Effect of Dual Task Training on Balance and Gait Over Regular and Diversified Land Surfaces in Independent Elderly (original) (raw)
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Journal of Exercise Therapy and Rehabilitation, 2021
Purpose: This study aimed to examine the effects of single-task, dual-task and successive physical-cognitive training on fall risk, balance, and gait performances in elderly. Methods: A total of 45 healthy older adults (73.0±4.6 years; 6 male and 39 female) underwent one of three interventions 3 times a week for 4 weeks. Group-1 performed single-task balance and gait exercises. Group-2 performed cognitive activity, balance, and gait exercises simultaneously. Group-3 performed successive cognitive activities and balance and gait exercises. Gait speed under single-task and dual-task conditions, Berg Balance Scale, Timed up and Go test, and Tinetti's Falls Efficacy Scale scores were evaluated before and after 4 weeks of interventions. Results: Gait speed under single-task condition, Timed up and Go Test, and Berg Balance Scale scores were improved in all groups (p<0.05). Gait speed under dual-task condition was improved in Groups-2 and 3 (p<0.05). Group-3 had greater improvement in Berg Balance Scale and Timed up and Go test scores than Group-2. Tinetti's Falls Efficacy Scale was improved in Group-1 and 3 after training while the improvement was greater in Group-3 (p=0.001). Conclusion: The present study suggests that an intervention involving cognitive and physical activities results in greater improvement in gait speed than interventions involving physical activities alone. However, successive physical-cognitive training may be more effective in reducing fear of fall and improving balance skills in elderly.
International Journal of Innovative Research in Engineering & Multidisciplinary Physical Sciences, 2023
Objective: This study assessed the impact of combined motor and cognitive training on balance, fall risk, and functional mobility in older adults. Methods: A total of 60 participants aged 65 and older were randomly assigned to one of three groups: combined motor and cognitive training, motor training only, or cognitive training only. Each group underwent their respective training for 60 minutes, three times a week over 12 weeks. Balance was assessed using the Berg Balance Scale (BBS), fall risk was measured by the Timed Up and Go Test (TUG), and functional mobility was evaluated with the Dynamic Gait Index (DGI). Results: The combined training group demonstrated significant improvements in balance (BBS: baseline 42.5, post-intervention 47.8, p=0.035), reduced fall risk (TUG: baseline 15.3 seconds, post-intervention 12.8 seconds, p=0.042), and enhanced functional mobility (DGI: baseline 18.6, post-intervention 22.3, p=0.029) compared to the motor and cognitive training-only groups. The motor training group showed moderate improvements, while the cognitive training group exhibited minimal changes. Conclusion: Combined motor and cognitive training effectively improves balance, reduces fall risk, and enhances functional mobility in older adults. This integrated approach offers a more comprehensive strategy for managing balance impairments compared to single-task training.
Physical therapy, 2021
Objective. The purpose of this study was to compare the effects of integrated and consecutive cognitive dual-task balance training in older adults on balance, fear of falling, and gait performance. Methods. Fifty-eight participants (age >65 years) were randomly assigned to an integrated dual-task training group (IDTT) (n = 29) and consecutive dual-task training group (CDTT) (n = 29). Balance exercises and cognitive tasks were performed simultaneously by the IDTT group and consecutively by the CDTT group for 8 weeks. Balance was assessed using the Berg Balance Scale as a primary outcome measure and the Timed "Up & Go" Test (TUG) (standard-cognitive), fear of falling was assessed using the Tinetti Falls Efficacy Scale, and gait speed was assessed using the 10-Meter Walk Test (10MWT) (under single-task and dual-task conditions). All tests were performed before and after the training. Results. There was no difference in group-time interaction in the Berg Balance Scale, TUG-standard, 10MWT-single task, and 10MWT-dual task tests. Group-time interaction was different in the TUG-cognitive and Tinetti Falls Efficacy Scale scores. Also, the effect of time was significantly different in all scales except for the 10MWT-single task in both groups. Conclusion. At the end of the 8-week training period, the impact of integrated and consecutive dual-task balance training on balance and gait performance in older adults was not statistically significantly different. This study suggests that consecutive dual-task balance training can be used as an alternative method to increase balance performance and gait speed in older adults who cannot perform integrated dual-task activities. Impact. There were no significant differences between the effects of the 2 dual-task training methods on balance and gait speed, suggesting that the consecutive dual-task balance training method can be used to improve the balance and gait of older adults. CDTT can be performed safely and considered as an alternative method for use in many rehabilitation training programs with older adults who cannot perform simultaneous activities.
Indian Journal of Physiotherapy and Occupational Therapy., 2018
The main impact of pathologies in geriatric population is falling due to abnormal gait deviations. Thus, fear of falling reduces their mobility that prevents independent living in geriatrics. Mobility depends on person's ability and perception to complete a task. Multiple task training is an interaction of motor and somatosensory inputs. Improvement of gait in geriatrics depends upon the type of task and environment, potentially due to cognitive dysfunction and reduced cognitive performance. Purpose of this study: Geriatric persons were trained with multiple task activity and mental tasking which may help them to improve their gait balance in the altered environment and eventually improve their gait task and reduced chances of fall. Materials and Method: 40 normal geriatric individuals were taken in 2 groups. One group was trained with multiple task exercise while the other was trained with the same and cognitive task for the period of 4 weeks. Gait balance is measured by Berg balance score and Time up and go test. Results: The independent t-test shows significant (p<0.05) difference between groups and the mean comparison shows multiple tasking with cognitive tasking has a better impact in improving gait balance in geriatric population. Conclusion: Multiple tasks exercises with cognitive task can be used as a better tool to improve the gait balance than the multiple task exercises
Training of Balance Under Single and Dual-Task Conditions in Older Adults With Balance Impairment
2006
Background and Purpose. Traditionally, rehabilitation programs emphasize training balance under single-task conditions to improve balance and reduce risk for falls. The purpose of this case report is to describe 3 balance training approaches in older adults with impaired balance. Case Descriptions. Three patients were randomly assigned to 1 of 3 interventions: (1) single-task balance training, (2) dual-task training under a fixed-priority instructional set, and (3) dual-task training under a variable-priority instructional set. Outcomes. The patients who received balance training under dual-task conditions showed dual-task training benefits; these training benefits were maintained for 3 months. The patient who received variable-priority training showed improvement on novel dual tasks. Discussion. Older adults may be able to improve their balance under dual-task conditions only following specific types of balance training. This case report gives insight on how this intervention might be combined with more traditional physical therapy intervention. [Silsupadol P, Siu KC, Shumway-Cook A, Woollacott MH. Training of balance under singleand dual-task conditions in older adults with balance impairment. Phys Ther. 2006;86:269 -281.] 27 Shumway-Cook A, Woollacott M, Kerns KA, Baldwin M. The effects of two types of cognitive tasks on postural stability in older adults with and without a history of falls.
Dual-task and risk of falls in elderly people a cross-sectional study
International Physical Medicine & Rehabilitation Journal, 2019
Older adult population has been increasing in the last decades. The Time Up and Go (TUG) is used in the exploration of elders and can discriminate the risk of falls. The aim of the study is to understand if aging people have more risk of falls while performing a dual-task in their daily life activities. A cross-sectional study with older people of the general community between 60-85 years was done. Participants were instructed to perform the TUG without Dual Task (DT), and with a cognitive and a motor secondary task. TUG with and without DT (motor and cognitive) presented shows statistical significance. There is an increase in time to perform TUG associated with a second task in elderly people. TUG tests can help in the multifactorial assessment of risk of falling.
International Journal of Scientific Research in Science and Technology, 2020
Background and Purpose: Balance is controlled through a complex process involving sensory, visual, vestibular and cerebral functioning which get affected by various neurological disorders such as fall. The purpose of the study was to compare the efficiency of three different balance training strategies in an effort to understand the mechanisms underlying training-related changes in dual task balance performance of older adults with balance impairment. Methods: 45 older adults with balance impairment were recruited and randomly assigned to three groups. Group one received single task balance training, group two received dual task training balance training under fixed priority, group three received dual task balance training under variable priority. Subjects received one-hour individualized training sessions, five times in a week for two weeks. Berg balance scale and time up and go test were the outcome measure and their scores for all groups were taken prior and after the training. Results: One-way analysis of variance was used to analyse the difference among the balance improvement in Group one, two and three. And the results revealed that post intervention scores were highly significant (p£ 0.05) in group two and group three performed better than group one. Conclusion: In conclusion, dual task training is effective in improving balance under dual task context in older adults with balance impairment, and single task training may not generalize to balance performance under dual task conditions.
Healthy older adults balance pattern under dual task conditions: exploring the strategy and trend
Health Promotion Perspectives, 2016
Background: In line with health promotion plans, early intervention and fall prevention in geriatric population, it is important to study healthy individuals balance mechanisms. The aim of this research was to investigate the effect of adding and removing visual input and dual task on elderly balance. Methods: Twenty healthy elderly recruited from four different senior citizen health club centers and from the University of Social Welfare and Rehabilitation Sciences (USWR) participated in this analytic cross-sectional study. At USWR's Motor Control Laboratory, the participants' postural sway were assessed using force plate in 4 distinct double leg standing conditions with and without presence of visual input and Stroop dual task. Postural and Stroop variables were compared. Results: Findings indicated that when the elderly encountered with either dual task or absence of visual input, they can still manage the situation in a way that changes in sway parameter would not become significant. But, when these two conditions occurred simultaneously, the participant's balance strategy fluctuated. Therefore, the mean velocity showed a significant difference between the "single quiet standing" condition and the condition of standing with eyes closed while the participants were answering Stroop dual task (Mean difference =-0.007, 95% CI =-0.012,-0.002). Conclusion: It appears that velocity parameter is sensitive to small changes, so it is recommended that researchers include this parameter in their future analyses. Balance in elderly can be manipulated by dual task and visual input deprivation.