Effects of dual-task balance training on postural performance in patients with Multiple Sclerosis: a double-blind, randomized controlled pilot trial

2016 ◽  
Vol 31 (2) ◽  
pp. 234-241 ◽  
Author(s):  
Saeideh Monjezi ◽  
Hossein Negahban ◽  
Shirin Tajali ◽  
Nava Yadollahpour ◽  
Nastaran Majdinasab
Keyword(s):  
Multiple Sclerosis ◽  
Dual Task ◽  
Pilot Trial ◽  
Balance Training ◽  
Berg Balance Scale ◽  
Timed Up And Go ◽  
Double Blind ◽  
Single Task ◽  
Task Training ◽  
Functional Gait

Objective: To investigate the effects of dual-task balance training on postural performance in patients with multiple sclerosis as compared with single-task balance training. Design: Double-blind, pretest-posttest, randomized controlled pilot trial. Setting: Local Multiple Sclerosis Society. Subjects: A total of 47 patients were randomly assigned to two equal groups labeled as single-task training and dual-task training groups. Interventions: All patients received supervised balance training sessions, 3 times per week for 4 weeks. The patients in the single-task group performed balance activities, alone. However, patients in dual-task group practiced balance activities while simultaneously performing cognitive tasks. Main measures: The 10-Meter Walk Test and Timed Up-and-Go under single-task and dual-task conditions, in addition to Activities-specific Balance Confidence, Berg Balance Scale, and Functional Gait Assessment were assessed pre-, and post intervention and also 6-weeks after the end of intervention. Results: Only 38 patients completed the treatment plan. There was no difference in the amount of improvement seen between the two study groups. In both groups there was a significant effect of time for dual-10 Meter Walk Test (F1, 36=11.33, p=0.002) and dual-Timed Up-and-Go (F1, 36=14.27, p=0.001) but not for their single-tasks. Moreover, there was a significant effect of time for Activities-specific Balance Confidence, Berg Balance Scale, and Functional Gait Assessment ( P<0.01). Conclusions: This pilot study did not show more benefits from undertaking dual-task training than single-task training. A power analysis showed 71 patients per group would be needed to determine whether there was a clinically relevant difference for dual-task gait speed between the groups.

scholarly journals Training of Balance Under Single- and Dual-Task Conditions in Older Adults With Balance Impairment

2006 ◽  
Vol 86 (2) ◽  
pp. 269-281 ◽  
Author(s):  
Patima Silsupadol ◽  
Ka-Chun Siu ◽  
Anne Shumway-Cook ◽  
Marjorie H Woollacott
Keyword(s):  
Older Adults ◽  
Case Report ◽  
Dual Task ◽  
Balance Training ◽  
Single Task ◽  
Balance Impairment ◽  
Instructional Set ◽  
Task Training ◽  
Dual Task Training ◽  
Task Conditions

Background and Purpose. Traditionally, rehabilitation programs emphasize training balance under single-task conditions to improve balance and reduce risk for falls. The purpose of this case report is to describe 3 balance training approaches in older adults with impaired balance. Case Descriptions. Three patients were randomly assigned to 1 of 3 interventions: (1) single-task balance training, (2) dual-task training under a fixed-priority instructional set, and (3) dual-task training under a variable-priority instructional set. Outcomes. The patients who received balance training under dual-task conditions showed dual-task training benefits; these training benefits were maintained for 3 months. The patient who received variable-priority training showed improvement on novel dual tasks. Discussion. Older adults may be able to improve their balance under dual-task conditions only following specific types of balance training. This case report gives insight on how this intervention might be combined with more traditional physical therapy intervention. [Silsupadol P, Siu KC, Shumway-Cook A, Woollacott MH. Training of balance under single- and dual-task conditions in older adults with balance impairment. Phys Ther. 2006;86:269–281.]

Effect of dual-task training on balance in patients with multiple sclerosis: A systematic review and meta-analysis

2021 ◽  
pp. 026921552110103
Author(s):  
Alex Martino Cinnera ◽  
Alessio Bisirri ◽  
Enza Leone ◽  
Giovanni Morone ◽  
Angela Gaeta
Keyword(s):  
Multiple Sclerosis ◽  
Systematic Review ◽  
Dual Task ◽  
Dynamic Balance ◽  
Meta Analysis ◽  
Berg Balance Scale ◽  
P Value ◽  
Balance Scale ◽  
Task Training ◽  
Dual Task Training

Objective: To evaluate the effects of dual-task training on static and dynamic balance in patients with multiple sclerosis. Data sources: PubMed/MEDLINE, EMBASE, Scopus, and PEDro databases were searched from inception to March 1, 2021. Methods: This study was conducted in agreement with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Two reviewers assessed studies for inclusion and extracted data. We used the Physiotherapy Evidence Database scale to evaluate the methodological quality and the risk-of-bias. Randomized clinical trial data were pooled for the meta-analysis. The effect sizes and 95% confidence interval (CI) were calculated by random-effect models. Egger regression and Begg-Mazumdar rank correlation test were used for publication bias. Results: A total of 13 studies involving 584 patients (42.3 ± 9 years mean ± SD; 377 females) met the inclusion criteria for the systematic review, while nine were included in the meta-analysis. People who received dual-task training interventions showed significant improvements in the Timed Up & Go test 0.44 [(95% CI = 0.22; 0.65), P-value<0.001], and in the Berg Balance scale 0.46 [(95% CI = 0.07; 0.85), P-value = 0.02]. Low and moderate heterogeneity between the studies was found for the Timed Up & Go test and the Berg Balance scale, respectively. Conclusion: The findings from the current meta-analysis support dual-task training as a beneficial therapy for improving dynamic balance and functional mobility in patients with multiple sclerosis. The limited number of studies that investigated static balance performance after dual-task training do not currently allow us to draw a conclusion about any possible improvements in this ability.

scholarly journals To Compare the Effect Between Two Different Priorities Dual Task Balance Training in Older Adults with Balance Impairment

2020 ◽  
pp. 238-250
Author(s):  
Meenakshi Verma ◽  
Supriya Awasthi ◽  
Bhavna Sharma
Keyword(s):  
Older Adults ◽  
Dual Task ◽  
Balance Training ◽  
Training Group ◽  
Balance Performance ◽  
Post Intervention ◽  
Single Task ◽  
Balance Impairment ◽  
Task Training ◽  
Dual Task Training

<p style="text-align: justify;"><strong>Background </strong>and Purpose: Balance is controlled through a complex process involving sensory, visual, vestibular and cerebral functioning which get affected by various neurological disorders such as fall. The purpose of the study was to compare the efficiency of three different balance training strategies in an effort to understand the mechanisms underlying training-related changes in dual task balance performance of older adults with balance impairment.</p> <p style="text-align: justify;"><strong>Methods:</strong> 45 older adults with balance impairment were recruited and randomly assigned to three groups. Group one received single task balance training, group two received dual task training balance training under fixed priority, group three received dual task balance training under variable priority. Subjects received one-hour individualized training sessions, five times in a week for two weeks. Berg balance scale and time up and go test were the outcome measure and their scores for all groups were taken prior and after the training.</p> <p style="text-align: justify;"><strong>Results:</strong> One-way analysis of variance was used to analyse the difference among the balance improvement in Group one, two and three. And the results revealed that post intervention scores were highly significant (p£ 0.05) in group two and group three performed better than group one.</p> <p style="text-align: justify;"><strong>Conclusion:</strong> In conclusion, dual task training is effective in improving balance under dual task context in older adults with balance impairment, and single task training may not generalize to balance performance under dual task conditions.</p>

scholarly journals The Effect of Cognitive and Motor Dual-task Training on Improvement of Balance and Some Spatiotemporal Gait Parameters in People With Idiopathic Parkinson's Disease

2019 ◽  
Vol 5 (4) ◽  
pp. 190-198
Author(s):  
Tahereh Pourkhani ◽  
◽  
Hassan Daneshmandi ◽  
Ali Asghar Norasteh ◽  
Babak Bakhshayesh Eghbali ◽  
...  
Keyword(s):  
Dual Task ◽  
Controlled Trial ◽  
Training Group ◽  
Control Group ◽  
Timed Up And Go ◽  
Yahr Stage ◽  
Single Task ◽  
Gait Parameters ◽  
Task Training ◽  
Dual Task Training

Background: Parkinson disease (PD) is characterized by motor and non-motor symptoms that affect patients’ functions, especially while performing dual-tasks a critical factor in everyday living. However, many controversies exist about the benefits of dual-task training in patients with PD. Objectives: This study assessed the efficacy of motor and cognitive dual-task training in improving balance and gait parameters in people with idiopathic PD. Materials & Methods: A single-blind controlled trial was conducted on PD patients living in Guilan Province of Iran, in 2018-2019. A total of 30 PD patients (Hoehn and Yahr stage II-III while on medication) were assigned to the cognitive dual-task training group (n=10), motor dual-task training group (n=10), and single-task control group (n=10). All groups received 30 sessions of different exercises for 10 consecutive weeks. The patients’ balance and some spatiotemporal gait parameters were respectively assessed with timed up and go test and HD VideoCam-Kinovea before and after training and then 1 month later. Results: Both dual-task and single-task trainings improved the outcome measures (timed up and go test (F=535.54; P=0.000), stride length (F=87.41; P=0.00), stride time (F=102.11; P=0.00), cadence (F=286.36; P=0.00), swing time (F=48.90; P=0.00), and stance time (F=40.56; P=0.00)). These improvements were maintained at 1-month follow-up, although the effect slightly reduced. No significant differences were found between the study groups (P>0.05). Conclusion: Motor/cognitive dual-task training and single-task training were found to be significantly and equally effective in improving balance and gait parameters in people with PD.

scholarly journals Randomised controlled pilot trial of an exercise plus behaviour change intervention in people with multiple sclerosis: the Step it Up study

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e016336 ◽  
Author(s):  
Sara Hayes ◽  
Marcin Kacper Uszynski ◽  
Robert W Motl ◽  
Stephen Gallagher ◽  
Aidan Larkin ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Treatment Effect ◽  
Cognitive Theory ◽  
Controlled Trial ◽  
Pilot Trial ◽  
Intervention Group ◽  
Control Group ◽  
Timed Up And Go ◽  
Double Blind ◽  
Exercise Guidelines

ObjectiveTo investigate feasibility of multiple sclerosis (MS) exercise guidelines for inactive people with MS (PwMS) and to examine preliminary efficacy for walking. To investigate effect of augmenting that intervention with education based on social cognitive theory (SCT).DesignPilot multicentre, double-blind, randomised, parallel, controlled trial.SettingCommunity-delivered programme.ParticipantsSixty-five physically inactive PwMS walked independently, scored 0–3 on the Patient Determined Disease Steps Scale, had no MS relapse or change in MS medication in 12 weeks.Interventions10-week exercise plus SCT education (SCT) compared with exercise plus attention control education (CON).Outcome measuresSix-Minute Walk Test (6MWT), Timed Up and Go (TUG) test and Multiple Sclerosis Walking Scale-12 (MSWS-12).Results174 expressed interest, 92 were eligible and 65 enrolled (SCT, n=32; CON, n=33). The intervention was feasible and delivered as intended. 68% of SCT group and 50% of control group met the exercise guidelines after intervention. Using linear mixed effects models, intention-to-treat basis, there was insufficient evidence for difference between the groups over the trial (6MWT, p=0.30; TUG, p=0.4; MSWS-12, p=0.8). Using secondary analysis of a cohort with data for≥3 assessments (SCT, n=21; CON, n=20), there was significant treatment effect favouring the intervention group (p=0.04) with mean effect for 6MWT 39.0 m (95% CI 2.26 to 75.73) at 12 weeks and 40.0 m (95% CI 2.3 to 77.8) at 36 weeks. Both groups improved significantly in 6MWT following 10-week intervention (SCT, mean ∆=83.02, SD=60.1, p≤0.01; CON, mean ∆=56.92, SD=73.5, p≤0.01), TUG (SCT, ∆=−0.70, SD=1.25, p≤0.01; CON, ∆=−0.54, SD=0.95, p≤0.01) and MSWS-12 (SCT, ∆=−8.03, SD=16.18, p=0.02; CON, ∆=−0.86, SD=18.74, p=0.81).ConclusionsA 10-week exercise programme based on the MS exercise guidelines for improving walking in previously inactive PwMS was feasible. There is marginal evidence of a treatment effect in favour of the exercise plus SCT intervention at 12 and 36 weeks.Trial registration numberNCT02301442; Results.

scholarly journals Combined Balance Training and tDCS Intervention for the Recovery of Postural Control Following Chronic Stroke: A Study Protocol for A Multi-Centre, Double Blind, Randomized Control Trial

2021 ◽  
Author(s):  
Fariba Yadolahi ◽  
◽  
Mohsen Roostaei ◽  
Minoo Khalkhali Zavieh ◽  
Abas Rahimi ◽  
...  
Keyword(s):  
Postural Control ◽  
Postural Sway ◽  
Balance Training ◽  
Berg Balance Scale ◽  
Chronic Stroke ◽  
Ambulatory Setting ◽  
Anodal Tdcs ◽  
Post Intervention ◽  
Timed Up And Go ◽  
Double Blind

Background: Stroke is one of the most debilitating diseases among the adults around the world which leads to persistent rehabilitation needs even at chronic stage. Achievement of good postural control is a critical requirement for daily activities which enhances quality of life in patients with stroke. There is increasing evidence that transcranial direct current stimulation (tDCS) may be considered as a promising adjunct technique to improve motor recovery after stroke. Evidence of augmented neuroplasticity after tDCS suggests that a paired rehabilitation followed by consecutive use of tDCS may optimize recovery outcomes. Although a few RCTs have been conducted on upper limbs rehabilitation in chronic stroke using tDCS, however no study focused on balance training in chronic stroke patients. This randomized, sham-controlled, double-blinded clinical study aims to address brain stimulation targeting postural control using tDCS in chronic stroke. Methods: The study participants will be chronic ischemic stroke individuals with postural control impairments who meet no exclusion criteria. Active or sham anodal tDCS will delivered to lesioned leg motor cortex combined with balance training. Experimental group receive active anodal tDCS stimulation (2mA) for 20 min, daily for 5 days paired with balance training. Linear and nonlinear approaches will be used to analyse postural sway changes pre and post-intervention. Postural sway fluctuation, Functional balance assessment using Berg balance scale, Timed Up-and-Go Test will be compared in active and sham groups. Conclusions: This trial could have significant implications for balance rehabilitation after stroke in the ambulatory setting. If found to be effective, this novel approach may improve rehabilitation protocol in this population.

scholarly journals Investigation and Motivation of Impact of Motor Dual Task Training on Post Stroke Patients

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 782-786
Author(s):  
Anil Kumar I ◽  
Sudhakar M ◽  
Aqib M ◽  
Lalitha R
Keyword(s):  
Middle Cerebral Artery ◽  
Dual Task ◽  
Sensory System ◽  
Berg Balance Scale ◽  
Stroke Patients ◽  
Single Task ◽  
Post Stroke ◽  
Task Training ◽  
Dual Task Training ◽  
The Impact

The motivation of investigation was to discover the impact of motor dual task training (MDTT) vs single task training (STT) on useful parity in post stroke patients. Thirty first beginning of one-sided ischemic “Middle Cerebral Artery (MCA)” domain stroke patients are haphazardly designated into 2 gatherings the STT gathering (n=15) got single task strengthening and balance practices and MDTT (n=11) got strengthening &balance practice alongside an optional engine task. Intercession is provided 45 minutes for every session, once in a day, 5 days of week for about fourteen days. The parity was dissected utilizing Berg Balance Scale (BBS).In 2 groups, balance expressively enhanced in BBS. Compared with STT group; MDTT group reached much statistically important development. The MDTT exercises efficiently promote balance initial in stroke patients. How parity is influenced relies upon a few variables, comprising the degree of sensory system harm, the number and degree of tactile misfortunes, and the accessibility of different faculties for pay. In numerous occurrences, greater than one tactile framework is hindered.

scholarly journals Efektivitas Dual-Task Training Motorik-Kognitif dalam Menurunkan Risiko Jatuh pada Lansia

2019 ◽  
Vol 15 (3) ◽  
pp. 284
Author(s):  
Nahdiah Purnamasari
Keyword(s):  
Dual Task ◽  
Berg Balance Scale ◽  
Test Design ◽  
Timed Up And Go ◽  
Balance Scale ◽  
Post Test ◽  
Task Training ◽  
Dual Task Training

Proses penuaan menyebabkan kemunduran dari berbagai aspek tubuh baik secara fisik, mental, maupun psikologis yang secara tidak langsung mengancam kemandirian lansia serta membuat mereka rentan terhadap kejadian jatuh. Latihan kombinasi Dual-Task motorik-kognitif menggabungkan latihan fisik dan kognitif secara bersama-sama dan menginduksi efek sinergis ketika digabungkan dalam satu intervensi. Penelitian ini bertujuan mengetahui pengaruh pemberian latihan dual-task terhadap risiko jatuh pada lansia. Metode yang digunakan adalah pre-eksperimental dengan one group pre-test post-test design dengan lama waktu perlakuan selama 4 minggu dengan frekuensi 3 kali seminggu. Sebelum dan setelah perlakuan, responden diukur tingkat keseimbangan dan risiko jatuhnya menggunakan Berg Balance Scale (BBS), Timed-Up and Go Test (TUGT), serta Tinetti Balance Assesment Tool. Hasil penelitian menunjukkan peningkatan keseimbangan lansia setelah pemberian 12 kali latihan berdasarkan alat ukur BBS (p<0.001) dan TUGT (p=0.079). Risiko jatuh terlihat mengalami penurunan setelah 12 kali perlakuan (p<0.001). Penurunan risiko jatuh paling tinggi terjadi setelah 6 kali perlakuan pertama (p=0.011). Disimpulkan bahwa latihan dual-task motorik-kognitif ini secara signifikan berpengaruh dalam penurunan risiko jatuh pada lansia.

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