A systematic review of interventions conducted in clinical or community settings to improve dual-task postural control in older adults

Abstract

BackgroundInjury due to falls is a major problem among older adults. Decrements in dual-task postural control performance (simultaneously performing two tasks, at least one of which requires postural control) have been associated with an increased risk of falling. Evidence-based interventions that can be used in clinical or community settings to improve dual-task postural control may help to reduce this risk.PurposeThe aims of this systematic review are: 1) to identify clinical or community-based interventions that improved dual-task postural control among older adults; and 2) to identify the key elements of those interventions.Data sourcesStudies were obtained from a search conducted through October 2013 of the following electronic databases: PubMed, CINAHL, PsycINFO, and Web of Science.Study selectionRandomized and nonrandomized controlled studies examining the effects of interventions aimed at improving dual-task postural control among community-dwelling older adults were selected.Data extractionAll studies were evaluated based on methodological quality. Intervention characteristics including study purpose, study design, and sample size were identified, and effects of dual-task interventions on various postural control and cognitive outcomes were noted.Data synthesisTwenty-two studies fulfilled the selection criteria and were summarized in this review to identify characteristics of successful interventions.LimitationsThe ability to synthesize data was limited by the heterogeneity in participant characteristics, study designs, and outcome measures.ConclusionDual-task postural control can be modified by specific training. There was little evidence that single-task training transferred to dual-task postural control performance. Further investigation of dual-task training using standardized outcome measurements is needed.

Fear of falling and activities of daily living function: mediation effect of dual-task ability

“…Indeed, previous studies (Friedman et al, 2002;Mendes da Costa et al, 2012;Murphy et al, 2002) have reported that restriction in ADL affects about 46%-56% older adults with FOF, underlining the necessity of intervention programmes focused on decreasing FOF and increasing ADL ability. Physical intervention programmes may decrease the FOF (Brustio, Magistro, Ivaldi, Caglio, Rabaglietti, & Liubicich, 2015;Huang, Chung, Chen, Chin, & Wang, 2016;Sjosten, Vaapio, & Kivela, 2008;Zijlstra et al, 2005) and decrease the DTC (Agmon, Belza, Nguyen, Logsdon, & Kelly, 2014); thus, we hypothesised, based on our results, that interventions focused on decreasing FOF (e.g. physical or cognitive interventions) and DTC may have positive effects by maintaining or improving ADL functionality, which is linked with successful ageing.…”

Effects of feedback-based balance and core resistance training vs. Pilates training on balance and muscle function in older women: A randomized-controlled trial

“…The fact that the gains in postural control were more pronounced in dual-task conditions is particularly interesting, since dual balance task are ecologically more valid, and may have an added value over the single balance task for fall prediction (Bergland & Wyller, 2004;Verghese et al, 2002). Also, recent research synthesis indicates that dual-task training appears to be necessary to improve dualtask performance (Agmon, Belza, Nguyen, Logsdon, & Kelly, 2014). The applied Huber intervention was a dual-task since the subjects were required to precisely modulate force applied on the handles via hitting the target area on the screen (see Section 2).…”

Effects of Physical Exercise Interventions on Gait-Related Dual-Task Interference in Older Adults: A Systematic Review and Meta-Analysis

“…The importance of dual-task interference in older adults is evidenced by the growing number of systematic reviews addressing the topic [1,[6][7][8][9][10][11][12][13][14][15] , with 5 of these focusing specifically on treatment effects for dual-task gait and mobility [7-9, 13, 14] . The earliest of these reviews [9] examined the effects of cognitive and cognitive-motor interventions on physical functioning in older adults and adults with stroke or traumatic brain injury; however, the authors did not explicitly examine intervention effects on dual-task walking or dual-task interference.…”