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Updated: May 15, 2025
Motor Dual-Tasks for Gait Analysis and Evaluation in Post-Stroke Patients
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Effects of a 24-week dual-task training on postural control complexity during standing and walking in older adults:
Francis Trombini-Souza1, Iara Dos Santos Leal2, Júlia Gomes de Alencar2
1Department of Physical Therapy, University of Pernambuco, Petrolina, PE, Brazil; Master's and Doctoral Programs in Rehabilitation and Functional Performance, University of Pernambuco, Petrolina, PE, Brazil.
Background:
Functional decline in gait motor control and the capacity to maintain balance during upright standing posture in older adults is influenced by deterioration in the complexity of various physiological systems involved in these daily activities.
Research Question:
Is a 24-week dual-task protocol training, beginning with alternating cognitive demands and progressing to simultaneous dual-tasking, more effective than a control group training only with alternating dual tasks in improving the physiological complexity of postural control in older adults during upright standing posture under interoceptive and exteroceptive demands and gait under dual tasks?
Methods:
This randomized controlled trial enrolled 60 community-dwelling older adults of both sexes, aged between 60 and 80. The experimental group (EG; n = 30) underwent training with progression from alternating dual-task (ADT) to simultaneous dual task (SDT) during activities such as gait, and static and dynamic functional balance. The control group (CG; n = 30) only underwent the ADT protocol throughout the six months of training. The primary outcome of this study was the physiological complexity of gait under dual task calculated by the refined composite multiscale fuzzy entropy method for the anteroposterior (AP), mediolateral (ML), and vertical (V) directions. The outcomes were acquired at baseline (T1) and after 24 weeks of intervention (T2). The analyses were based on the intention-to-treat principle, using generalized linear mixed models (GLMM) with a significance level of 5 %.
Results:
No interaction or group effects were observed. However, both groups significantly improved body sway physiological complexity in the AP direction during gait under ST, ADT, and SDT and in the V direction under ADT and SDT. No change in complexity during upright standing posture under interoceptive and exteroceptive demand was significantly observed, regardless of the group.
Significance:
Regardless of the training protocol, both groups significantly improved the physiological complexity of gait under dual task.
