Seated stepping exercise in a dual-task condition improves ambulatory function with a secondary task: a randomized controlled trial

Background and aims: A close relationship exists between dual-task (DT)-related gait changes and the risk of falling in the elderly. However, the impact of DT training on the incidence of falls in the elderly remains unclear. We aimed to evaluate the effects of a seated stepping exercise in DT conditions to improve walking ability in community-dwelling elderly. Methods: This was a randomized controlled trial (RCT) in community-dwelling elderly in Japan. Fifty-three participants were randomly assigned to a DT group (stepping exercise in DT conditions, n=26) and a single-task (ST) group (stepping exercise in ST conditions, n=27). All participants received 50 min group training sessions, once a week for 24 weeks. Outcome measures were based on differences in walking ability in single-task (ST), cognitive-task (CT), and manual-task (MT) conditions between DT and ST groups. Results: Participants in the DT group showed significantly greater improvement in outcome measures, including 10-m gait speed, walking cadence, and cost during cognitive and manual tasks. The number of enumerated figures during CT, as well as the numbers of steps taken and of enumerated figures during stepping with MT demonstrated significant Group × Time interactions (p<0.05). Conclusions: This RCT suggests that the seated stepping exercise is more effective at improving ambulatory function in DT conditions than in ST conditions.