Effectiveness of a multimodal physiotherapy programme on the functional and emotional capacity of older adults with severe intellectual disabilities

Abstract

Background: The increase in life expectancy of people with severe intellectual disabilities accelerates a premature ageing process that favours the presence of a process of physical and psychological frailty that affects quality of life.

Objectives: This study aims to investigate the effects of a multimodal physiotherapy intervention on the functional capacity of older adults with intellectual disabilities. This study was conducted over six months and consisted of adapted massage therapy sessions, therapeutic physical exercise in a natural environment and aquatic physiotherapy.

Method: Randomised controlled clinical trial. The inclusion criteria were to be over 50 years of age, have a diagnosis of severe intellectual disability according to the DSM-V criteria and be at high risk of developing dementia according to the NTG-EDSD. Participants were randomly assigned to the experimental and control groups. Physical variables were measured by means of the Abbreviated Alusti Test, 10MWT, 6MWT, TUG, SCPT, psychological variables by means of the NPI-Q and variables related to quality of life by means of the QUALID.

Results: The final sample was composed of 20 older adults, of which 10 were part of the experimental group in which significant differences were obtained with a p less than 0.005, an improvement in mobility (16.5%), in muscle power of the lower limb (90, 2%), in dynamic balance (7.2%), in cardio-respiratory capacity (19.3%), in walking speed (19.4%), in decreased neuropsychiatric symptoms (54.45%) and in improved quality of life (57.8%).

Conclusions: The multimodal physiotherapy intervention based on the combination of manual therapy sessions, physical exercise sessions in an outdoor circuit and the aquatic physiotherapy sessions of the AquaCap programme was able to improve functional capacity, decrease neuropsychiatric symptoms by improving the capacity for emotional expression and improve the quality of life of older adults with severe intellectual disability at high risk of dementia.

Keywords: manual therapy, physical exercise, aquatic physiotherapy, dementia.