Effects of a Multimodal Exercise Intervention on Single- and Dual-Task Gait Performance in Older Patients with...

Background/Objectives: To investigate the effects of a 12-week multimodal intervention (MMI [resistance + motor-cognitive dual-task training]) versus a unimodal intervention (UMI [resistance training]) on gait and cognitive performance in people with glaucoma during single-task (ST) and dual-task (DT) walking. Methods: In this randomized controlled pilot study, fifteen glaucoma patients (MMI: n = 8, UMI: n = 7) completed 24 supervised intervention sessions over 12 weeks. Spatio-temporal gait parameters (stride length, gait velocity, minimum toe clearance [MTC], and their respective coefficient of variance [CoV]) were assessed using inertial measurement units (sampling frequency 100 Hz) during ST and DT walking. During DT walking, the participants performed three cognitive tasks: reaction time task, N-Back task, and letter fluency task. Each cognitive task was performed with two levels of difficulty. Repeated measures analysis of covariance (TIME × INTERVENTION × CONDITION) was conducted to analyze the data. Results: No significant group or time effects were observed for ST walking or cognitive performance. Independent of intervention, dual-task costs (DTC) improved for MTC (p = 0.188, ηp2 = 0.205) and MTC_CoV (p = 0.021, ηp2 = 0.713) over time. UMI showed greater improvements over time than MMI for DTC MTC (p = 0.168, ηp2 = 0.223) and DTC MTC_CoV (p = 0.047, ηp2 = 0.407). Conclusions: This pilot study indicated that both MMI and UMI decreased DTC MTC and DTC MTCCoV in glaucoma patients, with probably higher effects after UMI. These preliminary findings must be interpreted with caution due to the small sample size, but the provided effect size measures and sample size calculations can be used for future randomized controlled trials to verify and extend these results.