High-intensity functional exercise in older adults with dementia: A systematic review and meta-analysis

This study aimed to investigate the efficacy of high-intensity functional exercise among older adults with dementia. In this systematic review and meta-analysis of randomized controlled trials, we collected articles published before August 2020 from PubMed, Embase, and the Cochrane Library to evalua...

Full description

Saved in:
Bibliographic Details
Published in:Clinical rehabilitation Vol. 35; no. 2; p. 169
Main Authors: Yeh, Shu-Wei, Lin, Li-Fong, Chen, Hung-Chou, Huang, Li-Kai, Hu, Chaur-Jong, Tam, Ka-Wai, Kuan, Yi-Chun, Hong, Chien-Hsiung
Format: Journal Article
Language:English
Published: England 01.02.2021
Subjects:
Activities of Daily Living
Dementia - psychology
Dementia - therapy
Exercise
Exercise Therapy - methods
Humans
Randomized Controlled Trials as Topic
meta-analysis
balance function
dementia
gait
High-intensity functional exercise
ISSN:1477-0873, 1477-0873
Online Access:Get more information
Tags: Add Tag
No Tags, Be the first to tag this record!
Abstract This study aimed to investigate the efficacy of high-intensity functional exercise among older adults with dementia. In this systematic review and meta-analysis of randomized controlled trials, we collected articles published before August 2020 from PubMed, Embase, and the Cochrane Library to evaluate the effect of high-intensity functional exercise on older adults with dementia. Primary outcomes included improvements in balance function and gait performance (speed, cadence, and stride length). The secondary outcomes included lower limb strength, activities of daily living, psychiatric well-being, depression, and cognition. Furthermore, we performed subgroup analysis with two high-intensity functional exercise programs: the Umeå program and Hauer's program. We identified 15 articles describing six trials including older adults with dementia undergoing high-intensity functional exercise or control activity. The meta-analysis indicated that high-intensity functional exercise, both in Hauer's program and in the Umeå program, significantly improved balance function (pooled standardized mean difference 0.57, 95% confidence interval 0.31-0.83). Hauer's program significantly improved gait speed, cadence, stride length, and lower limb strength. Beneficial effects on speed, cadence, and lower limb strength were retained for several months. The Umeå program facilitated activities of daily living and psychiatric well-being, with effects on activities of daily living lasting several months. In the only eligible trial, no effects on cognition were observed. Adverse effects of high-intensity functional exercise were minimal to none. High-intensity functional exercise is generally safe and is recommended for older individuals with mild or moderate dementia to provide benefits in motor performance and daily functioning.
AbstractList This study aimed to investigate the efficacy of high-intensity functional exercise among older adults with dementia.OBJECTIVEThis study aimed to investigate the efficacy of high-intensity functional exercise among older adults with dementia.In this systematic review and meta-analysis of randomized controlled trials, we collected articles published before August 2020 from PubMed, Embase, and the Cochrane Library to evaluate the effect of high-intensity functional exercise on older adults with dementia. Primary outcomes included improvements in balance function and gait performance (speed, cadence, and stride length). The secondary outcomes included lower limb strength, activities of daily living, psychiatric well-being, depression, and cognition. Furthermore, we performed subgroup analysis with two high-intensity functional exercise programs: the Umeå program and Hauer's program.METHODSIn this systematic review and meta-analysis of randomized controlled trials, we collected articles published before August 2020 from PubMed, Embase, and the Cochrane Library to evaluate the effect of high-intensity functional exercise on older adults with dementia. Primary outcomes included improvements in balance function and gait performance (speed, cadence, and stride length). The secondary outcomes included lower limb strength, activities of daily living, psychiatric well-being, depression, and cognition. Furthermore, we performed subgroup analysis with two high-intensity functional exercise programs: the Umeå program and Hauer's program.We identified 15 articles describing six trials including older adults with dementia undergoing high-intensity functional exercise or control activity. The meta-analysis indicated that high-intensity functional exercise, both in Hauer's program and in the Umeå program, significantly improved balance function (pooled standardized mean difference 0.57, 95% confidence interval 0.31-0.83). Hauer's program significantly improved gait speed, cadence, stride length, and lower limb strength. Beneficial effects on speed, cadence, and lower limb strength were retained for several months. The Umeå program facilitated activities of daily living and psychiatric well-being, with effects on activities of daily living lasting several months. In the only eligible trial, no effects on cognition were observed. Adverse effects of high-intensity functional exercise were minimal to none.RESULTSWe identified 15 articles describing six trials including older adults with dementia undergoing high-intensity functional exercise or control activity. The meta-analysis indicated that high-intensity functional exercise, both in Hauer's program and in the Umeå program, significantly improved balance function (pooled standardized mean difference 0.57, 95% confidence interval 0.31-0.83). Hauer's program significantly improved gait speed, cadence, stride length, and lower limb strength. Beneficial effects on speed, cadence, and lower limb strength were retained for several months. The Umeå program facilitated activities of daily living and psychiatric well-being, with effects on activities of daily living lasting several months. In the only eligible trial, no effects on cognition were observed. Adverse effects of high-intensity functional exercise were minimal to none.High-intensity functional exercise is generally safe and is recommended for older individuals with mild or moderate dementia to provide benefits in motor performance and daily functioning.CONCLUSIONSHigh-intensity functional exercise is generally safe and is recommended for older individuals with mild or moderate dementia to provide benefits in motor performance and daily functioning.
This study aimed to investigate the efficacy of high-intensity functional exercise among older adults with dementia. In this systematic review and meta-analysis of randomized controlled trials, we collected articles published before August 2020 from PubMed, Embase, and the Cochrane Library to evaluate the effect of high-intensity functional exercise on older adults with dementia. Primary outcomes included improvements in balance function and gait performance (speed, cadence, and stride length). The secondary outcomes included lower limb strength, activities of daily living, psychiatric well-being, depression, and cognition. Furthermore, we performed subgroup analysis with two high-intensity functional exercise programs: the Umeå program and Hauer's program. We identified 15 articles describing six trials including older adults with dementia undergoing high-intensity functional exercise or control activity. The meta-analysis indicated that high-intensity functional exercise, both in Hauer's program and in the Umeå program, significantly improved balance function (pooled standardized mean difference 0.57, 95% confidence interval 0.31-0.83). Hauer's program significantly improved gait speed, cadence, stride length, and lower limb strength. Beneficial effects on speed, cadence, and lower limb strength were retained for several months. The Umeå program facilitated activities of daily living and psychiatric well-being, with effects on activities of daily living lasting several months. In the only eligible trial, no effects on cognition were observed. Adverse effects of high-intensity functional exercise were minimal to none. High-intensity functional exercise is generally safe and is recommended for older individuals with mild or moderate dementia to provide benefits in motor performance and daily functioning.
Author Yeh, Shu-Wei
Hong, Chien-Hsiung
Kuan, Yi-Chun
Huang, Li-Kai
Tam, Ka-Wai
Hu, Chaur-Jong
Chen, Hung-Chou
Lin, Li-Fong
Author_xml – sequence: 1
  givenname: Shu-Wei
  surname: Yeh
  fullname: Yeh, Shu-Wei
  organization: School of Medicine, College of Medicine, Taipei Medical University, Taipei
– sequence: 2
  givenname: Li-Fong
  surname: Lin
  fullname: Lin, Li-Fong
  organization: Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei
– sequence: 3
  givenname: Hung-Chou
  orcidid: 0000-0001-8510-7437
  surname: Chen
  fullname: Chen, Hung-Chou
  organization: Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei
– sequence: 4
  givenname: Li-Kai
  surname: Huang
  fullname: Huang, Li-Kai
  organization: Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei
– sequence: 5
  givenname: Chaur-Jong
  surname: Hu
  fullname: Hu, Chaur-Jong
  organization: Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei
– sequence: 6
  givenname: Ka-Wai
  surname: Tam
  fullname: Tam, Ka-Wai
  organization: Cochrane Taiwan, Taipei Medical University, Taipei
– sequence: 7
  givenname: Yi-Chun
  orcidid: 0000-0001-9316-4976
  surname: Kuan
  fullname: Kuan, Yi-Chun
  organization: Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University
– sequence: 8
  givenname: Chien-Hsiung
  surname: Hong
  fullname: Hong, Chien-Hsiung
  organization: Department of Internal Medicine, Taipei Medical University Hospital, Taipei Medical University, Taipei
BackLink https://www.ncbi.nlm.nih.gov/pubmed/33040592$$D View this record in MEDLINE/PubMed
BookMark eNpNkDtPwzAUhS1URB-wMyGPLIFrx4-EraqAIlVigTlynZvWKHFK7FDy74lEkZjOGY4-6XxzMvGtR0KuGdwxpvU9cJVzJiWHXDGV6jMyY0LrBDKdTv71KZmH8AEAGRfsgkzTFATInM_Ibu12-8T5iD64ONCq9za61pua4jd21gWkztO2LrGjpuzrGOjRxT0tsUEfnXmgSxqGELEx0Vna4ZfDIzW-pA1Gk5iRNAQXLsl5ZeqAV6dckPenx7fVOtm8Pr-slpvEpkrGZIucaVlpgEpYYWE8iQpKo3UmkDFbapZLxWwFVmqErTLKylQowEyZTGV8QW5_uYeu_ewxxKJxwWJdG49tHwou5KiB61SP05vTtN82WBaHzjWmG4o_OfwH3URosQ
CitedBy_id crossref_primary_10_1186_s12877_021_02577_0
crossref_primary_10_15857_ksep_2024_00395
crossref_primary_10_1007_s42979_022_01618_8
crossref_primary_10_3390_ijerph18147631
crossref_primary_10_1186_s13102_025_01267_3
crossref_primary_10_1007_s12662_021_00765_z
crossref_primary_10_1155_jare_8814069
crossref_primary_10_1016_j_gerinurse_2024_10_019
crossref_primary_10_1038_s41598_024_54200_y
crossref_primary_10_1038_s41746_022_00684_9
crossref_primary_10_1111_2047_3095_12463
crossref_primary_10_1016_j_jamda_2023_10_031
crossref_primary_10_3389_fpubh_2025_1643510
crossref_primary_10_1519_JSC_0000000000004955
crossref_primary_10_1016_j_arr_2022_101698
crossref_primary_10_1080_13607863_2021_2019192
crossref_primary_10_1080_09638288_2025_2483470
crossref_primary_10_1186_s40945_022_00134_5
crossref_primary_10_1002_wps_20894
crossref_primary_10_1002_agm2_12256
crossref_primary_10_1007_s11760_025_04436_6
ContentType Journal Article
DBID CGR
CUY
CVF
ECM
EIF
NPM
7X8
DOI 10.1177/0269215520961637
DatabaseName Medline
MEDLINE
MEDLINE (Ovid)
MEDLINE
MEDLINE
PubMed
MEDLINE - Academic
DatabaseTitle MEDLINE
Medline Complete
MEDLINE with Full Text
PubMed
MEDLINE (Ovid)
MEDLINE - Academic
DatabaseTitleList MEDLINE - Academic
MEDLINE
Database_xml – sequence: 1
  dbid: NPM
  name: PubMed
  url: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed
  sourceTypes: Index Database
– sequence: 2
  dbid: 7X8
  name: MEDLINE - Academic
  url: https://search.proquest.com/medline
  sourceTypes: Aggregation Database
DeliveryMethod no_fulltext_linktorsrc
Discipline Occupational Therapy & Rehabilitation
Physical Therapy
EISSN 1477-0873
ExternalDocumentID 33040592
Genre Meta-Analysis
Systematic Review
Journal Article
GroupedDBID ---
-TM
.2E
.2F
.2G
.2J
.2N
.GJ
.WF
0-V
01A
0R~
1~K
29B
31R
31S
31U
31X
31Y
31Z
36B
39C
4.4
53G
54M
5GY
5VS
6PF
7RV
7X7
88E
8FI
8FJ
8R4
8R5
AABMB
AABOD
AACKU
AACMV
AACTG
AADUE
AAEJI
AAEWN
AAGGD
AAGLT
AAGMC
AAJIQ
AAJOX
AAJPV
AAKFR
AAKGS
AANSI
AAPEO
AAPII
AAQDB
AAQXH
AAQXI
AARDL
AARIX
AASIJ
AATAA
AATBZ
AAUAS
AAWTL
AAXOT
AAYTG
AAZBJ
ABAWP
ABCCA
ABCJG
ABDWY
ABEIX
ABFWQ
ABHKI
ABHQH
ABIDT
ABIVO
ABJNI
ABJZC
ABKRH
ABLUO
ABPGX
ABPNF
ABQKF
ABQXT
ABRHV
ABUJY
ABUWG
ABVFX
ABYTW
ACARO
ACDSZ
ACDXX
ACFEJ
ACFMA
ACFYK
ACGBL
ACGFS
ACGZU
ACJER
ACJTF
ACLFY
ACLHI
ACLZU
ACOFE
ACOXC
ACROE
ACRPL
ACSIQ
ACUAV
ACUIR
ACXKE
ACXMB
ADBBV
ADDLC
ADEBD
ADEIA
ADMPF
ADNBR
ADNMO
ADNON
ADRRZ
ADSTG
ADTBJ
ADUKL
ADVBO
ADYCS
ADZZY
AECGH
AECVZ
AEDTQ
AEFTW
AEILP
AEKYL
AENEX
AEPTA
AEQLS
AERKM
AESZF
AEUHG
AEWDL
AEWHI
AEXFG
AEXNY
AFEET
AFKBI
AFKRA
AFKRG
AFMOU
AFQAA
AFUIA
AFWMB
AFXQA
AGHKR
AGKLV
AGNHF
AGPXR
AGQPQ
AGWFA
AGWNL
AHDMH
AHHFK
AHMBA
AIGRN
AIIQI
AJABX
AJEFB
AJGYC
AJMMQ
AJSCY
AJUZI
AJVBE
AJXAJ
ALIPV
ALKWR
ALMA_UNASSIGNED_HOLDINGS
ALSLI
AMCVQ
ANDLU
AQUVI
ARALO
ARTOV
ASOEW
ASPBG
AUTPY
AUVAJ
AVWKF
AYAKG
AZFZN
AZQEC
B3H
B8M
B8O
B8R
B8Z
B93
B94
BBRGL
BDDNI
BENPR
BKEYQ
BKIIM
BKNYI
BKSCU
BPACV
BPHCQ
BSEHC
BVXVI
BWJAD
BYIEH
C45
CAG
CBRKF
CCPQU
CDWPY
CFDXU
CGR
COF
CORYS
CQQTX
CS3
CUTAK
CUY
CVF
DB0
DC-
DC.
DC0
DD-
DD0
DE-
DF0
DO-
DOPDO
DU5
DV7
DV9
DWQXO
D~Y
EBS
ECM
EIF
EJD
EMOBN
EX3
F5P
FEDTE
FHBDP
FYUFA
GNUQQ
GROUPED_SAGE_PREMIER_JOURNAL_COLLECTION
H13
HEHIP
HF~
HMCUK
HVGLF
HZ~
J5H
J8X
K.F
K.J
K9-
M0R
M0T
M1P
M2M
M2R
M2S
N9A
NAPCQ
NPM
O9-
OVD
P.B
P2P
PCD
PHGZM
PHGZT
PJZUB
POGQB
PPXIY
PQQKQ
PROAC
PRQQA
PSQYO
PSYQQ
Q1R
Q2X
Q7K
Q7L
Q7R
Q7U
Q7X
Q82
Q83
ROL
S01
SASJQ
SAUOL
SCNPE
SDB
SFB
SFC
SFK
SFN
SFT
SGA
SGO
SGP
SGR
SGV
SGX
SGZ
SHG
SNB
SPJ
SPQ
SPV
SQCSI
STM
TEORI
UKHRP
WOW
YRY
ZONMY
ZPPRI
ZRKOI
ZSSAH
7X8
AJHME
ID FETCH-LOGICAL-c365t-be2175f700f4c4c0177e60da7784e11cd719561cf0c57e0b6a6c53460e86a8682
IEDL.DBID 7X8
ISICitedReferencesCount 1130
ISICitedReferencesURI http://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=Summon&SrcAuth=ProQuest&DestLinkType=CitingArticles&DestApp=WOS_CPL&KeyUT=000578573100001&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D
ISSN 1477-0873
IngestDate Sun Sep 28 08:07:17 EDT 2025
Mon Jul 21 05:26:08 EDT 2025
IsPeerReviewed true
IsScholarly true
Issue 2
Keywords meta-analysis
balance function
dementia
gait
High-intensity functional exercise
Language English
LinkModel DirectLink
MergedId FETCHMERGED-LOGICAL-c365t-be2175f700f4c4c0177e60da7784e11cd719561cf0c57e0b6a6c53460e86a8682
Notes ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ObjectType-Undefined-3
ORCID 0000-0001-9316-4976
0000-0001-8510-7437
PMID 33040592
PQID 2450002737
PQPubID 23479
ParticipantIDs proquest_miscellaneous_2450002737
pubmed_primary_33040592
PublicationCentury 2000
PublicationDate 2021-Feb
20210201
PublicationDateYYYYMMDD 2021-02-01
PublicationDate_xml – month: 02
  year: 2021
  text: 2021-Feb
PublicationDecade 2020
PublicationPlace England
PublicationPlace_xml – name: England
PublicationTitle Clinical rehabilitation
PublicationTitleAlternate Clin Rehabil
PublicationYear 2021
SSID ssj0008241
Score 2.724376
SecondaryResourceType review_article
Snippet This study aimed to investigate the efficacy of high-intensity functional exercise among older adults with dementia. In this systematic review and...
This study aimed to investigate the efficacy of high-intensity functional exercise among older adults with dementia.OBJECTIVEThis study aimed to investigate...
SourceID proquest
pubmed
SourceType Aggregation Database
Index Database
StartPage 169
SubjectTerms Activities of Daily Living
Dementia - psychology
Dementia - therapy
Exercise
Exercise Therapy - methods
Humans
Randomized Controlled Trials as Topic
Title High-intensity functional exercise in older adults with dementia: A systematic review and meta-analysis
URI https://www.ncbi.nlm.nih.gov/pubmed/33040592
https://www.proquest.com/docview/2450002737
Volume 35
WOSCitedRecordID wos000578573100001&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D
hasFullText
inHoldings 1
isFullTextHit
isPrint
link http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV1NS8MwGA7qPHhxOr_mFxHUW1japknrRUQcXhxDJuxW8lXZwXbaKvjvTdKU6kEQvPTUhvLmTfLk_XgeAM6loBEWKUPKoFVEFBNIGFiEsLBti0lqc01ObIJNJsl8nk59wK3yZZXtnug2alVKGyMfhSRuyFfY9fIVWdUom131EhqroBcZKGO9ms07tvAkdMqVAWEM4YRFXZpyZK4eaWjpx6zkCY3Y7wDTHTTj_n9_cQtseogJbxqf2AYruhiAi-90wnDWcAnAS_j4g6l7APpTP3HtOzvg2daCoEVT615_QnsU-nFawSa4KGBp9b6h4_OooA3vQuVCjwt-BW9gxxgNm24ZyAsFX3TNEfe8KLvgaXw3u71HXp8ByYjGNRLa3GfinGGcE0mkWdtMU6w4YwnRQSAVs82IgcyxjJnGgnIq44hQrBPKE5qEe2CtKAt9AKAIFM455VpLYayYcp2TVAZKhVgomqdDcNaaPDP-b5MavNDle5V1Rh-C_WbesmVD1JHZWI2Bj-HhH74-AhuhLVdxBdnHoJeb1a9PwLr8qBfV26lzLPOcTB--AJGL2ZE
linkProvider ProQuest
openUrl ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=High-intensity+functional+exercise+in+older+adults+with+dementia%3A+A+systematic+review+and+meta-analysis&rft.jtitle=Clinical+rehabilitation&rft.au=Yeh%2C+Shu-Wei&rft.au=Lin%2C+Li-Fong&rft.au=Chen%2C+Hung-Chou&rft.au=Huang%2C+Li-Kai&rft.date=2021-02-01&rft.issn=1477-0873&rft.eissn=1477-0873&rft.volume=35&rft.issue=2&rft.spage=169&rft_id=info:doi/10.1177%2F0269215520961637&rft.externalDBID=NO_FULL_TEXT
thumbnail_l http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1477-0873&client=summon
thumbnail_m http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1477-0873&client=summon
thumbnail_s http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1477-0873&client=summon