The Effect of 2 Types of Dual-Task Training on the Balance of Older Adults: Allocated Attention Ability

Objectives The inability to allocate attention to balance when performing concurrent tasks may cause the older adults to fall. Therefore, thisstudy aimed to investigate the effect of 2 types of dual-task training on the balance of older adults. Methods & Materials This quasi-experimental study included 36 eligible older adults (aged > 65 years) living in Kerman City, Iran. The selected participants were randomly divided into 3 groups based on the Berg balance scale scores, and each group consisted of 12 older adults. Our training groups comprised dual-task group under fixed priority, dual-task group under variable priority balance training, and control group. The experimental groups received 45-minute individualized training session, 3 times a week for 1 month (4 weeks). The training comprised of 3 kinds of activities: standing, transferring, and walking. The training was administered based on 2 principles of difficulty of moving task and individual's safety as well as corresponding with the classification of Gentile's moving task. We used the Berg balance test and sitting and walking times test for 2 conditions of single and dual tasks to evaluate balance in older people. For data analysis, we performed analysis of covariance and Bonferroni post hoc test. Results It was found that there were significant differences (P <= 0.05) between the control group and dual-task groups with fixed and variable priorities with regard to the balance performance test and the time of walking and sitting under single-task condition. In other words, 2 dual-task groups had better performance than the control group. However, no significant difference was seen between the 2 training groups of dual-task (P>0.05) with fixed and variable priorities in the test of the single-task condition. Moreover, the results of tests of sitting and walking time under dual-task condition showed significant differences between the control group and the dual-task groups with fixed or variable priorities and also between the 2 dual-task training groups with fixed and variable priorities (P <= 0.05). Conclusion The superiority of training with dual-task over single one and the superiority of dual-task training with variable priority over the fixed one (under dual-task condition) may be due to the "limited capacity of attention" theory, which explains the reduction in performance when performing imultaneous tasks. This difference and dominance may also be explained by other mechanisms, such as the capability of attention and focus on doing tasks simultaneously, involved in this process. Therefore, by designing balance training based on dual-task methods, especially training based on the ability to turn the focus of cognitive capabilities and their suitable allocation, the attention to these tasks improves and consequently, the risk of falling decreases in the older adults.