title: Home-based interventions improve trained, but not novel, dual-task balance performance in older adults: A randomized controlled trial.
abstract: The purpose of this study was to compare the efficacy of four different home-based interventions on dual-task balance performance and to determine the generalizability of the four trainings to untrained tasks. Sixty older adults, aged 65 and older, were randomly assigned to one of four home-based interventions: single-task motor training, single-task cognitive training, dual-task motor-cognitive training, and dual-task cognitive-cognitive training. Participants received 60-min individualized training sessions, 3 times a week for 4 weeks. Prior to and following the training program, participants were asked to walk under two single-task conditions (i.e. narrow walking and obstacle crossing) and two dual-task conditions (i.e. a trained narrow walking while performing verbal fluency task and an untrained obstacle crossing while counting backward by 3s task). A nine-camera motion capture system was used to collect the trajectories of 32 reflective markers placed on bony landmarks of participants. Three-dimensional kinematics of the whole body center of mass and base of support were computed. Results from the extrapolated center of mass displacement indicated that motor-cognitive training was more effective than the single-task motor training to improve dual-task balance performance (p=0.04, ES=0.11). Interestingly, balance performance under both single-task and dual-task conditions can also be improved through a non-motor, single-task cognitive training program (p=0.01, ES=0.13, and p=0.01, ES=0.11, respectively). However, improved dual-task processing skills during training were not transferred to the novel dual task (p=0.15, ES=0.09). This is the first study demonstrating that home-based dual-task training can be effectively implemented to improve balance performance during gait in older adults.
authors.affiliation: Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand.
authors.forename: Suleeporn
authors.initials: S
authors.lastname: Wongcharoen
authors.affiliation: Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand.
authors.forename: Somporn
authors.initials: S
authors.lastname: Sungkarat
authors.affiliation: Department of Occupational Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand.
authors.forename: Peeraya
authors.initials: P
authors.lastname: Munkhetvit
authors.affiliation: Whitaker International Program, New York, USA.
authors.forename: Vipul
authors.initials: V
authors.lastname: Lugade
authors.affiliation: Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand. Electronic address: psilsupa@gmail.com.
authors.forename: Patima
authors.initials: P
authors.lastname: Silsupadol
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D005260:Female; D005684:Gait; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D019636:Neurodegenerative Diseases / Q000503:physiopathology* / Q000534:rehabilitation; D026741:Physical Therapy Modalities; D004856:Postural Balance; D013647:Task Performance and Analysis; D016896:Treatment Outcome; D016138:Walking
keywords: Aging; Cognition; Dual task; Gait; Home-based training