Effect of Dual-Task Training on Gait Performance in Older Adults With Mild Cognitive Impairment: A Pilot Randomized Controlled Trial.

OBJECTIVES

To evaluate the efficacy of a virtual reality (VR)-based cognitive-motor dual-task training (CDTT) program on single-task gait performance, dual-task cost (DTC) of gait, and functional outcomes in older adults with mild cognitive impairment (MCI).

DESIGN

A single-blinded, parallel-group randomized controlled trial.

SETTING AND

PARTICIPANTS

Community-dwelling older adults (N = 41; mean age, 71.4 years) with MCI from the geriatric medicine specialist outpatient clinic of a tertiary hospital and a neuroscience specialist center in Singapore.

METHODS

Participants with MCI were randomized into 3 arms: CDTT, N = 14; cognitive single-task training, N = 13; and motor single-task training, N = 14. Participants underwent 16 training sessions over 8 weeks. The cognitive component utilized a VR-based fruit-catching game that progresses in difficulty and hence provides a graded attentional load. The motor component consisted of treadmill walking only. Gait parameters were collected under single- and dual-task conditions at baseline, postintervention, and 6-month follow-up. Secondary outcomes of the Timed Up and Go test and the Berg Balance Scale scores were collected at the 6-month follow-up.

RESULTS

For gait outcomes assessed under single-task walking conditions, the CDTT group showed within-group improvements in gait speed, step length, step time, and double-support time, which were maintained at 6-month follow-up. DTCs in these same parameters were reduced postintervention in the CDTT group. Between-group comparisons did not reveal a significant difference. Timed Up and Go scores improved in both cognitive training groups.

CONCLUSIONS AND IMPLICATIONS: VR-based dual-task training may be associated with improvements in gait performance and reductions in DTC in functionally independent older adults with MCI, but larger trials are required to determine the relative efficacy compared with existing single-task training programs.