Comparing the Effects of Single-Task versus Dual-Task Balance Training on Gait Smoothness and Functional Balance in Community-Dwelling Older Adults: A Randomized Controlled Trial

Abstract

To compare the effects of single- versus dual-task balance training on the gait smoothness and balance of community-dwelling older adults, 69 volunteers were randomized to single-, dual-task training, and control (no intervention) groups. Exercises were received in 18 sessions through 6 weeks. The gait smoothness was measured by the harmonic ratio of trunk accelerations using a triaxial accelerometer. Balance performance was assessed through the Fullerton Advanced Balance scale, Timed Up and Go test, Activities-specific Balance Confidence, and gait speed. After the trial, all variables improved significantly in the training groups. Moreover, differences in the mean change of all variables, except the Timed Up and Go test, were statistically significant between the interventional groups and the control group, but no significant difference was reported between the two training groups. This study suggests that balance training can improve gait smoothness as well as balance status in healthy older adults.

A Systematic Review Exploring the Theories Underlying the Improvement of Balance and Reduction in Falls Following Dual-Task Training among Older Adults

“…The DT interventions delivered in the included studies were (1) motor-cognitive, (2) motor-motor, or (3) cognitive–cognitive DT, as reported in Table 1 . Among the 30 included studies, 22 studies [ 21 , 22 , 29 , 44 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 ] used motor-cognitive DT training, 6 [ 23 , 28 , 30 , 45 , 59 , 64 ] used a motor-motor type of task, and 2 [ 65 , 66 ] included cognitive exercise in both tasks.…”

“…Across the 30 included studies, different types of exercises were applied. Balance exercises appeared most frequently, as they were used in 12 studies [ 21 , 22 , 30 , 47 , 50 , 51 , 54 , 58 , 61 , 62 , 63 , 64 ]. Balance exercises were performed using free-hand, low-tech systems with minimal technology support or technology-dependent, computerized balance systems.…”

“…Thirteen of the 30 included studies [ 21 , 23 , 30 , 45 , 47 , 50 , 51 , 52 , 54 , 64 , 65 , 66 , 67 ] employed passive comparators instructing participants to either follow the fall prevention booklet ( n = 1), continue with routine care ( n = 3), or receive no intervention ( n = 9). One study did not specifically report pre- and post-assessment time [ 44 ].…”

“…Balance was assessed in 25 studies [ 21 , 22 , 23 , 28 , 29 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 52 , 53 , 54 , 55 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 ]. Almost 30% of the studies employed the BBS [ 23 , 28 , 50 , 51 , 55 , 58 , 59 , 63 , 66 ], while six [ 45 , 49 , 52 , 60 , 62 , 65 ] used the TUG scale, and both scales were utilized in three studies [ 46 , 47 , 61 ].…”

“…Over the past two decades, there has been a growing literature [ 21 , 22 , 23 ] on DT training, which entails the concurrent performance of a primary and a secondary task [ 19 ]. Initial attempts at performing DT are challenging, as it involves responding to two stimuli [ 24 ]: The primary task corresponds to the first delivered stimulus, whereas the secondary task corresponds to the second stimulus [ 24 ].…”