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Dual-task training on a treadmill to improve gait and cognitive function in elderly idiopathic fallers
Moran Dorfman1, Talia Herman, Marina Brozgol
1Laboratory for Gait & Neurodynamics, Movement Disorders Unit, Department of Neurology, The Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel (M.D., T.H., M.B., S.S., A.W., J.M.H., A.M.); School of Health Related Professions, Ben Gurion University, Beer Sheba, Israel (M.D.); Department of Physical Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel (J.M.H.); Harvard Medical School, Boston, Massachusetts (J.M.H.); and Sagol School of Neuroscience, Tel Aviv University, Tel-Aviv, Israel (J.M.H.).
Background And Purpose:
Daily activities require the ability to dual task (DT), utilizing cognitive resources while walking to negotiate complex environmental conditions. For older adults, these additional cognitive demands often lead to reduced gait quality that increases the risk of falls. The aim of this study was to assess whether a combined intervention, consisting of treadmill training (TT) while performing DT, improves cognitive and motor performance in older adults with a history of multiple falls.
Methods:
A repeated measures design was used to evaluate the effects of training in 10 elderly fallers (mean age, 78.1 ± 5.81 y, 7 women). The progressive intensive training sessions included walking on a treadmill while practicing a variety of dual tasks 3 times a week for more than 6 weeks. Cognitive and motor measures were used to assess the effects of the intervention immediately after training and 1 month posttraining.
Results:
Improvements were observed in Berg Balance Scale (P = 0.02), Dynamic Gait Index (P = 0.03), gait speed during usual walking and while DT (P < 0.05), and cognitive performance as measured by the Trails Making Test B (P = 0.02). Furthermore, quality of life improved (SF-36: P = 0.01) as did physical activity (Physical Activity Scale for Elderly: P = 0.02). At 1 month postintervention, changes were not significant.
Discussion And Conclusions:
After 6 weeks of TT + DT program, elderly fallers demonstrated improved scores on tests of mobility, functional performance tasks, and cognition.Dual task training can be readily implemented by therapists as a component of a fall-risk reduction training program.Video Abstract available. See Video (Supplemental Digital Content 1, http://links.lww.com/JNPT/A81) for more insights from the authors.
