Effect of Single and Dual Task Balance Training with Fixed and Variable Priority on Gait Speed, Cognitive Function and Fear of Falling in Older Adults

Document Type : Original Article

Authors

1 Department of Sports Management and Motor Behavior, Faculty of Sports Sciences, Shahid Bahonar University of Kerman, Kerman, Iran;

2 Department of Sport Management and Motor Behavior, Faculty of Sport Sciences, Ferdowsi University of Mashhad, Mashhad, Iran.

3 Department of Motor Behavior, Faculty of Sport Sciences, Alzahra University, Tehran, Iran.

4 MS in Motor Behavior, Tehran, Iran.

Abstract

Purpose: The aim of this study was to investigate the effects of single and dual-task training with fixed and variable priority on gait speed, cognitive performance, and fear of falling in older adults.
Methods: Forty-eight older adults aged over 65 years from Kerman city, were randomly assigned to four 12-per Forty-eight older adults (aged over 65 years) from Kerman city were randomly assigned to one of four groups (dual-task with fixed priority, dual-task with variable priority, single-task, and control). The experimental groups performed standing, transfer, and walking exercises over a four-week period (three sessions per week). Dependent variables were assessed using the Timed Up and Go (TUG) test under single- and dual-task conditions, a serial reaction time task, and the Falls Efficacy Scale (FES).
Results: Analysis of covariance revealed that all three experimental groups showed significant improvements across most measures compared to the control group (P< 0.05). Furthermore, the dual-task groups (both fixed and variable priority) demonstrated superior outcomes to the single-task group in most assessments, except for the single-task TUG condition and fear of falling (P< 0.05).
Conclusion: Both single- and dual-task balance training enhance motor and cognitive performance in older adults. This approach promotes faster information processing and reduces interference between concurrent tasks. Increasing the variability of prioritization in elderly exercise programs improves balance, coordination, and the transfer of skills to daily activities.
 

Keywords

References

  1. Khan K, Ghous M, Malik AN, Amjad MI, Tariq I. Effects of turning and cognitive training in fall prevention with dual task training in elderly with balance impairment. Rawal Medical Journal. 2018;43(1):124-8.
  2. Silsupadol P, Shumway-Cook A, Lugade V, van Donkelaar P, Chou L-S, Mayr U, et al. Effects of single-task versus dual-task training on balance performance in older adults: a double-blind, randomized controlled trial. Archives of physical medicine and rehabilitation. 2009;90(3):381-7.

https://doi.org/10.1016/j.apmr.2008.09.559

  1. Lampit A, Hallock H, Valenzuela M. Computerized cognitive training in cognitively healthy older adults: a systematic review and meta-analysis of effect modifiers. PLoS medicine.2014;11(11):e1001756. https://doi.org/10.1371/journal.pmed.1001756
  2. Balci La, Soğukkanli K, Burcu S, Hanoğlu L. Effects of single-task, dual-task and successive physical-cognitive training on fall risk and balance performance in older adults: a randomized trial. Journal of Exercise Therapy and Rehabilitation. 2022;9(1):1-11.

https://doi.org/10.15437/jetr.675975

  1. Schoene D, Heller C, Aung YN, Sieber CC, Kemmler W, Freiberger E. A systematic review on the influence of fear of falling on quality of life in older people: is there a role for falls? Clinical interventions in aging. 2019:701-19. https://doi.org/10.2147/CIA.S197857
  2. Iranmanesh, H., Arab Ameri, E., Farrokhi, A., Iranmanesh, H. The effect of Single Task and Dual Task Balance Training on the Balance of Older Adults. Journal of Sports and Motor Development and Learning, 2014; 6(2): 195-215. In Persian

https://doi.org/10.22059/jmlm.2014.50457

  1. Silsupadol P, Lugade V, Shumway-Cook A, van Donkelaar P, Chou L-S, Mayr U, et Training-related changes in dual-task walking performance of elderly persons with balance impairment: a double-blind, randomized controlled trial. Gait & posture. 2009;29(4):634-9.

https://doi.org/10.1016/j.gaitpost.2009.01.006

  1. Lövdén M, Bäckman L, Lindenberger U, Schaefer S, Schmiedek F. A theoretical framework for the study of adult cognitive plasticity. Psychological bulletin. 2010;136(4):659.

https://doi.org/ 10.1037/a0020080

  1. Assariparambil AR, Noronha JA, George A. Effectiveness of comprehensive cognitive and balance training strategies (CCBTS) on gait, balance, quality of life, and fall-related self-efficacy among institutionalized elderly in Udupi District: A mixed-method study protocol. F1000Research. 2022; 11:460.

https://doi.org/10.12688/f1000research.110462.1

  1. Nascimento MdM, Maduro PA, Rios PMB, Nascimento LdS, Silva CN, Kliegel M, et al. The Effects of 12-Week Dual-Task Physical–Cognitive Training on Gait, Balance, Lower Extremity Muscle Strength, and Cognition in Older Adult Women: A Randomized Study. International Journal of Environmental Research and Public Health. 2023;20(8):5498.

https://doi.org/ 10.3390/ijerph20085498

  1. Manor B, Zhou J, Harrison R, Lo O-Y, Travison TG, Hausdorff JM, et al. Transcranial direct current stimulation may improve cognitive-motor function in functionally limited older adults. Neurorehabilitation and neural repair. 2018;32(9):788-98

https://doi.org/10.1177/1545968318792616

  1. Yuzlu V, Oguz S, Timurtas E, Aykutoglu E, Polat MG. The Effect of 2 Different Dual-Task Balance Training Methods on Balance and Gait in Older Adults: A Randomized Controlled Trial. Physical therapy. 2022;102(3): pzab298.

https://doi.org/10.1093/ptj/pzab298

  1. Trombini-Souza F, de Moura VTG, da Silva LWN, dos Santos Leal I, Nascimento CA, Silva PST, et al. Effects of two different dual-task training protocols on gait, balance, and cognitive function in community-dwelling older adults: a 24-week randomized controlled trial. PeerJ. 2023;11: e15030.

https://doi.org/ 10.7717/peerj.15030

  1. Bayot M, Dujardin K, Tard C, Defebvre L, Bonnet CT, Allart E, et al. The interaction between cognition and motor control: A theoretical framework for dual-task interference effects on posture, gait initiation, gait and turning. Neurophysiologie Clinique. 2018;48(6):361-75.

https://doi.org/10.1016/j.neucli.2018.10.003

  1. Bayatlu A, Salavati M, Akhbari B. Comparison the allocated attention in walking and motor and cognitive dual task in older adults with and without background of falling. Iranian Journal of Ageing. 2010;5(4):14-20. In Persian
  2. Silsupadol P, Siu K-C, Shumway-Cook A, Woollacott MH. Training of balance under single-and dual-task conditions in older adults with balance impairment. Physical therapy. 2006;86(2):269-81. https://doi.org/10.1093/ptj/86.2.269
  3. Wollesen B, Wanstrath M, Van Schooten K, Delbaere K. A taxonomy of cognitive tasks to evaluate cognitive-motor interference on spatiotemoporal gait parameters in older people: a systematic review and meta-analysis. European review of aging and physical activity. 2019;16(1):1-27.

https://doi.org/10.1186/s11556-019-0218-1

  1. Plummer P, Zukowski LA, Giuliani C, Hall AM, Zurakowski D. Effects of physical exercise interventions on gait-related dual-task interference in older adults: a systematic review and meta-analysis. Gerontology. 2015;62(1):94-117. https://doi.org/1159/000371577
  2. Montero-Odasso M, Almeida QJ, Burhan AM, Camicioli R, Doyon J, Fraser S, et al. SYNERGIC TRIAL (SYNchronizing Exercises, Remedies in Gait and Cognition) a multi-Centre randomized controlled double-blind trial to improve gait and cognition in mild cognitive impairment. BMC geriatrics. 2018;18(1):1-15.

https://doi.org/ 10.1186/s12877-018-0782-7.

  1. Buragadda S, Alyaemni A, Melam GR, Alghamdi MA. Effect of dualtask training (fixed priority-versus-variable priority) for improving balance in older adults. World Appl Sci J. 2012;20(6):884-8.

https://doi.org/10.5829/idosi.wasj.2012.20.06.71190

  1. Gobbo S, Bergamin M, Sieverdes JC, Ermolao A, Zaccaria M. Effects of exercise on dual-task ability and balance in older adults: a systematic review. Archives of gerontology and geriatrics. 2014;58(2):177-87.

https://doi.org/10.1016/j.archger.2013.10.001

  1. Lussier M, Bugaiska A, Bherer L. Specific transfer effects following variable priority dual-task training in older adults. Restorative Neurology and Neuroscience. 2017;35(2):237-50.

https://doi.org/ 10.3233/RNN-150581

  1. Cassavaugh ND, Kramer AF. Transfer of computer-based training to simulated driving in older adults. Applied ergonomics. 2009;40(5):943-52

https://doi.org/10.1016/j.apergo.2009.02.001

  1. Lussier M, Brouillard P, Bherer L. Limited benefits of heterogeneous dual-task training on transfer effects in older adults. Journals of Gerontology Series B: Psychological Sciences and Social Sciences. 2017;72(5):801-12.

 https://doi.org/10.1093/geronb/gbv105

  1. Xiao Y, Yang T, Shang H. The Impact of Motor-Cognitive Dual-Task Training on Physical and Cognitive Functions in Parkinson’s Disease. Brain Sciences. 2023;13(3):437.

https://doi.org/10.3390/brainsci13030437

  1. Ghai S, Ghai I, Effenberg AO. Effects of dual tasks and dual-task training on postural stability: a systematic review and meta-analysis. Clinical interventions in aging. 2017; 557-577.

https://doi.org/10.2147/CIA.S125201

  1. Green CS, Bavelier D. Exercising your brain: a review of human brain plasticity and training-induced learning. Psychology and aging. 2008;23(4):692.

https://doi.org/ 10.1037/a0014345

  1. Bier B, de Boysson C, Belleville S. Identifying training modalities to improve multitasking in older adults. Age. 2014; 36:1-16.

https://doi.org/10.1007/s11357-014-9688-2

  1. Amboni M, Barone P, Hausdorff JM. Cognitive contributions to gait and falls: evidence and implications. Movement disorders. 2013;28(11):1520-33.

https://doi.org/10.1002/mds.25674

  1. Salavati M, Negahban H, Mazaheri M, Soleimanifar M, Hadadi M, Sefiddashti L, et al. The Persian version of the berg balance scale: Inter and intra-rater reliability and construct validity in elderly adults. Disability and rehabilitation. 2012;34(20):1695-8. In Persian https://doi.org/3109/09638288.2012.660604
  2. Lam WK, Maxwell JP, Masters R. Analogy learning and the performance of motor skills under pressure. Journal of Sport and Exercise Psychology. 2009;31(3):337-57.

https://doi.org/ 10.1123/jsep.31.3.337

  1. Iranmanesh H, Kakhki AS, Taheri H, Shea CH. Motor memory consolidation in children: The role of awareness and sleep on offline general and sequence-specific learning. Biomedical Human Kinetics. 2022;14(1):83-94. https://doi.org/ 2478/bhk-2022-0011
  2. Yardley L, Donovan-Hall M, Francis K, Todd C. Older people's views of advice about falls prevention: a qualitative study. Health education research. 2006;21(4):508-17.

https://doi.org/10.1093/her/cyh077

  1. Mostamand J, Shafizadegan Z, Tarrahi MJ, Hosseini ZS. Comparing the effect of kinesiology taping on dynamic balance and pain of men and women with unilateral patellofemoral pain syndrome. Archives of Rehabilitation. 2020;21(4):470-87. In Persian https://doi.org/32598/RJ.21.4.3071.1
  2. Trombini-Souza F, Nogueira RTdSA, Serafim ACB, Lima TMMd, Xavier MKA, Perracini MR, et al. Concern about falling, confidence in balance, quality of life, and depression symptoms in community-dwelling older adults after a 24-week dual-task training with variable and fixed priority: A randomized controlled trial. Research on Aging. 2022;44(9-10):658-68.

https://doi.org/10.1177/01640275221073993

  1. Cadore EL, Casas-Herrero A, Zambom-Ferraresi F, Idoate F, Millor N, Gómez M, et al. Multicomponent exercises including muscle power training enhance muscle mass, power output, and functional outcomes in institutionalized frail nonagenarians. Age. 2014; 36:773-85.

https://doi.org/10.1007/s11357-013-9586-z

  1. Gopher D, Kramer A, Wiegmann D, Kirlik A. Emphasis change as a training protocol for high-demand tasks. Attention: From theory to practice. 2007; 101:209-24.

https://doi.org/10.1093/acprof:oso/9780195305722.003.0015

  1. Makizako H, Doi T, Shimada H, Yoshida D, Tsutsumimoto K, Uemura K, et al. Does a multicomponent exercise program improve dual-task performance in amnestic mild cognitive impairment? A randomized controlled trial. Aging clinical and experimental research. 2012 Dec;24(6):640-6. https://doi.org/10.3275/8760
  2. Mirelman A, Maidan I, Herman T, Deutsch JE, Giladi N, Hausdorff JM. Virtual reality for gait training: can it induce motor learning to enhance complex walking and reduce fall risk in patients with Parkinson's disease? Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences. 2011;66(2):234-40

https://doi.org/10.1093/gerona/glq201

  1. Goh H-T, Pearce M, Vas A. Task matters: an investigation on the effect of different secondary tasks on dual-task gait in older adults. BMC geriatrics. 2021;21(1):1-12. https://doi.org/1186/s12877-021-02464-8
  2. Smith E, Cusack T, Cunningham C, Blake C. The influence of a cognitive dual task on the gait parameters of healthy older adults: a systematic review and meta-analysis. Journal of aging and physical activity. 2017;25(4):671-86. https://doi.org/10.1123/japa.2016-0265.
  3. Hawley JA. Specificity of training adaptation: time for a rethink? The journal of physiology. 2008;586(Pt1):1.https://doi.org/1113/jphysiol.2007.147397
  4. Mirelman A, Herman T, Brozgol M, Dorfman M, Sprecher E, Schweiger A, et al. Executive function and falls in older adults: new findings from a five-year perspective study link fall risk to cognition. PloS one. 2012;7(6): e40297.

https://doi.org/10.1371/journal.pone.0040297

  1. Mirelman A, Rochester L, Maidan I, Del Din S, Alcock L, Nieuwhof F, et al. Addition of a non-immersive virtual reality component to treadmill training to reduce fall risk in older adults (V-TIME): a randomised controlled trial. The Lancet. 2016;388(10050):1170-82.

http://dx.doi.org/10.1016/S0140-6736(16)31325-3

  1. Liu-Ambrose T, Nagamatsu LS, Graf P, Beattie BL, Ashe MC, Handy TC. Resistance training and executive functions: a 12-month randomized controlled trial. Archives of internal medicine. 2010;170(2):170-8.

https://doi.org/10.1001/archinternmed.2009.494

  1. Muir-Hunter S, Wittwer J. Dual-task testing to predict falls in community-dwelling older adults: a systematic review. Physiotherapy. 2016;102(1):29-40.

https://doi.org/10.1016/j.physio.2015.04.011

  1. Sengar S, Raghav D, Verma M, Alghadir AH, Iqbal A. Efficacy of dual-task training with two different priorities instructional sets on gait parameters in patients with chronic stroke. Neuropsychiatric disease and treatment. 2019:2959-69. https://doi.org/10.2147/NDT.S197632
  2. Iranmanesh H, Arab Ameri E, Sheykh M, Iranmanesh H. The Effect of 2 Types of Dual-Task Training on the Balance of Older Adults: Allocated Attention Ability. Salmand: Iranian Journal of Ageing 2016; 11 (1) :30-43. In Persian

http://dx.doi.org/10.21859/sija-110130

Sports Psychology
Volume 16, Issue 2
2024
Pages 325-350

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History

  • Receive Date: 29 December 2023
  • Revise Date: 02 August 2024
  • Accept Date: 11 September 2024

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