This innovative pilot study aimed to evaluate the safety, feasibility, and effectiveness of a remotely-monitored walking program in enhancing walking performance among individuals with dementia.
Community-dwelling ambulatory individuals with dementia were recruited in this remotely-monitored walking program augmented with personalized feedback on daily steps through a smartwatch (Fitbit Sense 2). Participants and their spouses received personalized feedback on the participants’ walking performance, along with weekly goals based on a percentage increase from the previous week's average daily steps. These weekly goals were discussed via phone for six weeks, and participants were encouraged to walk with their spouses in their local communities to meet them. Safety and feasibility were assessed through monitoring adverse events, participant compliance, and qualitative interviews. Efficacy measures included walking performance, tracked by daily step counts, and walking capacity, measured by the six-minute walk test both pre- and post-intervention. Additionally, participants’ cognition was evaluated using the Mini Mental State Examination and their quality of life was assessed using the quality of life in Alzheimer’s Disease questionnaire. Statistical analysis involved descriptive statistics, frequency counts, and Wilcoxon signed-rank tests.
Six individuals with dementia (1 female/5 males) participated, all demonstrating 100% compliance with no adverse events, and reported a positive experience with the remotely-monitored walking program. They found the Fitbit easy to use, and the feedback motivating. Four participants met their step targets at least 50% of the time during the six-week intervention, while the other two met their targets 16-33% of the time. Despite this, a non-significant trend of improvement was observed in daily walking performance (pre-intervention: 3850±2542 steps/day; post-intervention: 4045±1689 steps/day, p>0.05), and in walking capacity, as measured by the six-minute walk test (pre-intervention: 293±68 meters; post-intervention: 332±99 meters, p>0.05). However, measures of cognition and quality of life did not show any changes.
Preliminary findings suggest that the remotely monitored walking program is safe, feasible, and potentially beneficial for increasing walking capacity and performance in individuals with dementia. Caregiver support was crucial to the program's success. Our future research will investigate longer intervention durations, individualized virtual counseling, and a larger participant cohort to rigorously evaluate the program’s effectiveness through a randomized controlled trial.
This pilot study contributes important insights to geriatric research by demonstrating advanced strategies for enhancing walking activity in individuals with dementia. Physiotherapists are encouraged to incorporate feedback from user-friendly smartwatches to improve daily walking performance, thereby facilitating a physically active lifestyle while ensuring safety and personalized support for individuals with dementia.
Geriatrics
Wearable Technology
