Telereabilitação como alternativa ao atendimento presencial devido à pandemia Covid-19 e seus efeitos na cognição e desempenho de dupla tarefa de idosos com demência: um ensaio clínico randomizado e controlado

Abstract

The COVID-19 pandemic has changed the way health services are provided. Older people with dementias, have three times the risk of COVID-19 severity and death. the detachment social was an effective measure to control the pace of viral transmission, however, when added physical inactivity generates serious losses of cognitive abilities, as well as worsening impairment of performance when performing two tasks at the same time - Dual Task (DT), enabling greater functional impairment. Telerehabilitation can be an alternative professional intervention in the fight against physical inactivity, however, in Brazil, studies involving this theme are still scarce. Objective: To analyze the effects of a telerehabilitation program with physical exercises Multimodality in cognition and performance of TD in elderly with dementia in the face of social distancing against COVID-19. Methods: Volunteers were randomized and allocated into two groups: Telerehabilitation (TG) and Control (GC) and followed for 12 weeks, with the TG receiving the intervention three times a week on non-consecutive days. Participants were diagnosed of dementia confirmed by the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders V (DSM-V) and classified in mild and moderate stage by the Clinical Scale of Dementia Assessment (CDR). The volunteers were evaluated cognitively by tests Mini Mental State Examination (MMSE), Clock Drawing Test (DRT) and Fluency Test Verbal Semantics (FVS), as well as physically through the dual task, respectively, through the tests of the Time Up and Go (TUG) and Time Up and Go-Dupla Task (TUG-DT), in the pre and immediately following the intervention, with all testing also taking place in an online format. He was Anova two-ways test was used to analyze the results. Results: Participated in the present study 77 elderly people with dementia, being randomized 38 for the CG and 39 for the TG. Finished the two evaluation moments 63 elderly (29 in the CG and 34 in the TG). Through Anova two-ways, Observed statistically significant difference (p<0.05) for the FVS variables (p<0.001) and TUG-DT (p = 0.038) between evaluation times. The TUG-DT was also statistically significant for the difference between groups (p = 0.033). Finally, the cost of dual tasking, for the outcome time (CDT-T), there was a significant difference in the relationship between groups and time (Time*Group) (p=0.038) and between groups (p=0.032). The other variables do not showed significant values. Conclusion: Given these findings, the program of telerehabilitation for elderly people with dementia, in the face of social distancing in the face of COVID-19 has maintenance effects of dual task capacities, avoiding the worsening in the cost of this variable. At the However, there are no improvement effects on cognitive functions. New studies need to be designed to study this topic.