The influence of carrying an anterior load on attention demand and obstacle clearance before, during, and after obstacle crossing.

Carrying an anterior load during obstacle negotiation increases attention demand, which may differ at various crossing stages. Less is known on the impact of lower visual field obstruction and the weight of the anterior load on obstacle negotiation and attention demand. The objectives of this study were to: (1) determine if carrying a weighted anterior load, lower visual field occlusion, or both, modify obstacle clearance and/or reaction time (RT); and (2) examine whether RT is modulated across obstacle crossing phases as measured by a probe RT protocol. Sixteen young adults crossed an obstacle while carrying no load, a clear 5 kg load, and an opaque 5 kg load, while performing a simple RT task. Auditory stimuli were presented at five locations: (1) two steps before the obstacle; (2) one step before the obstacle; (3) as the leading limb crossed the obstacle; (4) as the lead limb touched down after the obstacle; and (5) as the trail limb crossed the obstacle. The toe clearance height of the leading limb was greatest for the weighted opaque box load type followed by the weighted clear box type compared to the no box load type. Carrying an anterior load during obstacle crossing did not influence RT. RTs were longer at the pre-crossing and beginning of the crossing phases compared to after-crossing phases. Results suggest that carrying a weighted anterior load and lower visual field occlusion increase the risk for tripping. Attention demands differ across obstacle crossing phases during dual-tasking and should be considered in fall-risk assessments.

The Ottawa Panel guidelines on programmes involving therapeutic exercise for the management of hand osteoarthritis.

OBJECTIVE:: To identify programmes involving therapeutic exercise that are effective for the management of hand osteoarthritis and to provide stakeholders with updated, moderate to high-quality recommendations supporting exercises for hand osteoarthritis. METHODS:: A systematic search and adapted selection criteria included comparable trials with exercise programmes for managing hand osteoarthritis. Based on the evaluated evidence, a panel of experts reached consensus through a Delphi approach endorsing the recommendations. A hierarchical alphabetical grading system (A, B, C+, C, C-, D-, D, D+, E, F) was based on clinical importance (≥15%) and statistical significance ( P < 0.05). RESULTS:: Ten moderate- to high-quality studies were included. Eight studies with programmes involving therapeutic exercise (e.g. range of motion (ROM) + isotonic + isometric + functional exercise) seemed to be effective. Forty-six positive grade recommendations (i.e. A, B, C+) were obtained during short-term (<12 weeks) trials for pain, stiffness, physical function, grip strength, pinch strength, range of motion, global assessment, pressure pain threshold, fatigue and abductor pollicis longus moment and during long-term (>12 weeks) trials for physical function and pinch strength. CONCLUSION:: Despite that many programmes involving exercise with positive recommendations for clinical outcomes are available to healthcare professionals and hand osteoarthritis patients that aid in the management of hand osteoarthritis, there is a need for further research to isolate the specific effect of exercise components.

The knitting community-based trial for older women with osteoarthritis of the hands: design and rationale of a randomized controlled trial.

BACKGROUND: The prevalence of hand osteoarthritis (HOA) has been reported to be higher amongst women over 50 years old (66%) compared to men of the same age (34%). Although exercise therapy has been shown effective in reducing symptoms and disability associated with HOA, adherence to treatment programs remains low. The primary objective of this RCT is to examine the effectiveness of a 12-week knitting program for morning stiffness (primary outcome) and pain relief (secondary outcome) 2 h post-wakening in females (aged 50 to 85 years old) with mild to moderate hand osteoarthritis (HOA). METHODS/DESIGN: A single-blind, two-arm randomized controlled trial (RCT) with a parallel group design will be used to reach this objective and compare results to a control group receiving an educational pamphlet on osteoarththritis (OA) designed by the Arthritis Society. The premise behind the knitting program is to use a meaningful occupation as the main component of an exercise program. The knitting program will include two components: 1) bi-weekly 20-min knitting sessions at a senior's club and 2) 20-min home daily knitting sessions for the five remaining weekdays. Participants assigned to the control group will be encouraged to read the educational pamphlet and continue with usual routine. Pain, morning stiffness, hand function, self-efficacy and quality of life will be measured at baseline, six weeks, 12 weeks (end of program) with standardized tools. We hypothesize that participants in the knitting program will have significant improvements in all clinical outcomes compared to the control group. A published case study as well as the preliminary results of a feasibility study as examined through a 6-week pre-post study (n = 5 women with HOA) involving 20-min daily knitting morning sessions led to this proposed randomized controlled trial research protocol. This article describes the intervention, the empirical evidence to support it. DISCUSSION: This knitting RCT has the potential to enhance our understanding of the daily HOA symptoms control and exercise adherence, refine functional exercise recommendations in this prevalent disease, and reduce the burden of disability in older women. TRIAL REGISTRATION: (ACTRN12617000843358) registered on 7/06/2017.

Age-related differences in Fukuda stepping and Babinski-Weil tests, within-day variability and test-retest reliability.

BACKGROUND: The Fukuda stepping and Babinski-Weil tests are associated with unperceived body rotation and linear displacements in young adults, but performance in older adults on these two tests has yet to be determined. AIM: The main purpose was to compare the performance and reliability of the Fukuda stepping and Babinski-Weil tests in young and older adults. METHODS: Fifty older and 50 young adults executed three trials of each test on day 1 (test) and day 2 (retest). Lateral and longitudinal displacements and body rotation relative to the starting position were measured. Means and standard deviations (SD) were compared between the two groups with Mann-Whitney tests. Test-retest reliability was assessed with intra-class correlation coefficients (ICC). Foot preference was determined from the score on the Waterloo Footedness Questionnaire and correlated with test scores. RESULTS: Lateral and longitudinal displacements were significantly larger in older than young participants on the Fukuda stepping test (p < .01) and significantly smaller on the Babinski-Weil test (p < .001). Older participants displayed a significantly smaller SD on the three Babinski-Weil test trials (p < .001). Displacement and rotation measures ICC ranged between 0.25 and 0.77 in older and between 0.58 and 0.80 in young participants. Foot preference correlated with rotation on the Fukuda stepping test in young (p < .05), but not in older participants (p > .05). DISCUSSION AND CONCLUSION: Linear displacements, but not body rotation, were different between older and young adults. There was no clear age-related differences in test-retest reliability, but the moderate reliability indicates that performance can vary from day to day in both age groups.

Balance and mobility training with or without concurrent cognitive training improves the timed up and go (TUG), TUG cognitive, and TUG manual in healthy older adults: an exploratory study.

BACKGROUND AND AIMS: The purpose was to explore the impact of balance and mobility training (BMT), balance and mobility plus cognitive training (BMT + C) and no training on the timed up and go (TUG), TUG cognitive (TUGcog), and TUG manual (TUGman) in older adults. A preliminary experiment examined the stability of these TUG measures over a 5-week period in older adults. METHODS: Fifteen participants in the BMT group (70.2 ± 3.2 years) and 14 participants in the BMT + C group (68.7 ± 5.5 years) trained one-on-one, 3×/week for 12 weeks on a balance obstacle course. The BMT group and the BMT + C group completed two or three tasks simultaneously, respectively. Fifteen participants in the control group received no training (66.7 ± 4.2 years). The TUG, TUGcog, and TUGman were measured in seconds at baseline, after the 12-week training, and after the 12-week follow-up. During the preliminary experiment, ten participants (67.0 ± 6.9 years) completed the three TUG measures 1/week for 5 weeks. RESULTS: Both the BMT and BMT + C groups, but not the control group, exhibited significantly faster TUG, TUGcog, and TUGman after the intervention and maintained these improvements at the 12-week follow-up. No differences between the BMT and BMT + C groups emerged. The preliminary experiment showed that the three TUG measures were stable across five testing sessions. DISCUSSION AND CONCLUSION: Both training groups improved functional mobility after the interventions and sustained these improvements over 12 weeks. This is likely not a function of repeating the TUG, TUGcog, and TUGman tests since no repeated exposure effect was shown.

Examining the stability of dual-task posture and reaction time measures in older adults over five sessions: a pilot study.

BACKGROUND AND AIM: Improved performance may be inherent due to repeated exposure to a testing protocol. However, limited research has examined this phenomenon in postural control. The aim was to determine the influence of repeated administration of a dual-task testing protocol once per week for 5 weeks on postural sway and reaction time. METHODS: Ten healthy older adults (67.0 ± 6.9 years) stood on a force plate for 30 s in feet apart and semi-tandem positions while completing simple reaction time (SRT) and choice reaction time (CRT) tasks. They were instructed to stand as still as possible while verbally responding as fast as possible to the stimuli. RESULTS: No significant differences in postural sway were shown over time (p > 0.05). A plateau in average CRT emerged as the time effect revealed longer CRT during session 1 compared to sessions 3-5 (p < 0.05). Furthermore, the time effect for within-subject variability of CRT uncovered no plateaus as it was less variable in session 5 than sessions 1-4 (p < 0.05). DISCUSSION: The lack of a plateau in variability of CRT may have emerged as older adults may require longer to reach optimal performance potential in a dual-task context. CONCLUSION: Postural sway and SRT were stable over the 5 testing sessions, but variability of CRT continued to improve over time. These findings form a basis for future studies to examine performance-related improvements due to repeated exposure to a testing protocol in a dual-task setting.

Prioritizing attention on a reaction time task improves postural control and reaction time.

Flexible and appropriate allocation of attention resources is important during dual-tasking to achieve task goals while maintaining postural safety. This pilot study aimed to examine the influence of explicit prioritization of attention on the dual-task paradigm by employing two levels of difficulty for the postural tasks and reaction time (RT) tasks in healthy young adults. The task entailed standing on a force platform on two feet or on one foot, attending to posture or RT, and completing a simple or choice RT task. Participants verbally responded "top" as soon as the light cue illuminated. In general, attending to RT produced faster RTs (F(1,19) = 30.9, p < 0.001) and improved center of pressure (COP) Displacement (F(1,19) = 5.1, p < 0.05) and 95% Area Ellipse (F(1,19) = 7.1, p < 0.05). These findings suggest that prioritizing attention away from posture may be beneficial for postural performance when completing a second task.

Effect of ankle weight on blind navigation.

This study tested the hypotheses that loading the ankle with a 2.3 kg weight would modify deviation (unilateral loading) and distance (unilateral and bilateral loading) during three blind navigation tasks. Ankle loading increased the distance traveled while navigating toward a previously seen target at an 8 m distance and reduced the undetected fore-aft displacement while stepping in place for 100 steps. Unilateral ankle loading had no effect on deviation during these tasks, nor in walking back and forth on an imaginary straight line. The results suggest that somatosensory cues associated with ankle loading and the increased effort to walk and step interacted with motor and cognitive functions involved in blind navigation and influenced the control of anterior-posterior body displacement.

Effect of Dual Task on Step Variability during Stepping in Place without Vision.

Stepping in place without vision is a spatial orientation task that is associated with unperceived foot displacements. This study was aimed at determining whether foot displacement variability is modified by a concurrent cognitive task. Fourteen young adults stepped for 50 steps with their vision blocked and performed a continuous mental counting task. 3-D Kinematic data from both feet (heel and big toe) was recorded. The variability of foot displacements was either unchanged or slightly lower in dual task, while the foot displacements were significantly shorter (p < 0.05) in dual task than without the cognitive task. The results suggest that the concurrent cognitive task might have allowed a better control of the repetitive lower limb movements.

Traduction franco-canadienne de l'Assessment of Systematic Reviews Revised (AMSTAR 2) : validation transculturelle et fidélité interjuges.

Objective: Produce a French-Canadian translation of AMSTAR 2, affirm its content validity, and examine interrater reliability. Methods: Based on Vallerand's methodological approach, we conducted forward and parallel inverse-translations. Subsequently, an expert panel evaluated the translations to create a preliminary experimental French-Canadian version. A second expert panel examined this version and proposed additional modifications. Twenty future health professionals then rated the second experimental version for ambiguity on a scale (from 1 to 7). The principal co-investigators then reviewed the problematic elements and proposed a pre-official version. To ascertain content validity, a final back-translation was conducted resulting in the official version. Four judges evaluated 13 systematic reviews using the official French-Canadian version of AMSTAR 2. The Kappa coefficient was used to evaluate interrater reliability. Results: This rigorous adaptation enabled the development of a Franco-Canadian version of AMSTAR 2. Its application demonstrated low ambiguity (mean 1.15; SD 0.26) as well as good overall interrater reliability (total κ > 0.64) across all items. Conclusion: The French-Canadian version of AMSTAR 2 can now support francophone clinicians, educators, and managers in Canada as they undertake evidence-based practice.

The Fukuda Stepping Test Is Influenced by a Concurrent Cognitive Task and Step Height in Healthy Young Adults: A Descriptive Study.

Purpose: The Fukuda stepping test assesses spatial orientation in people with vestibular disorders. To standardize the test, it is important to know which factors influence the outcome. This study investigated the impact of two factors, a concurrent cognitive task and step height, on the Fukuda stepping test in healthy individuals. Method: A total of 16 young adults participated and completed 20 trials of the 50-step Fukuda stepping test in four conditions: comfortable and high step height and with and without a cognitive task. Body kinematics were collected using the three-dimensional motion analysis Vicon system. The cognitive task was to listen to a sequence of three-digit numbers and identify the total number of times that one pre-determined digit was presented. Results: All participants slowly turned and drifted forward during the test. The concurrent cognitive task yielded significantly shorter forward displacement and lateral deviation and lower stepping height, and high stepping produced significantly greater body rotation and lateral deviation. Conclusions: Performance on the Fukuda stepping test in healthy young individuals is influenced by a concurrent cognitive task and by step height. Clinicians and researchers must instruct people to use a comfortable step height during the test, and they must be aware that a concurrent cognitive task may improve test performance, at least among young adults.

Objectif : le test de Fukuda évalue l'orientation spatiale chez les personnes ayant une pathologie vestibulaire. Pour le standardiser, il est important de connaître les facteurs qui influent sur le résultat. La présente étude portait sur l'effet de deux facteurs, une tâche cognitive conjuguée à la hauteur des pas sur le test de Fukuda chez des personnes en bonne santé. Méthodolgie : au total, 16 jeunes adultes ont terminé les 20 essais du test de Fukuda de 50 pas dans quatre conditions : pas d'une hauteur confortable ou élevée, accompagnés ou non d'une tâche cognitive. Les chercheurs ont enregistré la cinématique à l'aide du système d'analyse du mouvement tridimensionnel de Vicon. La tâche cognitive consistait à écouter une série de nombres à trois chiffres puis à établir le nombre de répétitions d'un chiffre prédéterminé. Résultats : tous les participants ont tourné et avancé lentement pendant le test. L'ajout de la tâche cognitive était lié à un déplacement et à une déviation latérale moins marqués et à un pas moins élevé. Une hauteur de pas élevée était associée à une rotation du corps et une déviation latérale plus importantes. Conclusion : la performance au test de Fukuda est influencée par une tâche cognitive simultanée et par la hauteur du pas chez de jeunes adultes en bonne santé. Les cliniciens et les chercheurs doivent expliquer l'importance d'adopter une hauteur de pas confortable pendant le test et doivent savoir qu'une tâche cognitive simultanée peut améliorer la performance, du moins chez les jeunes adultes.

The effects of an 8-week knitting program on osteoarthritis symptoms in elderly women: A pilot randomized controlled trial.

BACKGROUND: Exercise therapy is effective in reducing symptoms and disability associated with hand osteoarthritis (HOA) but often has low adherence. An intervention consisting in a meaningful occupation, such as knitting, may improve adherence to treatment. This pilot randomized controlled trial (RCT) studied the adherence and clinical effectiveness of a knitting program in older females suffering from HOA to evaluate the acceptability of this intervention and assess the feasibility of a larger-scale RCT. METHODS: Single-blind, two-arm pilot RCT with a parallel group design with 37 participants (18 control, 19 intervention). Control participants were given an educational pamphlet and assigned to a waiting list. The knitting program (8-week duration) had two components: bi-weekly 20-min group knitting sessions and daily 20-min home knitting session on the 5 remaining weekdays. Measures included knitting adherence (implementation outcomes) as well as stiffness, pain, functional status, hand physical activity level, patient's global impression of change, health-related quality of life, self-efficacy, and grip strength (clinical outcomes measured throughout the 8-week program and 4 weeks after the intervention). RESULTS: Our protocol is feasible and the intervention was acceptable and enjoyable for participants, who showed high adherence. No difference was observed between the two groups for any of the clinical outcome measures (all p > .05). CONCLUSION: Knitting is a safe and accessible activity for older women with HOA. However, our 8-week knitting program did not result in improvements in any of our outcome measures. Knitting for a longer period and/or with higher frequency may yield better outcomes.

Effect of Bilateral and Unilateral Plantarflexor Muscle Fatigue on Blind Navigation Precision and Gait Parameters.

The objective was to evaluate the impact of bilateral and unilateral fatigue of the plantarflexor muscles on blind navigation. Thirty-eight young adults walked 8-m without vision before fatigue (pre-fatigue), then fatigued either one or both of their plantarflexor muscles by performing isometric contractions. After each fatigue, two blind navigation trials were performed (post-fatigue trials 1 and 2). Results revealed no effect of bilateral muscle fatigue on navigation precision and gait parameters. Unilateral muscle fatigue led to longer linear distance travelled during post-fatigue trial 2 compared to pre-fatigue and to a change in angular deviation between pre- and post-fatigue. In general, results suggest that participants were able to make adaptive changes to counter muscle fatigue during blind navigation.

Predictors of daily mobility skills 6 months post-discharge from acute care or rehabilitation in older adults with stroke living at home.

PURPOSE: To determine the evolution of daily mobility skills from the timed up-and-go (TUG) upto 6 months after home return in older adults with stroke discharged from acute care or rehabilitation; and to identify the best predictive factors of the TUG at 6 months post-discharge. METHODS: In this longitudinal prospective study, people with stroke aged 65 years or more and discharged home from an acute care hospital (n = 82) or a rehabilitation service (n = 109) were included. The TUG was measured at discharge (T1), and at 3 and 6 months post-discharge (T2 and T3). Correlations between the TUG at T3 and sociodemographic and clinical variables, as well as physical, cognitive, perceptual and psychological measures at T1, were used in a multiple regression model to identify the best predictors of TUG at T3. RESULTS: TUG did not change between T1, T2 and T3 in the two groups of participants. The best predictors of TUG at T3 in participants from acute care were the use of a walking aid in daily life, age, deficits in oral expression and the presence of depressive symptoms. In participants from rehabilitation, predictors were the stage of motor recovery of the foot, the use of a walking aid in daily life, number of schooling years and memory impairments. CONCLUSION: Daily mobility skills, as assessed with the TUG, did not deteriorate upto 6 months after home return in older adults with stroke. The best predictor of the TUG at T3 is the use of a walking aid during daily life in participants from acute care, and motor recovery of the foot in participants from rehabilitation.

La version franco-canadienne du « STrengthening the Reporting of OBservational studies in Epidemiology ¼ (STROBE) Statement : L'outil STROBE.

Purpose: The main purpose is to produce a French-Canadian translation of the "STrengthening the Reporting of OBservational studies in Epidemiology" (STROBE) Statement under the proposed name of "outil STROBE" and to assess the cross-cultural validity of its content. The secondary purpose is to examine its preliminary interrater reliability. Method: A modified approach to Vallerand's cross-cultural validation methodology was used. First, professional translators and clinical practitioners produced a parallel reverse translation of the "STROBE Statement." Then, a committee of experts (P1) examined the translated versions and created a first experimental draft of the "outil STROBE." This draft was assessed and modified by a second committee of experts (P2). Finally, 32 future professionals doing their master's degree in physiotherapy and occupational therapy assessed this second experimental version of the tool using an ambiguity scale of 8 points (0 meaning "not at all ambiguous" and 7 meaning "extremely ambiguous"). The main co-researchers examined the problematic elements and proposed final modifications. Ten observational studies published in French after 1980 were assessed by two independent raters using the French-Canadian version of the "outil STROBE." The kappa coefficient was used to examine interrater reliability. Results: For the different elements of the final version of the "outil STROBE," the averages on the ambiguity scale varied from 0.0 to 2.4. No element received an average below 2.4, which showed a high level of clarity. The interrater reliability (n = 2) for the "outil STROBE" is thought to be good for 74% of individual elements, according to the kappa coefficient values obtained. Conclusions: The process's five rigorous steps enabled the production of a valid French-Canadian version of the "STROBE Statement."

Validation transculturelle de contenu de la version franco-canadienne de l'échelle COREQ.

Purpose: The main purpose of this article is to produce a French-Canadian translation of the Consolidated criteria for reporting qualitative studies (COREQ) scale under the proposed name "échelle COREQ" and to assess the transcultural validity of its content. The secondary purpose is to examine the inter-rater reliability of the French-Canadian version of the COREQ scale. Method: A modified approach to Vallerand's methodology (1989) for cross-cultural validation was used. First, a parallel back-translation of the COREQ scale was performed, by both professionals and clinicians. Next, a first committee of experts(P1) examined the translations to create a first draft of the French-Canadian version of the COREQ scale. This draft was then evaluated and modified by a second committee of experts (P2). Finally, 28future professionals (master's students in physiotherapy) rated this second draft of the tool for clarity using a seven-point scale (1:very clear; 7:very ambiguous). The principal co-investigators then reviewed the problematic elements and proposed final changes. Two independent raters used this French-Canadian version of the COREQ scale to assess 13qualitative studies that were published in French after the year2007. The kappa coefficient was used to examine inter-rate reliability. Results: The different elements of the final version of the COREQ scale received an average ambiguity rating between 1.04 and 2.56. These low values show a high level of clarity for the French-Canadian version of the COREQ scale. In relation to the total score of the COREQ scale, inter-rater reliability (n = 2) is considered to be average to excellent for 62.5% of individual elements, according to the kappa values obtained. Conclusions: A valid French-Canadian version of the COREQ scale was created using this rigorous five-step process.

Effect of navigation direction on the dual-task of counting backward during blind navigation.

Blind navigation towards a remembered target is associated with large direction errors when executed with a side stepping walking pattern. To investigate whether sideways navigation requires higher attention resource than forward navigation, a dual-task paradigm of backward counting during blind navigation was used. The objectives were to determine the effect of this dual-task on navigation errors, gait velocity and the rate of backward counting and to establish whether this effect is larger during sideways than forward navigation. A group of 17 subjects participated. The primary task was to navigate without vision towards previously seen targets located on the floor 8m away in four directions (ahead, behind, to the right or left) and to stop at the place the target was presumed to be. Forward, backward and side stepping gait patterns were used to reach corresponding targets. The secondary task was to count backwards in steps of three. The dual-task was to perform blind navigation while counting backwards. The rate of backward counting was significantly decreased in the dual-task relative to a controlled sitting condition (p<0.05), but this reduction was similar among navigation directions. Navigation errors were not changed between navigation only and dual-task. Gait velocity was significantly slower in the dual-task than in navigation only (p<0.05). This suggests that counting backward while navigating without vision towards a remembered target exceeded the subjects' attention capacity. However, sideways navigation did not seem to require more attention than forward navigation, even though navigation was much less precise in sideways than forward navigation.

Effect of Transient Perturbations of Short-Term Memory on Target-Directed Blind Locomotion.

It is difficult to walk without vision to a nearby destination if there is a time delay between watching the destination and walking toward it. Indeed, path deviation occurred when delays were introduced before initiating straight ahead blindfolded walking (R. A. Tyrrell, K. K., Rudolph, B. G., Eggers, & H. W. Leibowitz, 1993 ). The questions are whether the location of a 60-s delay in the walking path and whether performing a cognitive task during the delay influence the accuracy in reaching a previously seen target while walking without vision. Thirty young adults walked blindfolded and stopped when they believed they had reached a target at 8 m. Delays were 60 s in duration, were located at 0, 4, and 7 m, and involved waiting or backward counting. Significant differences were found between 0-m and 4-m delay locations for distance to target, distance travelled and path deviation (p < .05). Significant effect of backward counting during the 60-s delay was found at the 0-m delay for distance travelled (p < .05). The interaction between retaining visual guidance information during 60 s and performing a cognitive task likely influenced target-directed blind navigation.

Improvements in Obstacle Clearance Parameters and Reaction Time Over a Series of Obstacles Revealed After Five Repeated Testing Sessions in Older Adults.

The purpose of this study was to investigate obstacle clearance and reaction time parameters when crossing a series of six obstacles in older adults. A second aim was to examine the repeated exposure of this testing protocol once per week for 5 weeks. In total, 10 older adults (five females; age: 67.0 ± 6.9 years) walked onto and over six obstacles of varying heights (range: 100-200 mm) while completing no reaction time, simple reaction time, and choice reaction time tasks once per week for 5 weeks. The highest obstacles elicited the lowest toe clearance, and the first three obstacles revealed smaller heel clearance compared with the last three obstacles. Dual tasking negatively impacted obstacle clearance parameters when information processing demands were high. Longer and less consistent time to completion was observed in Session 1 compared with Sessions 2-5. Finally, improvements in simple reaction time were displayed after Session 2, but choice reaction time gradually improved and did not reach a plateau after repeated testing.

Balance and Mobility Training With or Without Simultaneous Cognitive Training Reduces Attention Demand But Does Not Improve Obstacle Clearance in Older Adults.

The purpose of this study was to determine whether balance and mobility training (BMT) or balance and mobility plus cognitive training (BMT + C) would improve obstacle clearance and reaction time (RT); whether further improvements would be exposed in the BMT + C group relative to the BMT group; and whether possible improvements would be sustained at the follow-up. Healthy older adults were allocated to the BMT (n = 15; age: 70.2 ± 3.2), BMT + C (n = 14; age: 68.7 ± 5.5), or control group (n = 13; age: 66.7 ± 4.2). The BMT and BMT + C groups trained one-on-one, three times per week for 12 weeks on a balance obstacle course. The BMT + C group also completed cognitive training. Participants walked onto and over six obstacles of varying heights while completing no RT, simple RT, and choice RT tasks at baseline, posttraining, and at the 12-week follow-up. Both the BMT and BMT + C groups improved RT and maintained these improvements at the follow-up. No meaningful improvements in obstacle clearance emerged following training. Thus, dual-task balance training likely reduces attention demand.