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Effects of single-task versus dual-task training on balance performance in older adults: a double-blind, randomized controlled trial.

Abstract：

OBJECTIVE:To compare the effect of 3 different approaches to balance training on dual-task balance performance in older adults with balance impairment. DESIGN:A double-blind, randomized controlled trial. SETTING:University research laboratory. PARTICIPANTS:Older adults (N=23) with balance impairment (mean age, 74.8y). They scored 52 or less on the Berg Balance Scale (BBS) and/or walked with a self-selected gait speed of 1.1m/s or less. INTERVENTIONS:Participants were randomly assigned to 1 of 3 interventions: single-task training, dual-task training with fixed-priority instructions, and dual-task training with variable-priority instructions. Participants received 45-minute individualized training sessions, 3 times a week for 4 weeks. MAIN OUTCOME MEASURES:Gait speed under single-task and dual-task conditions was obtained at baseline, the second week, the end of training, and the twelfth week after the end of training. Other measures, including the BBS and the Activities-specific Balance Confidence (ABC) Scale, were collected at baseline and after training. RESULTS:Participants in all groups improved on the BBS (P<.001; effect size [ES]=.72), and walked significantly faster after training (P=.02; ES=.27). When a cognitive task was added, however, only participants who received dual-task training with fixed-priority instructions and dual-task training with variable-priority instructions exhibited significant improvements in gait speed (P<.001, ES=.57; and P<.001, ES=.46, respectively). In addition, only the dual-task training with variable-priority instructions group demonstrated a dual-task training effect at the second week of training and maintained the training effect at the 12-week follow-up. Only the single-task training group showed a significant increase on the ABC after training (P<.001; ES=.61). CONCLUSIONS:Dual-task training is effective in improving gait speed under dual-task conditions in elderly participants with balance impairment. Training balance under single-task conditions may not generalize to balance control during dual-task contexts. Explicit instruction regarding attentional focus is an important factor contributing to the rate of learning and the retention of the dual-task training effect.

journal_name

Arch Phys Med Rehabil

journal_title

Archives of physical medicine and rehabilitation

authors

Silsupadol P,Shumway-Cook A,Lugade V,van Donkelaar P,Chou LS,Mayr U,Woollacott MH

doi

10.1016/j.apmr.2008.09.559

subject

Has Abstract

pub_date

2009-03-01 00:00:00

pages

381-7

issue

eissn

0003-9993

issn

1532-821X

pii

S0003-9993(08)01675-4

journal_volume

pub_type

杂志文章,随机对照试验

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Effects of single-task versus dual-task training on balance performance in older adults: a double-blind, randomized controlled trial.