Effects of Dual-Task Management and Resistance Training on Gait Performance in Older Individuals: A Randomized Controlled Trial

Abstract

Background: Dual-task (DT) training is a well-accepted modality for fall prevention in older adults. DT training should include task-managing strategies such as task switching or task prioritization to improve gait performance under DT conditions.Methods: We conducted a randomized controlled trial to evaluate a balance and task managing training (BDT group) in gait performance compared to a single task (ST) strength and resistance training and a control group, which received no training. A total of 78 older individuals (72.0 ± 4.9 years) participated in this study. The DT group performed task managing training incorporating balance and coordination tasks while the ST group performed resistance training only. Training consisted of 12 weekly sessions, 60 min each, for 12 weeks. We assessed the effects of ST and BDT training on walking performance under ST and DT conditions in independent living elderly adults. ST and DT walking (visual verbal Stroop task) were measured utilizing a treadmill at self-selected walking speed (mean for all groups: 4.4 ± 1 km h-1). Specific gait variables, cognitive performance, and fear of falling were compared between all groups.>Results: Training improved gait performance for step length (p < 0.001) and gait-line (ST: p < 0.01; DT p < 0.05) in both training groups. The BDT training group showed greater improvements in step length (p < 0.001) and gait-line (p < 0.01) during DT walking but did not have changes in cognitive performance. Both interventions reduced fear of falling (p < 0.05).Conclusion: Implementation of task management strategies into balance and strength training in our population revealed a promising modality to prevent falls in older individuals.Trial registration: German register of clinical trials DRKS00012382.

A Novel Dual-Task Balance Challenge to Prevent Falls in Older Adults: A Randomized Pilot Study

“…In this pilot study, participants in the MOB plus DTBC group had significant improvements in balance and gait, with less fear of falling post-intervention, when compared to baseline. Our findings are similar to other dual-task intervention studies conducted among older adults, reporting improvements in balance, [24,25] gait, [24,26,27] and less fear of falling [27]. Balance improvements among the participants in the MOB plus DTBC group indicated they had a better ability to maintain their balance as their body moved and swayed while standing in a neutral position, with their eyes open (ankle sway) and eyes closed (hip sway and anteroposterior center of mass).…”

Complexity: A Novel Load Progression Strategy in Strength Training

“…Other resources used less frequently in studies, but not less effective in increasing complexity, are (1) the unilateral or alternating execution of exercises, which increases the coordination level, also providing changes in the activation pattern of trunk stabilizer muscles (Behm et al, 2005), (2) the execution of double task exercises, increasing the technical difficulty because the attentional focus is directed from the physical to a cognitive task (Silsupadol et al, 2009; Wollesen et al, 2017), (3) the performance of exercises with non-cyclical patterns of movement (e.g., Olympic style weightlifting), which elevates the level of coordination and improves motor control (Hedrik and Wada, 2008), and (4) exercises with visual deprivation, which increases the need for proprioception (somatosensory system) and contributes to the increase in the acute strength performance (Maior et al, 2007).…”

The Impact of 12-Week Jaques-Dalcroze Eurhythmics Programme on the Dynamic Agility in Single-Dual-Task Conditions in Older Women: A Randomized Controlled Trial

“…It has been shown that the difference in the quality of single-task (ST) performance compared to DT is significantly related to cognitive functions [13] and the risk of falls in elderly people [14,15]. Positive effects of multitasking training involving motor and cognitive functions have been demonstrated in both healthy individuals [16,17] and those with osteoporosis [18] and Parkinson's disease [19]. At the same time, some studies indicate a lack of improvement in both the physical and cognitive spheres under the influence of DT training [20].…”