The effectiveness of postural control training under dual task conditions with graded sensory context in older adults at risk for fall

Abstract

Background: Fall prevention programs commonly address sensorimotor systems under single task conditions. Older adults are at risk of fall under dual task conditions that are inevitable in daily activities. Research is required to determine if, postural control training under dual task conditions is effective in decreasing falls, and risk factors for falls. Objectives: To determine if postural control training under dual task conditions in older adults (1) decreases falls and fall risk in older adults as compared to conventional exercises, (2) is influenced by the nature of the secondary task used in training and (3) newlineis influenced by the sensory context in which training is done. Methods: The sample consisted of 93 older adults aged over 60 years identified as at risk of fall and consenting to participate in the study. The participants were randomly assigned to the control Group-A (conventional exercises under single task conditions, n = 23) and experimental groups (postural control training under dual task conditions with a secondary task), Group-B (manual tasks, n = 24), Group-C (manual-cognitive tasks, n = 23), Group-D (manual-cognitive tasks in a graded sensory context, n = 23). The participants were assessed for physical risk factors (balance, gait, functional mobility under single and dual task conditions, automaticity of functional mobility) and psychological risk factors (fear of fall and depression) at baseline (Pre-assessment), and following ten training sessions (Post-assessment-I). After three months, Postassessment- newlineII was done and the participant s adherence to home program, fall or near fall events were recorded. Results: The study groups were equivalent with respect to socio-demographic characteristics, number of falls in the previous year, and baseline performance on tests of physical and psychological risk factors for falls. At Post-assessment-I, as compared to the control group, the experimental groups demonstrated significant improvements in some physical risk factors (static balance and gait