Table 3.
DySplit—Characteristics of Included Studies in Which Care Recipients Exercised, and Caregivers Received a Nonexercise Intervention or UC (N = 5)
| Study | Participants | Caregiver interventions | Caregiver measures and outcomes | Care recipient interventions | Care recipient measures and outcomes |
|---|---|---|---|---|---|
| Barnes et al. (2015)Pilot, non RCTB/L, cross-over (18 weeks), post (36 weeks) N dyads = 12 | CG: Partners (N = 2M), Daughters (N = 9D); N = 11 (2M/9F)FM: N = 6 (5D/1M-P); age = 57.5 yearsUC: N = 5 (4D/1M-P); age = 54.6 yearsCR with mild to moderate dementia:N = 11FM: N = 6 (5F/1M); age = 85.67 yearsUC: N = 5 (4F/1M); age = 81.6 years | CG interventions: HomeGrp 1 FM: (N = 6 at 18 weeks, and N = 3 at 36 weeks); UC for CG, but instructors met with the dyad to provide exer instruction for CR and assess CR goals and interests; four in-home visits over 18 weeks, plus biwkly calls to CG for reporting of CR adverse events Grp 2 UC: (N = 4 at 18 weeks, and N = 6 at 36 weeks); biwkly calls for adverse events Cross-over design: From 1 to 18 weeks, Grp 1 in FM and Grp 2 in UC; from 19–36 weeks, Grp 1 in UC and Grp 2 in FM | Distress: NPI-QBtwGrp: NS (ES + 0.21) w/iGrp1: NS (ES + 0.26) w/iGrp2: NS (ES + 0.49) Burden: CBIBtwGrp: NS (ES + 0.49)w/iGrp1: NS (ES + 1.92)w/iGrp2: NS (ES − 0.05) CR Func’l Ability: ADCS-ADLBtwGrp: NS (ES = 0.07)w/iGrp1: NS (ES 0.12) w/iGrp2: NS (ES − 0.31) CR Behavior: NPI-QBtwGrp: NS (ES + 0.02)w/iGrp1: NS (ES + 0.59)w/iGrp2: NS (ES − 1.22)CR QOL: QOL-AD BtwGrp: NS (ES + 0.33) w/iGrp1: NS (ES + 0.50) w/iGrp2: NS (ES + 0.47) All BtwGrp comparisons at 18 weeks. For effect sizes, +Favors FM, –Favors UC, =Both groups same; authors defined ES ≥ 0.25 as clinically meaningful. | CR interventions: Adult day care Grp 1 Functional Movement (FM): (N = 6 at 18 weeks; N = 4 at 36 weeks); combination of physical therapy occupational therapy, yoga, Tai Chi, dance; 18weeks/2 days/ week/45 min Grp 2 UC: (N = 5 at 18 weeks, N = 6 at 36 weeks); usual care of chair-based exercises, art, music; 18 weeks/2 days/ week/20 min Cross-over design: same as CGs | Physical function: PPB and SFT Lower extremity function BtwGrp: NS (ES + 0.34) w/iGrp1: NS (ES + 0.25) w/iGrp2: NS (ES + 0.34) Sit and reach BtwGrp: NS (ES – 0.32) w/iGrp1: NS (ES – 0.49) w/iGrp2: NS (ES + 0.71) Back scratch BtwGrp: NS (ES + 0.35) w/iGrp1: NS (ES + 0.99) w/iGrp2: NS (ES – 0.40) Mobility-8ft up and go BtwGrp: NS (ES + 0.24) w/iGrp1: NS (ES + 0.29) w/iGrp2: NS (ES + 0.32) Cognitive function: ADAS BtwGrp: NS (ES + 0.76) w/iGrp1: NS (ES + 0.55) w/iGrp2: NS (ES + 0.38) Quality of life: QOL-AD BtwGrp: NS (ES + 0.83) w/iGrp1: NS (ES + 1.61) w/iGrp2: NS (ES – 1.06) |
| Lamb et al. (2018) RCT Pre, post (6 months), F/U (12 months) N dyads = 459 | CG: Spouse (S), Adult Child (AC), or Other (O) Ex ± UC: N = 305 (218F/87M); 239(S), 55(AC), 11(O); age = 69.1 years UC: N = 154 (125F/29M), 117(S), 32(AC), 4(O); age = 70.2 years CR with mild to moderate dementia:Ex ± UC: N = 329 (195M/134F); age = 76.9 years UC: N = 165 (106M/59F); age = 78.4 years | CG interventions: Community and home Ex ± UC: (N = 258; 184F/74M) UC: (N = 129; 104F/25M) All CGs received UC | Burden: ZBI, NS Health-related QOL: EQ-5D, NS All comparisons are main effects at 12 months. | CR interventions: Same as CGs Ex ± UC: (N = 278; 112F/166M); cycling (25 min) and strength training (3 sets/20 reps), moderate to hard intensity, plus usual care; doses: (1) gym: 4 months/2×/ week/60–90 min; (2) home: 4 months/1 hr/week; (3) postintervention home: 150 min/week with behavioral strategies UC: (N = 137; 51F/86M); usual care included clinical assessment, carer counseling, Rx treatments, brief PA advice | Cognition: ADAS, both groups declined, exer significantly worse (p = .03) Praxis/memory/ language: ADAS, NS ADLs: BADL-proxy by CG, NS Behavior: NPI-proxy by CG, NS Health-related QOL: EQ-5D, NS Quality of life: QOL-AD, NS Falls and fractures: NS 6-min walk test: 6MWD, Ex group improved by 18.1 m (p = .001); only tested in Ex group |
| Maci et al. (2012) Pilot RCT B/L, post (3 months) N dyads = 14 | CG: Family members; wives (W), husbands (H), daughters (D), sons (S) PA ± Cog ± Soc: N = 7 (3W/3D/1S); age = 54.6 years UC: N = 7 (3W/2H/2D); age = 60.4 years CR with Alzheimer’s Disease:PA ± Cog ± Soc: N = 7 (4F/3M); age = 75 yearsUC: N = 7 (4F/3M); age = 70.3 years | CG interventions: Respite PA ± Cog ± Soc: CGs received 12 weeks/3–4 hrs/day (15–20 hr/week); researchers transported CRs to and from gym setting UC: Usual care | Burden: CBI, PA+ improved (p < .05); UC worsened (p < .05) Depression: BDI, PA + improved (p < .05); UC worsened (p < .05) QOL of CR: QOL-AD, PA + improved (p < .05); UC worsened (p < .05) All comparisons w/iGrp. | CR interventions: Community PA ± Cog ± Soc: Physical activity (aerobic, balance, gait, coordination) at mild intensity, plus cognitive stimulation, and socialization; 12 weeks/5×/ week/60 min (PA) + 60 min(cog) +60 min(soc) UC: Treatment as usual | Cognitive: MMSE, NS either group ADLs: NS either group Executive function: FAB, UC worse (p < .05); NS PA+ Anxiety: HAM, PA+ improved (p < .05); NS UC Depression: CSDD, PA + improved (p < .05); UC worsened (p < .05) Apathy: AES, PA+ improved (p < .05); NS UC QOL: QOL-AD (total and patient), PA + improved (p < .05); UC worsened (p < .05) QOL: CBS, PA + improved (p < .05); NS UC |
| Marques et al. (2015) Mixed Methods w/a Single Arm Feasibility Trial B/L, post (12 weeks) N dyads = 9 | CG: Family members; N = 9 (8F/ 1M); age = 63.8 years CR with COPD: COPD, N = 35 (2F/7M); age = 69.6 years Demographics provided only on the portion of participants involved in the feasibility trial. | CG intervention: Primary care clinic Psychosoc ± Educ: psychosocial support and education for CG and CR together; 12 weeks/1×/week/90 min | Family coping: F-COPES, improved in passive appraisal (p = .043), and total score (p = .011); NS in social support, reframing, spiritual support, and accepting helpAdjustment to illness: PAIS-SR, improved in sexual relationship (p = .013), and psychological distress (p = .012); NS in health care orientation, domestic environment, extended family relationships, social environment, and total score All comparisons t-tests. | CR intervention: Primary care clinic Rehab ± Psychosoc ± Educ: Pulmonary rehabilitation (endurance, resistance, balance), 12 weeks/3×/ week/60 min; plus psychosocial support and education for CR and CG together, 12 weeks/1×/ week/90 min | Dyspnea: mMRC, NS Quadriceps strength: 10RM, increased strength (p = .002) Walking distance: 6MWD, increased by 26.8 m (p = .023) Mobility and balance: TUG, improved (p = .002) Health-related QOL: SGRQ, NS Family coping: F-COPES, improved in social support (p = .018), accepting help (p = .027), passive appraisal (p = .043), and total score (p = .026); NS in reframing and spiritual support. Adjustment to illness: PAIS-SR, NS in all subscales and total All comparisons t-tests. |
| Yu et al. (2015) Pilot, Feasibility Study w/a Single. Arm B/L, post (3 months), F/U (6 months) N dyads = 26 | CG: Family members; N = 26 (20F/6M); age = 64 years CR with Alzheimer’s Disease:N = 26 (16F/10M) community- dwelling, age = 78 years | CG intervention: Respite CGs received 8–10 hr/ week; researchers transported CRs to and from gym setting | Distress: NPI-Q, B/L to 3 months: NS, though an 8% decrease 3 to 6 months: Decrease of 32% (p < .05) CR behavior: NPI-Q, 3 and 6 months: NS, but maintained B/L score All comparisons MEtime. | CR interventions: Community Cycling: Moderate intensity cycling, supervised, individualized, 6 months/3×/week/15–45 min, plus 10 min each of warm-up and cool down | Cognition: ADAS, 3 and 6 months: NS, but maintained B/L score ADLs: DAD 3 and 6 months: NS, but maintained B/L score All comparisons MEtime. |
Key - General Abbreviations: ADLs = activities of daily living; B/L = baseline; CG = caregiver; CR = care recipient; F/U = follow up; PA = physical activity; Rx = prescription; UC = usual care (also treatment as usual).
Key - Measures Abbreviations: 6MWD = 6-meter walking distance; 10RM = 10-repetition maximum; ADAS = Alzheimer’s Disease Assessment Scale; ADCS-ADL = Alzheimer’s Disease Cooperative Study—Activities of Daily Living; AES = Apathy Evaluation Scale; BADL = Bristol Activity of Daily Living Index; BDI = Beck Depression Inventory; CBI = Caregiver Burden Inventory; CBS = Cornell-Brown Scale for Quality of Life in Dementia; CSDD = Cornell Scale for Depression in Dementia; DAD = Disability Assessment for Dementia; EQ-5D = EuroQOL-5 dimension; FAB = Frontal Assessment Battery; F-COPES = Family-Crisis Oriented Personal Scale; HAM = Hamilton Anxiety Rating Scale; mMRC = Modified Medical Research Council Dyspnea Scale; MMSE = Mini-Mental State Exam; NPI-Q = Neuropsychiatric Inventory Questionnaire; PAIS-SR = Psychosocial Adjustment to Illness Scale-Self-Report; PPB = Physical Performance Battery; QOLAD = Quality of Life Scale in Alzheimer’s Disease; SFT = Senior Fitness Test; SGRQ = St. George’s Respiratory Questionnaire; TUG = Timed Up and Go test; ZBI = Zarit Burden Interview.
Key - Statistical Tests Abbreviations: BtwGrp = between groups; ES = effect size; MEtime = main effect of time; SD = standard deviation; w/iGrp = within group.