, or torsion movement. Objectives This study aims to examine the effectiveness of the postural treatment of the Mezieres method on elite rhythmic gymnastics athletes with low back pain. Design Double-blind, randomized, controlled trial. Setting The sports hall of "Puente Tocinos," Murcia, Spain. Participants Ninety gymnastics athletes were randomized into 2 parallel groups (intervention: n = 39; control: n = 51), of whom 98.9% were women (women = 89; man = 1). Intervention The Mezieres method postural therapy was implemented. It lasted about 60 minutes in repeated sessions of 2 to 3 meetings per week by counting in overall 60 sessions during a 24-week period. Main outcome measures Visual analog scale of pain, sit and reach flexibility test, Runtastic (pedometer performance android application), Roland-Morris Questionnaire for the physical disability, and the Health Status Questionnaire were used. Results The univariate analysis of variance and independent sample t test revealed a significant improvement in the intervention group concerning the visual analog scale pain assessment scale (P 0.8) compared with the control one. The same situation persists even for Roland-Morris Questionnaire (P 0.8). Conclusion The Mezieres method treatment performed on athletes with low back pain has caused positive effects on all the outcomes analyzed compared with the ones of control group.

The Effectiveness of the Mézières Method in Elite Rhythmic Gymnastics Athletes With Low Back Pain: A Randomized Controlled Trial

Background and objectives Based on the Alzheimer disease (AD) prevention and slowing down, this study has shown interest in evaluating the effects of Global Postural Reeducation (GPR) on the cognitiveness of individuals with AD. It is important to verify that by modifying and improving postural attitudes through GPR, a better concentration of cognitions in older people is achieved, increases self-awareness and proprioception in comparison with the effects of frequent therapies implemented in elderly centers. Methods A randomized controlled clinical trial with parallel assignment and single blind outcomes assessment analysis was deployed. 135 patients with AD (46 male and 89 female; average age = 80.7; SD = 5.32) were randomly allocated to either the GPR group or control group. The patients in GPR group underwent 2 weekly/30–40 min sessions each for a period of 24 week versus the control group that did not receive any specific therapy except of residences daily conventional protocol exercises. To evaluate the cognitivity of both groups were used the Mini Mental State Examination questionnaire (MMSE); for the depression were Geriatric Depression Scale (GDS) and Neuropsychiatric Inventory (NPI), for the quality of life was Quality of Life in Alzheimer's Disease (QoL-AD) and for the autonomy and equilibrium were Barthel Index (BI) and Tinetti Scale (TS). Results The experimental group showed a significant increase in the cognitive abilities in the end of treatment compared with control one (p  Conclusion This study demonstrates feasibility concerning GPR on individuals with AD.

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Papers

An Experimental Pilot Study of Global Postural Reeducation Concerning the Cognitive Approach of Patients With Alzheimer's Disease

Why Not a Global Postural Reeducation as an Alternative Therapy Applied to Alzheimer's Patients in Nursing Homes? A Pioneer Randomized Controlled Trial.

The Effectiveness of the Mézières Method in Elite Rhythmic Gymnastics Athletes With Low Back Pain: A Randomized Controlled Trial

A single blind randomized controlled trial of global postural re-education: Cognitive effects on Alzheimer disease patients

Treatment of infant colic with craniosacral therapy. A randomized controlled trial.