Original articleEffects of Single-Task Versus Dual-Task Training on Balance Performance in Older Adults: A Double-Blind, Randomized Controlled Trial
Section snippets
Participants
Fifty older adults with balance impairment were recruited through flyers in the local community. The 2-step eligibility process included an initial telephone interview screen for the following inclusion criteria: (1) age 65 years or older; (2) ability to walk 10m without the assistance of another person; (3) no neurologic or musculoskeletal diagnosis such as cerebral vascular accident, significant orthopedic involvement, or significant visual and auditory impairments; and (4) approval of their
Results
Fifty older adults were evaluated for potential enrollment (fig 1); 17 people did not meet the inclusion criteria. Of 33 people who may have been eligible, 10 declined to participate in the study. Twenty-three older adults who met the eligibility criteria and agreed to participate were randomly assigned to 1 of 3 training groups; 22 completed the training program (1 single-task balance training participant died; 1 variable-priority participant was excluded because of surgery just prior to
Discussion
This randomized controlled trial provides evidence that an individualized training program was effective in improving balance under single-task contexts in older adults with balance impairment. After the 4-week intervention program, participants in all training groups significantly improved performance on single-task gait speed and the BBS. In fact, 15 and 18, respectively, out of 21 older adults exceeded the boundaries of the MDC for the single-task gait speed (0.1m/s) and the BBS (3 points).
Conclusions
Dual-task training is effective in improving gait speed under dual-task contexts in elderly persons with impaired balance, and single-task training may not generalize to balance performance under dual-task conditions. The instructional set was an important contributing factor for improvement in dual-task performance. The variable-priority instructional set offered advantages over the fixed-priority instructional set in terms of the rate of learning and the ability to maintain the skill level
Acknowledgments
We thank Cooper Boydston, BS, for assistance with data collection. We acknowledge Charlene Halterman, MS, Teresa Hawkes, BFA, Chu-jui Chen, PT, MS, and Sujitra Boonyong, PT, MS, for their assistance with training sessions.
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Supported by the National Institutes of Health (grant no. AG 021598).
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.