Physical Therapy for Gait, Balance, and Cognition in Individuals with Cognitive Impairment: A Retrospective Analysis

The purpose of this study was to determine if a pragmatic physical therapy (PT) program was associated with improvedcognition, gait, and balance in individuals with cognitive impairment. This study investigated these associations for individuals withAlzheimer disease (AD), vascular dementia (VaD), dementia with Lewy bodies (DLB), and mild cognitive impairment (MCI) in orderto better characterize outcomes to PT for each diagnostic group.Methods. Data before and after one month of physical therapy wereextracted from patient records (67 with AD, 34 with VaD, 35 with DLB, and 37 with MCI). The mean number of PT sessions over amonth was 3.4 (±1.8). Outcomes covered the domains of gait, balance, and cognition with multiple outcomes used to measuredifferent constructs within the balance and gait domains.Results. All groups showed improvements in balance and at least one gaitoutcome measure. Those with MCI improved in every measure of gait and balance performance. Lastly, cognition as measured byMontreal Cognitive Assessment improved in individuals in the AD, VaD, and MCI groups.Conclusion. While this retrospectiveanalysis is not appropriate for causal inference, results of one month of physical therapy were associated with decreases in gait,balance, and cognitive impairment in individuals with AD, VaD, DLB<, and MCI.Clinical Implications. While physical therapy isnot typically a primary treatment strategy for individuals with cognitive impairment, the results of this study are consistent withthe literature that demonstrates improvement from physical therapy for other neurodegenerative diseases. Further clinical andresearch exploration for physical therapy as a primary treatment strategy in these populations is warranted