Dual-task interference of reactive stepping kinematics for balance recovery strategies in older adults

Objective: To characterize the interference of reactive stepping kinematics related to the increase or maintenance of the number of steps in response to a large perturbation during dual tasks among older adults. Methods: This was a cross-sectional study that included 52 community-dwelling healthy older adults. Reactive stepping performance was analyzed after forward balance loss during a single task and a second cognitive task. The number of steps taken to recover balance and dual-task interference (DTI) for muscular onset latency, anteroposterior (AP) center of pressure (COP) displacement and velocity before step initiation, and step temporal and spatial variables were measured. The DTI of the variables was compared between the participants who increased versus those who maintained the number of steps taken during the dual task relative to the single task. Results: Twenty-eight (53.8 %) participants increased their steps during dual tasks relative to a single task. In older adults, the AP COP peak velocity (P P < 0.001) and step length (P P < 0.001) were significantly worse during dual tasks than during a single task. However, this was not observed for older adults who did not increase their steps. The DTI for the AP COP peak velocity and step length were significantly larger for the older adults who increased their steps than those who did not (AP COP peak velocity; P = 0.044, step length; P = 0.003). Both groups showed a significant muscular onset delay during dual tasks than during a single task (P P < 0.001), and no significant differences were found between the groups. Conclusions: Our findings suggest that reactive stepping strategies in older adults after a large external perturbation during secondary cognitive tasks can be attributed to interference with COP control before step initiation and step length.