Effects of Single-Task, Dual-Task and Analogy Training during Gait Rehabilitation of Older Adults at Risk of Falling: A Randomized Controlled Trial

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It has been suggested that implicit motor learning via dual-task or analogy training during gait rehabilitation may yield better outcomes in older adults by reducing the propensity for the conscious processing of movements (movement-specific reinvestment). The current study investigated the immediate effects of single-task, dual-task, and analogy training on reinvestment propensity and fall-related rehabilitation outcomes among older adults at risk of falling. Seventy-one older adults were randomly allocated to the single-task (ST), dual-task (DT), or analogy (AG) training conditions and received 12 training sessions. We assessed the reinvestment propensity, functional gait and balance, functional mobility, balance ability, single-task and dual-task walking abilities, and fear of falling at baseline (before training) and immediately after training. Our findings revealed a lack of training effect on reinvestment propensity for all groups. However, all groups displayed significant improvements in functional gait and balance (p < 0.001), functional mobility (p = 0.02), and balance ability (p = 0.01) after training. AG appeared to be superior to DT and ST, as it was the only condition that resulted in significant improvements in both single-task and dual-task walking abilities (p < 0.001). Implementing movement analogies could be a feasible and useful gait rehabilitation strategy for fall prevention and wellbeing promotion among older adults.