Improved walking ability in elderly with osteoporosis after participating in a balance training programme with dual- and multi-tasks

Abstract

Introduction: Falls and fear of falling are common in the elderly population, and in combinationwith osteoporosis a fall can be very costly for both the society and for the individual. Aging and fear of falling has an impact on walking ability, and when adding a secondary task, cognitive or motor, the gait pattern is further altered [1]. Previous studies have shown that walking ability in elderly can be improved by balance training [2]. The aim of this study was to evaluate the effect of a three months progressive balance training with focus on dualand multi-tasks on spatial and temporal gait parameters in elderly with osteoporosis and self reported fear of falling. Patients/Materials And Methods: A total of 72 elderly (aged: 66–87years) subjectswith osteoporosis, self reported fear of falling and balance deficits were recruited by advertisement. Participants were randomized to either a training group (n=45) or to a control group (n=27). The training group participated in a progressive and highly challenging balance training program, with focus on dualand multi-cognitive and/or motor tasks, during 12 weeks, three times a week, 45min/session [2]. The control group was encouraged to continue with their usual activities, and were offered the same balance training at the end of the study. All subjects were assessed at baseline and directly after the intervention period. Gait parameters, i.e. velocity, cadence, step length, step width and double support phase were assessed using an instrumented walkway system (GAITRite). Participants walked at their preferred speed, as fast as they could without tripping and/or falling and at their preferred speed during a cognitive dual task (reciting every second letter of the alphabet). Each condition was performed six times and a mean value was used for analysis. For statistical calculations PASWStatistics version 19.0was used. AMixedmodel analysiswas performed on all gait parameters. Statistical significance was set to <0.05. Results: Analysis over time and between groups after the intervention revealed significant differences all in favour for the training group compared to the control group. At preferred speed, with and without a cognitive dual-task, a significant increase was seen in velocity (p=0.002 and p=0.034, respectively) and cadence (p=0.009 and p=0.029, respectively). The participants in the training group increased their velocity with 13% during the dual-task condition, resulting in similar velocity during both conditions at preferred speed. During gait at fast speed, significantly increased velocity (p=0.002), cadence (p=0.004) and step length (p=0.044) were seen in the training group. Discussion and conclusions: To participate in a three months progressive balance training programmewill significantly improve walking ability, especially under dualor multi-task conditions, in elderly with osteoporosis. This ability is important in daily life and may prevent hazardous falls, and also have positive impact on physical activity levels, contributing to a better general health. References