Investigation of the Effects of Dual-Task Balance Training on Gait and Balance in Transfemoral Amputees: A Randomized Controlled Trial.

OBJECTIVES

To investigate the effects of dual-task balance training on static and dynamic balance, functional mobility, cognitive level, and sleep quality in individuals with transfemoral amputation.

DESIGN

Randomized controlled clinical trial.

PARTICIPANTS

Transfemoral amputees (N=20).

INTERVENTIONS

Participants were randomly assigned to the single-task gait and balance training group (n=10) or the dual-task gait and balance training group (n=10). Training was given in sessions of 60 min/d, 3 d/wk for 4 weeks. The single-task training group performed traditional gait and balance exercises, and the dual-task training group practiced cognitive and motor tasks while performing gait and balance exercises.

MAIN OUTCOME MEASURES

The 1-leg stance test and the Four Square Step Test were used for balance assessment. The timed Up and Go test and 10-m walk test were used for gait assessment. Three test conditions to evaluate the training effects were single walking, walking while performing a cognitive task (serial subtraction), and walking while performing a motor task (tray carrying). The Montreal Cognitive Assessment scale was used for cognitive assessment and the Pittsburgh Sleep Quality Index for sleep quality assessment.

RESULTS

Balance and mobility improved in both groups. Dual-task balance performance, functional mobility, and gait speed improved more in the dual-task training group after training (P<.05). Cognitive status and sleep quality improved significantly in the dual-task group (P<.05).

CONCLUSIONS

Dual-task training was more effective than single-task training in the improvement of dual-task performance and cognitive status. The inclusion of dual-task exercises in the rehabilitation program of transfemoral amputees will provide a different perspective because of increased task automation.