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Investigation of the effects of dual task balance training on gait and balance in transfemoral amputees: a randomised controlled trial
Demirdel S, Erbahceci F
Archives of Physical Medicine and Rehabilitation 2020 Oct;101(10):1675-1682
clinical trial
4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVES: To investigate the effects of dual task balance training on static and dynamic balance, functional mobility, cognitive level, and sleep quality in individuals with transfemoral amputation. DESIGN: Randomised controlled clinical trial. PARTICIPANTS: Transfemoral amputees (n = 20). INTERVENTIONS: Participants were randomly assigned to the single task gait and balance training group (n = 10) or the dual task task gait and balance training group (n = 10). Training was given in sessions of 60 min/day, 3 days/wk for 4 weeks. The single task training group performed traditional gait and balance exercises, and the dual task training group practised cognitive and motor tasks while performing gait and balance exercises. MAIN OUTCOME MEASURES: The one leg stance test and the four-square step test were used for balance assessment. The Timed Up and Go test, and 10-meter walk test were used for gait assessment. Three test conditions to evaluate the training effects were single walking, walking while performing a cognitive task (serial subtraction), and walking while performing a motor task (tray-carrying). The Montreal Cognitive Assessment scale was used for cognitive assessment and the Pittsburgh Sleep Quality Index for sleep quality assessment. RESULTS: Balance and mobility improved in both groups. Dual task balance performance, functional mobility and gait speed improved more in the dual task training group after training (p < 0.05). Cognitive status and sleep quality improved significantly in the dual task group (p < 0.05). CONCLUSIONS: Dual-task training was more effective than single task training in the improvement of dual task performance and cognitive status. The inclusion of dual task exercises in the rehabilitation program of transfemoral amputees will provide a different perspective due to increased task automation.

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