Comparison of the effect of online physical exercise and computerized cognitive stimulation in patients with Alzheimer's disease during the COVID-19 pandemic

The purpose of the current study was to investigate the effect of physical exercise alone and in combination with cognitive stimulation on cognition, physical function, and quality of life in individuals with Alzheimer's Disease (AD) with the telerehabilitation method during the Covid-19 pandemic. This randomized controlled trial included 60 individuals diagnosed with AD by the neurology specialist according to DSM-V diagnostic criteria. The participants were randomly divided into Physical Exercise (PE) (n=20), Physical Exercise and Cognitive Stimulation (PE+CS) (n=20) and control (n=20) groups. An online physical exercise program consisted of a range of motion, stretching, strengthening, balance/flexibility, and aerobic exercises. It was conducted twice a week for 12 weeks for PE and PE+CS groups volunteers. For the PE+CS group, the cognitive stimulation program was given a minimum of three or a maximum of five days for 12 weeks. No treatment was given for the control group. All participants were assessed in terms of cognition, quality of life, balance, functional mobility, upper and lower extremity strength, activities of daily living, and depression. Data were collected from the patients at pretreatment, after twelve weeks, and at the end of the study at 24 weeks. The findings of the present study demonstrated that the PE+CS group caused a statistically more signficant increase in cognition, balance, functional mobility, upper extremity strength, instrumental activities of daily living, and reduction in depression compared to the control group (p<0.05). Besides, individuals in the PE+CS group had statistically superior quality of life and instrumental activities of daily living than the PE group (p<0.05). Furthermore, the PE group alone had a significant increase in balance, functional mobility, and upper extremity strength compared to the control group (p<0.05). In conclusion, the addition of cognitive stimulation to the online physical exercise program was a safe and effective method to gain more significant improvements in cognition, balance, functional mobility, upper extremity strength, instrumental activities of daily living, and reduction in depression in patients with AD.