A Game-Changer Novel Methodology for Testing Muscle Strength in Dementia Patients

A study conducted by the Federal University of São Carlos (UFSCar) in São Paulo, Brazil, has demonstrated that tests for functional mobility and muscle strength can be adapted for remote administration at home, under the supervision of healthcare professionals. This is particularly beneficial for older adults with dementia. The telehealth approach also includes caregiver training.

These tests, commonly used by physical therapists and geriatricians, are essential for evaluating aging, prescribing treatments or physical exercise, and assessing the impact of therapeutic interventions in older adults.

“The reliability of the remotely supervised tests was confirmed by our findings. The study’s main contribution is its potential to expand access to healthcare for older adults with dementia. With telehealth, sessions can be more frequent, allowing healthcare providers to more thoroughly monitor patient progress,” said Larissa Pires de Andrade, a professor in UFSCar’s Department of Physical Therapy and the study’s senior author, which was published in the journal Geriatrics, Gerontology and Aging.

Andrade noted that conducting these tests remotely is a viable option for individuals unable to visit a clinic due to financial constraints or physical limitations. It also proves useful in situations where patients cannot leave their homes, as seen during the COVID-19 pandemic.

This study was part of Carolina Tsen’s Ph.D. research, the first author of the article, and was included in a broader telerehabilitation project led by UFSCar’s Healthy Aging Research Laboratory (LaPeSI).

“Confirming that these widely-used clinical tests can be conducted remotely marks the first step in our research on telerehabilitation for older adults with dementia,” Andrade stated.

In the study, 43 dementia patients underwent functional mobility and muscle strength tests via video calls, with caregiver assistance. Standard rehabilitation and physical therapy assessments were utilized, such as the Short Physical Performance Battery (SPPB), which evaluates balance, lower limb strength, and gait speed, among other functional mobility indicators.

The researchers also adapted three other tests: the 30 Seconds Sit to Stand Test (STS 30), which measures lower limb strength; the Timed Up and Go (TUG), assessing the risk of falls through a series of movements; and the TUG Dual Task, where patients perform the TUG test while answering questions, to assess cognitive performance.

The patients participated in these tests from home through an online platform, with caregivers properly trained to administer them. A healthcare professional supervised the process remotely in real-time, providing guidance as needed.

Andrade explained that performing these tests can be challenging for older adults with dementia, whether in a clinic or via video call, due to cognitive impairments such as memory loss and attention deficits.

“Therefore, we not only trained caregivers and prepared the home environment for testing, but we also simplified and shortened verbal instructions, adding pauses to help elderly patients with dementia better understand the tasks. This adaptation was crucial for achieving satisfactory test results,” she said.

For further details: Carolina Tsen et al., Adaptation and reliability of tests of functional mobility and muscle strength using telehealth for older people with dementia, Geriatrics Gerontology and Aging (2024). DOI: 10.53886/gga.e0000087_EN

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