Reactive stepping behavior during dual tasking is related to falls in community-dwelling older adults: A cross-sectional study.

Abstract

We investigated whether reactive stepping during dual tasking is associated with falls in community-dwelling older adults. In 78 healthy community-dwelling older adults, we evaluated quiet standing stability, limits of stability, and reactive stepping performance during single and dual tasking. Participants were suspended in a forward-leaning position using a lean control cable with a load of 12 % of their body weight and were instructed to regain balance upon release by taking steps forward. Reactive stepping was induced under two conditions: (1) simple front-fixed gaze (single-task condition) and (2) reading color names written in different colors (dual-task condition). Reactive stepping performance was measured using the onset latency of the medial gastrocnemius of the stepping limb and the number of steps required to recover balance after forward balance loss. Participants were classified as fallers or non-fallers based on fall history during the past 12 months. Twenty-two participants were classified as fallers. Both fallers and non-fallers exhibited a significantly increased number of steps during dual-tasking compared to the single-task condition. An interaction between group and condition was observed. The increased number of steps to balance recovery from forward balance loss during dual-tasking was significantly associated with falls after controlling for age, sex, body mass, cognitive function, and concerns about falling. The number of steps taken to recover balance during dual-tasking was independently related to fall history in community-dwelling older adults. Fall prevention strategies for older adults should include measuring and improving their response to balance loss while dual tasking.