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Exercise rehabilitation on home-dwelling patients with Alzheimer's disease - a randomized, controlled trial. Study protocol

Kaisu H Pitkala1*, Minna M Raivio12, Marja-Liisa Laakkonen13, Reijo S Tilvis4, Hannu Kautiainen56 and Timo E Strandberg7

Author Affiliations

1 Unit of General Practice, Helsinki University Central Hospital, University of Helsinki, PO Box 20, 00014 University of Helsinki, Finland

2 The Social Insurance Institution of Finland, Helsinki, Finland

3 Helsinki City Health Center, Laakso Hospital, Lääkärikatu 8, 00250 Helsinki, Finland

4 Department of Internal Medicine and Geriatrics, Helsinki University Central Hospital, PO Box 340, 00029 HUS, Finland

5 Orton Orthopedic Hospital, Orton Foundation, Helsinki, Finland

6 Unit of Family Practice, Central Finland Central Hospital, Jyväskylä, Finland, Hämeentie 1, 44150 Äänekoski, Finland

7 Institute of Health Sciences/Geriatrics, University of Oulu, Oulu, Unit of General Practice, PO Box 5000, FIN-90014 Oulu, Finland

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Trials 2010, 11:92  doi:10.1186/1745-6215-11-92

Published: 6 October 2010



Besides cognitive decline, Alzheimer's disease (AD) leads to physical disability, need for help and permanent institutional care. The trials investigating effects of exercise rehabilitation on physical functioning of home-dwelling older dementia patients are still scarce. The aim of this study is to investigate the effectiveness of intensive exercise rehabilitation lasting for one year on mobility and physical functioning of home-dwelling patients with AD.


During years 2008-2010, patients with AD (n = 210) living with their spousal caregiver in community are recruited using central AD registers in Finland, and they are offered exercise rehabilitation lasting for one year. The patients are randomized into three arms: 1) tailored home-based exercise twice weekly 2) group-based exercise twice weekly in rehabilitation center 3) control group with usual care and information of exercise and nutrition. Main outcome measures will be Guralnik's mobility and balance tests and FIM-test to assess physical functioning. Secondary measures will be cognition, neuropsychiatric symptoms according to the Neuropsychiatric Inventory, caregivers' burden, depression and health-related quality of life (RAND-36). Data concerning admissions to institutional care and the use and costs of health and social services will be collected during a two year follow-up.


To our knowledge this is the first large scale trial exploring whether home-dwelling patients with AD will benefit from intense and long-lasting exercise rehabilitation in respect to their mobility and physical functioning. It will also provide data on cost-effectiveness of the intervention.

Trial registration