Effects of Dual-Task Training on Gait Ability in Older Adults with Mild Cognitive Impairment: A Randomized Controlled...

Older adults with mild cognitive impairment (MCI) often show gait impairment during dual-task walking and obstacle negotiation. This assessor-blinded randomized controlled trial investigated whether dual-task gait training with visual adaptation, added to a general exercise program, improves gait and related functional outcomes in older adults with MCI. Forty participants aged 65 years or older who met the MCI criteria were randomly allocated to a dual-task gait training with visual adaptation group or a control group (n = 20 each). Spatiotemporal and adaptive gait parameters were assessed before and after 4 weeks of intervention during level walking and during predictable and unpredictable obstacle negotiation under light and noise conditions. Balance, executive function, and concern about falling were also evaluated. Compared with the control group, the intervention group showed greater improvements in level walking and predictable obstacle negotiation, including longer step and stride length, shorter step and stride time, higher cadence, and faster gait speed. Under unpredictable obstacle conditions, gains were more selective and were observed mainly in step and stride length and adaptive gait indices. The intervention group also showed greater improvement in balance and executive function and a larger reduction in concern about falling. These findings suggest that adding dual-task gait training with visual adaptation to a general exercise program may have clinical value for improving adaptive gait and related functional outcomes in older adults with MCI. However, because the intervention group received additional gait-specific training and a higher total training dose than the control group, future dose-matched studies are needed to clarify the specific contribution of visual adaptation.