Effects of single- and dual-task training on dual-task walking performance, prosthetic-limb dynamics and quality of life in unilateral transtibial amputees.

INTRODUCTION

The aim of the study was to compare the effects of single-task versus dual-task training on dual-task walking performance, prosthetic-limb kinematics, centre-of-pressure behaviour, and health-related quality of life in adults with transtibial amputation.

METHODS

Forty-five participants undertook an eight-week intervention and were randomly allocated to one of three groups: control, single-task training, or dual-task training. Gait variables were obtained from 3D motion capture and force-plate analysis, while health-related quality of life was assessed using a composite measure derived from the WHOQOL-BREF.

RESULTS

Two-way mixed ANOVA showed that both single-task and dual-task training produced significant improvements in dual-task walk-performance time compared with the control group (p < 0.0001). Positive training effects were also observed for prosthetic-limb step length (p < 0.001), knee and hip joint range of motion (p < 0.05), and anterior-posterior (p < 0.001) and mediolateral (p < 0.01) centre-of-pressure displacement, with dual-task training producing greater improvements than single-task training across all gait variables. Only dual-task training resulted in significant pre- to post-intervention improvements in participants quality of life (p < 0.0001).

DISCUSSION: These findings indicate that an eight-week programme of single- or dual-task training improves walking capability in individuals with transtibial amputation, reflective in improved gait automaticity and more stable, efficient centre-of-pressure transitions from foot strike to push-off in the affected limb. Dual-task training provides additional benefit, producing greater gains across all gait variables and resulting in a significant improvement in perceived quality of life. Future research should examine the long-term transfer of cognitive-motor training to real-world mobility and participation outcomes.