Caracterización del desempeño en diferentes tareas motrices en personas con demencia – funcionamiento ejecutivo como determinante (Characterization of performance in different motor tasks in people with dementia – executive functioning as a determinant)

Autores/as

  • Marlene Rosa School of Health Sciences, Polytechnic Institute of Leiria, Center for Innovative Care and Health Technology
  • Susana Lopes Universidade de Salamanca
  • Natália Martins Escola Superior de Saúde, Instituto Politécnico de Leiria

DOI:

https://doi.org/10.47197/retos.v50.100006

Palabras clave:

demencia, rendimiento motor, funciones ejecutivas, miembros superiores

Resumen

Introducción: Existe un interés creciente por el estudio del funcionamiento ejecutivo y su papel en el rendimiento motor de las personas con demencia, así como por la valoración diferencial de las tareas motoras, según su tipología. Objetivo: caracterizar el desempeño de personas con demencia en tareas motrices continuas y discretas, según el perfil de funciones ejecutivas. Metodología: Se reclutaron ancianos institucionalizados con diagnóstico de demencia (leve/moderado), capaces de comprender órdenes simples. Se recogieron datos sociodemográficos y se realizó una evaluación de la función ejecutiva (Batería de Evaluación Frontal). Posteriormente, se midió el desempeño en una tarea discreta (EUROFIT) y continua (TaTi). Se caracterizó la función ejecutiva de los participantes (med.; IIQ[Q3-Q1]; freq.; %), se analizó la variabilidad entre intentos en las dos tareas, así como la diferencia entre el mejor desempeño (Wilcoxon Prueba). La muestra se dividió en dos partes considerando la mediana en cada tarea y se compararon los valores FAB (Mann-Whitney). Resultados: De los 29 participantes reclutados, solo 26 completaron al menos un intento tanto para EUROFIT como para TaTi. Las dificultades más frecuentes y graves (puntuación 0;1) en la FAB fueron la fluidez léxica (78 %) y las instrucciones contradictorias (70 %). La variabilidad entre ensayos (p=0,018) solo fue significativa en EUROFIT. Las diferencias en el rendimiento entre tareas fueron significativas (p=0,01). El subgrupo con peor desempeño en el EUROFIT>505.60, presenta valores significativamente más bajos en el FAB (p=0.028). Conclusión: Los participantes del presente estudio mostraron un desempeño estadísticamente más positivo y menor variabilidad en la tarea discreta.

Palabras clave: demencia; rendimiento de motor; funciones ejecutivas; miembros superiores.

Abstract. Introduction: There is a growing interest in the study of executive functioning and its role in motor performance in people with dementia, as well as in the differential assessment of motor tasks, according to their typology. Objective: to characterize the performance of people with dementia during continuous and discrete motor tasks, according to the profile of executive functions. Methodology: Institutionalized elderly diagnosed with dementia (mild/moderate stage), capable of understanding simple commands, were recruited. Sociodemographic data were collected and an executive function assessment (Frontal Assessment Battery) was conducted. Subsequently, performance was measured in a discrete task (Disk Test, EUROFIT) and in a continuous task (TaTi evaluation kit). The executive function of the participants was characterized (med.; IIQ[Q3-Q1]; freq., %), the variability between attempts in the two tasks was analyzed, as well as the difference between the best performance in the two (Wilcoxon Test). The sample was divided into two parts considering the median in each task and the FAB values ​​were compared (Mann-Whitney). Results: Of the 29 participants recruited, only 26 completed at least one attempt for both EUROFIT and TaTi. The most common and severe difficulties (score 0;1) in the FAB were lexical fluency (78%) and conflicting instructions (70%). Intertrial variability (p=0.018) was only significant in EUROFIT. Differences in performance between tasks were significant (p=0.01). The subgroup with the worst performance in the EUROFIT>505.60, presents significantly lower values ​​in FAB (p=0.028). Conclusion: The participants of the present study showed a statistically more positive performance and less variability in the discrete task.

Key-words: dementia; motor performance; executive functions; upper limbs.

Citas

Adams, J. A. (1987). Historical review and appraisal of research on the learning, retention, and transfer of human motor skills. Psychological Bulletin, 101(1), 41–74. https://doi.org/10.1037/0033-2909.101.1.41

Bank, P. J. M., Marinus, J., Tol, R. M., Groeneveld, I. F., Goossens, P. H., Groot, J. H., Hilten, J. J., & Meskers, C. G. M. (2018). Cognitive‐motor interference during goal‐directed upper‐limb movements. European Journal of Neurosci-ence, 48(10), 3146–3158. https://doi.org/10.1111/ejn.14168

Baum, C. M., Edwards, D. F., Leavitt, K., Grant, E., & Deuel, R. M. (1988). Performance Components in Senile Dementia of the Alzheimer Type: Motor Planning, Language, and Memory. The Occupational Therapy Journal of Research, 8(6), 356–368. https://doi.org/10.1177/153944928800800603

Beauchet, O., Allali, G., Montero-Odasso, M., Sejdić, E., Fantino, B., & Annweiler, C. (2014). Motor Phenotype of De-cline in Cognitive Performance among Community-Dwellers without Dementia: Population-Based Study and Meta-Analysis. PLoS ONE, 9(6), e99318. https://doi.org/10.1371/journal.pone.0099318

Bruce-Keller, A. J., Brouillette, R. M., Tudor-Locke, C., Foil, H. C., Gahan, W. P., Nye, D. M., Guillory, L., & Keller, J. N. (2012). Relationship Between Cognitive Domains, Physical Performance, and Gait in Elderly and Demented Sub-jects. Journal of Alzheimer’s Disease, 30(4), 899–908. https://doi.org/10.3233/JAD-2012-120025

Chandra, S. R., Issac, T. G., & Abbas, M. M. (2015). Apraxias in Neurodegenerative Dementias. Indian Journal of Psycho-logical Medicine, 37(1), 42–47. https://doi.org/10.4103/0253-7176.150817

Dick, M. B., Hsieh, S., Bricker, J., & Dick-Muehlke, C. (2003). Facilitating acquisition and transfer of a continuous motor task in healthy older adults and patients with Alzheimer’s disease. Neuropsychology, 17(2), 202–212. https://doi.org/10.1037/0894-4105.17.2.202

Dubois, B., Slachevsky, A., Litvan, I., & Pillon, B. (2000). The FAB: A frontal assessment battery at bedside. Neurology, 55(11), 1621–1626. https://doi.org/10.1212/WNL.55.11.1621

Duke, L. M., & Kaszniak, A. W. (2000). Executive control functions in degenerative dementias: a comparative review. Neuropsychology Review, 10(2), 75–99. https://doi.org/10.1023/A:1009096603879

Farias, S. T., Harrell, E., Neumann, C., & Houtz, A. (2003). The relationship between neuropsychological performance and daily functioning in individuals with Alzheimer’s disease: ecological validity of neuropsychological tests. Archives of Clinical Neuropsychology : The Official Journal of the National Academy of Neuropsychologists, 18(6), 655–672.

Gorus, E., De Raedt, R., Lambert, M., Lemper, J.-C., & Mets, T. (2008). Reaction Times and Performance Variability in Normal Aging, Mild Cognitive Impairment, and Alzheimer’s Disease. Journal of Geriatric Psychiatry and Neurology, 21(3), 204–218. https://doi.org/10.1177/0891988708320973

Guerreiro, M. (2010). Testes de rastreio de defeito cognitivo e demência: Uma perspectiva prática. Revista Portuguesa de Clínica Geral, 26(1), 46–53. https://doi.org/10.32385/rpmgf.v26i1.10711

Gupta, A., Prakash, N. B., & Sannyasi, G. (2021). Rehabilitation in Dementia. Indian Journal of Psychological Medicine, 43(5_suppl), S37–S47. https://doi.org/10.1177/02537176211033316

Leandro Ferreira, & Sebastião Gobbi. (2003). Agilidade geral e agilidade de membros superiores em mulheres de terceira idade treinadas e não treinadas. Rev. Bras. Cineantropom. Desempenho Hum., 5(1).

Lima, C. F., Meireles, L. P., Fonseca, R., Castro, S. L., & Garrett, C. (2008). The Frontal Assessment Battery (FAB) in Parkinson’s disease and correlations with formal measures of executive functioning. Journal of Neurology, 255(11), 1756–1761. https://doi.org/10.1007/s00415-008-0024-6

Masiá, C. R., & Moreno Hernández, F. J. (2021). Aprendizaje guiado por constreñimientos y modulación de la dificultad de práctica: Una propuesta de caso para el entrenamiento de la técnica en Gimnasia Rítmica (Constraints-led approach learning and practice complexity modulation: A case proposal for te. Retos, 42, 906–915. https://doi.org/10.47197/retos.v42i0.81077

Matur, Z., & Oge, A. E. (2017). Sensorimotor Integration During Motor Learning: Transcranial Magnetic Stimulation Studies. Nöro Psikiyatri Arşivi, 54(4), 358–363. https://doi.org/10.5152/npa.2016.18056

Mc Ardle, R., Galna, B., Donaghy, P., Thomas, A., & Rochester, L. (2019). Do Alzheimer’s and Lewy body disease have discrete pathological signatures of gait? Alzheimer’s & Dementia, 15(10), 1367–1377. https://doi.org/10.1016/j.jalz.2019.06.4953

Meijer, E., Casanova, M., Kim, H., Llena-Nozal, A., & Lee, J. (2022). Economic costs of dementia in 11 countries in Eu-rope: Estimates from nationally representative cohorts of a panel study. The Lancet Regional Health - Europe, 20, 100445. https://doi.org/10.1016/j.lanepe.2022.100445

Miyake, A., Friedman, N. P., Emerson, M. J., Witzki, A. H., Howerter, A., & Wager, T. D. (2000). The Unity and Di-versity of Executive Functions and Their Contributions to Complex “Frontal Lobe” Tasks: A Latent Variable Analysis. Cognitive Psychology, 41(1), 49–100. https://doi.org/10.1006/cogp.1999.0734

Miyazaki, A., Ito, Y., Okuyama, T., Mori, H., Sato, K., Ichiki, M., Hiyama, A., Dinet, J., & Nouchi, R. (2023). Associa-tion between upper limb movements during drumming and cognition in older adults with cognitive impairment and de-mentia at a nursing home: a pilot study. Frontiers in Rehabilitation Sciences, 4. https://doi.org/10.3389/fresc.2023.1079781

Nef, T., Chesham, A., Schütz, N., Botros, A. A., Vanbellingen, T., Burgunder, J.-M., Müllner, J., Martin Müri, R., & Urwyler, P. (2020). Development and Evaluation of Maze-Like Puzzle Games to Assess Cognitive and Motor Function in Aging and Neurodegenerative Diseases. Frontiers in Aging Neuroscience, 12. https://doi.org/10.3389/fnagi.2020.00087

Richard A. Magill. (1993). Motor Learning: Concepts and Applications (4th ed.). Brown & Benchmark.

Richard Schmidt, & Tim Lee. (1988). Motor Control and Learning: A Behavioral Emphasisis (2nd ed.). Publisher, Human Kinetics.

Rosa, M., Marinho, R., Gordo, S., & Pocinho, R. (2021). O jogo como sistema de avaliação no idoso institucionalizado – um estudo piloto (El juego como sistema de evaluación en ancianos institucionalizados - estudio piloto) (Game performance to assess elderly people in long term care – a pilot study). Retos, 43, 370–378. https://doi.org/10.47197/retos.v43i0.89551

Rosa, M. N., Gordo, S., Pocinho, R., & Marinho, R. (2021). Uso de um jogo de tabuleiro na reabilitação dos membros superiores de idosos institucionalizados em Portugal: um estudo piloto quase-experimental. Revista Pesquisa Em Fisioterapia, 11(4), 657–670. https://doi.org/10.17267/2238-2704rpf.v11i4.3944

Rycroft, S. S., Quach, L. T., Ward, R. E., Pedersen, M. M., Grande, L., & Bean, J. F. (2019). The Relationship Between Cognitive Impairment and Upper Extremity Function in Older Primary Care Patients. The Journals of Gerontology: Se-ries A, 74(4), 568–574. https://doi.org/10.1093/gerona/gly246

Schambra, H. M., Parnandi, A., Pandit, N. G., Uddin, J., Wirtanen, A., & Nilsen, D. M. (2019). A Taxonomy of Func-tional Upper Extremity Motion. Frontiers in Neurology, 10. https://doi.org/10.3389/fneur.2019.00857

Scherder, E., Dekker, W., & Eggermont, L. (2008). Higher-Level Hand Motor Function in Aging and (Preclinical) Demen-tia: Its Relationship with (Instrumental) Activities of Daily Life – A Mini-Review. Gerontology, 54(6), 333–341. https://doi.org/10.1159/000168203

Sheridan, P. L., Solomont, J., Kowall, N., & Hausdorff, J. M. (2003). Influence of Executive Function on Locomotor Func-tion: Divided Attention Increases Gait Variability in Alzheimer’s Disease. Journal of the American Geriatrics Society, 51(11), 1633–1637. https://doi.org/10.1046/j.1532-5415.2003.51516.x

Taylor, M. E., Lasschuit, D. A., Lord, S. R., Delbaere, K., Kurrle, S. E., Mikolaizak, A. S., Kvelde, T., & Close, J. C. T. (2017). Slow gait speed is associated with executive function decline in older people with mild to moderate dementia: A one year longitudinal study. Archives of Gerontology and Geriatrics, 73, 148–153. https://doi.org/10.1016/j.archger.2017.07.023

Trautwein, S., Barisch-Fritz, B., Scharpf, A., Bossers, W., Meinzer, M., Steib, S., Stein, T., Bös, K., Stahn, A., Niessner, C., Altmann, S., Wittelsberger, R., & Woll, A. (2019a). Recommendations for assessing motor performance in indi-viduals with dementia: suggestions of an expert panel – a qualitative approach. European Review of Aging and Physical Activity, 16(1), 5. https://doi.org/10.1186/s11556-019-0212-7

Trautwein, S., Barisch-Fritz, B., Scharpf, A., Bossers, W., Meinzer, M., Steib, S., Stein, T., Bös, K., Stahn, A., Niessner, C., Altmann, S., Wittelsberger, R., & Woll, A. (2019b). Recommendations for assessing motor performance in indi-viduals with dementia: suggestions of an expert panel – a qualitative approach. European Review of Aging and Physical Activity, 16(1), 5. https://doi.org/10.1186/s11556-019-0212-7

van Halteren-van Tilborg, I. A. D. A., Scherder, E. J. A., & Hulstijn, W. (2007). Motor-Skill Learning in Alzheimer’s Disease: A Review with an Eye to the Clinical Practice. Neuropsychology Review, 17(3), 203–212. https://doi.org/10.1007/s11065-007-9030-1

Publicado

2023-09-15

Cómo citar

Rosa, M., Lopes, S. ., & Martins, N. (2023). Caracterización del desempeño en diferentes tareas motrices en personas con demencia – funcionamiento ejecutivo como determinante (Characterization of performance in different motor tasks in people with dementia – executive functioning as a determinant). Retos, 50, 651–659. https://doi.org/10.47197/retos.v50.100006

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