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A Systematic Review Exploring the Theories Underlying the Improvement of Balance and Reduction in Falls Following Dual-Task Training among Older Adults

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  • Mohammad Jobair Khan

    (Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong 999077, China)

  • Priya Kannan

    (Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong 999077, China)

  • Thomson Wai-Lung Wong

    (Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong 999077, China)

  • Kenneth N. K. Fong

    (Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong 999077, China)

  • Stanley John Winser

    (Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong 999077, China)

Abstract

Background: Balance impairment causes frequent falls in older adults, and preventing falls remains challenging. Dual-task (DT) training reduces falls by improving balance, but the precise theory is not fully understood. This review aims to explore the theories underlying the effectiveness of DT in improving balance and reducing falls in older adults. Methods: Eleven electronic databases were searched from database inception to June 2022. Two reviewers independently performed study screening and data extraction. The risk of bias (RoB) in the included studies was assessed using the Cochrane Collaboration RoB 2 tool. Results: The searches yielded 1478 citations, of which 30 studies met the inclusion criteria and were included in the review. Twenty-two of the 30 included studies utilized the motor-cognitive type of DT for training, while six used motor-motor and two utilized cognitive–cognitive DT. The included studies reported 20 different theories to explain the effectiveness of DT for improving balance and reducing falls in older adults. The predominant theory identified in the included studies was attention theory ( n = 14). Overall, 26 studies reported improved balance and five studies found a reduction in fall incidence following DT training. Balance and falls improved significantly in 15 motor-cognitive DT intervention studies. Conclusion: Attention shifting between two tasks is reported to occur following DT training. Motor-cognitive DT training improves balance and reduces fall incidence in older adults by shifting attention based on the difficulty and priority of a task from the motor to the cognitive task.

Suggested Citation

  • Mohammad Jobair Khan & Priya Kannan & Thomson Wai-Lung Wong & Kenneth N. K. Fong & Stanley John Winser, 2022. "A Systematic Review Exploring the Theories Underlying the Improvement of Balance and Reduction in Falls Following Dual-Task Training among Older Adults," IJERPH, MDPI, vol. 19(24), pages 1-33, December.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:24:p:16890-:d:1004989
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    References listed on IDEAS

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    1. Regina R. Buccello-Stout & Jacob J. Bloomberg & Helen S. Cohen & Elbert B. Whorton & Gayle D. Weaver & Ronita L. Cromwell, 2008. "Effects of Sensorimotor Adaptation Training on Functional Mobility in Older Adults," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 63(5), pages 295-300.
    2. Kochaphan Phirom & Teerawat Kamnardsiri & Somporn Sungkarat, 2020. "Beneficial Effects of Interactive Physical-Cognitive Game-Based Training on Fall Risk and Cognitive Performance of Older Adults," IJERPH, MDPI, vol. 17(17), pages 1-12, August.
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