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Table 4 Included studies with fallers

From: A taxonomy of cognitive tasks to evaluate cognitive-motor interference on spatiotemoporal gait parameters in older people: a systematic review and meta-analysis

AuthorTitleStudy designStudy aimsNo. of subjectsAge (yr)Dual-task type
Auvinet et al., 2017 [74]Gait disorders in the elderly and dual task gait analysisProspec-tive cohort study1. To assess the value of gait instability as a clinical symptom,
2. To quantify gait disorders by means of the DTC in order to differentiate between peripheral pathologies and central nervous system pathologies,
3. To identify motor phenotypes according to the DTC for stride frequency and gait regularity
4. To identify correlations between these motor phenotypes and conventional brain MRI findings.
Overall (n = 103), Gait instability (n = 46), Recurrent falls (N = 30), Memory impairment (n = 19), Cautious Gait (n = 8)
Falls assessment of previous falls in the last 12 months
Overall (76 ± 7), Gait instability (77 ± 8), Recurrent falls (77 ± 8), Memory impairment (76 ± 5), Cautious Gait (81 ± 5)Arithmetic DT:
Walking + counting aloud backwards from 50 subtracting serial 1 s (one by one)
SR: auditory-verbal
Bauer et al., 2010 [75]First Results of Evaluation of a Falls ClinicCross-sectional studyTo assess risk factors for falls in community dwelling older people and to recommend targeted interventionsFallers (n = 42)
Non-fallers (n = 19)
Previous falls in the last 12 months were assessed by questionnaire
Fallers (75.95)
Non-fallers (75.35)
No SD reported
Arithmetic DT:
1. Walking+ counting backwards from 50 subtracting serial 1 s (one by one)
2. walking + subtracting serial 3 s from 100
Verbal fluency task:
Walking + naming animals
SR: auditory verbal
Beauchet et al., 2008 [19]Recurrent falls and dual task-related decrease in walking speed: is there a relationship?Prospec-tive cohort studyTo determine whether DT–related changes in walking speed were associated with recurrent falls in frail older peopleFallers (n = 37) vs Non-Fallers (n = 156) vs Recurrent fallers (n = 20)
Falls assessment of previous falls in the last 12 months
Fallers (84.7 ± 5.1) vs Non-Fallers (83.9 ± 5.5) vs. Recurrent fallers (87.2 ± 5.7)Arithmetic DT:
Walking + subtracting serial 1 s (one by one) from 50
SR: auditory verbal
Bootsma-van der Wiel et al., 2003 [76]Walking and talking as predictors of falls in the general populationProspective population-based follow-up studyTo compare the added value of DT in predicting falling in the general population of oldest old with that of an easy-to-administer STNone (n = 22), One (n = 87), and Recurrent (n = 71)
Previous falls in the last 12 months and the last month assessed by questionnaire
Leiden 85-plus Study (no precise information)Verbal fluency task:
Walking + reciting names of animals or professions during a 30-s period
SR: auditory verbal
Freire Junior et al., 2017 [21]The effects of a simultaneous cognitive or motor task on the kinematics of walking in older fallers and non-fallersCohort studyComparing kinematics of ST gait, cognitive DT gait, and motor DT gait in both older fallers and non-fallersNo Falls (n = 35) vs. One fall (n = 27)
Previous falls in the last 6 months and the last month assessed by questionnaire
No Falls (67.97 ± 4.82) vs One fall (67.96 ± 5.7)1. Verbal fluency task:
Walking + naming animals
SR: auditory verbal
2. Secondary motor task:
Walking + transferring a coin from one pocket to another
SR: auditory-manual
Howcroft et al., 2016 [77]Analysis of dual-task elderly gait in fallers and non-fallers using wearable sensorsProspective population-based follow-up studyUse wearable sensors to detect gait differences between:
(1) fallers and non-fallers for ST walking,
(2) between fallers and non-fallers for DT walking,
(3) ST and DT walking for fallers, and
(4) ST and DT walking for non-fallers.
Fallers (n = 24), Non-Fallers (n = 76)
Previous falls in the last 6 months and the last month assessed by questionnaire
Fallers (76.3 ± 7,0),
Non-Fallers (75,2 ± 6,6)
Verbal fluency task:
Walking + naming words starting with A, F or S)
SR: auditory verbal
Johansson et al., 2016 [78]Greater Fall Risk in Elderly Women Than in Men Is Associated With Increased Gait Variability During MultitaskingProspective observational study1. investigate variability in gait patterns among men and women aged 70 years during progressively challenging gait conditions.
2. investigate associations of gender with gait patterns and the risk of incident falls.
Non-Fallers (1202), Fallers (148)
Falls assessment of previous falls in the last six and 12 months
Fallers (70), Non. Fallers (70),
Inclusion criteria: age of exactly 70 years at the time of testing.
Arithmetic task:
Walking + subtracting 1 s from the number 100
SR: auditory verbal
Mirelman et al., 2012 [79]Executive function and falls in older adultsCohort study (Follow Up)(1) Evaluate if reduced Executive Function is a risk factor for future falls,
(2) assess whether ST and DT walking abilities, an alternative window into EF, were associated with fall risk.
256
Participant recorded there falls in a falls calendar
76.4 ± 4.5Arithmetic task
Walking + subtracting 3 s from a predefined 3 digit number
SR: auditory verbal
Muhaidat et al., 2013 [20]Exploring gait-related dual task tests in community-dwelling fallers and non-fallerPilot studyAssess differences in DT performance between the two groups on both primary and secondary tasks to help narrow down the potential choices of tasks, using simple clinical outcome measures that only require the use of a stopwatch, for future research.Fallers (n = 12), Non-Fallers (n = 15)
Falls assessment of previous falls in the last 12 months
Fallers (75.5 (8.5 IQR),
Non-Fallers 72 (4 IQR)
Arithmetic tasks:
1. Walking + subtracting 3 s
2. Walking + subtracting 7 s
Verbal fluency tasks:
3. Walking + Generating words e starting with the letter I, N, or O
4. Walking + Generating animal names
Visual spatial task:
5. Walking + clock task
SR 1.-5.: auditory verbal
Secondary motor task:
6. Walking + carrying a cup
SR: auditory- manual
Discrimination task:
7. Walking + Stroop (high/ low; different pitches)
SR: auditory verbal
Nordin et al., 2010 [80]Changes in step-width during dual-task walking predicts fallsCohort study (Follow Up)Evaluate whether gait pattern changes between single- and DT conditions were associated with risk of falling in older peopleFallers (n = 120), Non-Fallers (n = 110)
Participant recorded there falls in a falls dairy
Non-Fallers (78)
Fallers (80)
No SD available
1. Secondary motor task:
Walking + carrying a cup on a tray)
SR: auditory-manual
2. Verbal fluency task:
Walking + naming animals
3. Arithmetic task:
Walking + subtracting 3 s from 50
SR 2. +  3.: auditory verbal
Reelick et al., 2011 [81]Increased intra-individual variability in stride length and reaction time in recurrent older fallersCross-sectional studyTo compare mean performance measures as well as intra-individual variability measures of stride length and reaction time in vulnerable recurrent and non-recurrent older fallers.Non- fallers (n = 38), Recurrent fallers (n = 22)
Falls assessment of previous falls in the last 6 months
Non-recurrent Fallers (75.8 ± 7.2), recurrent Fallers (75.7 ± 5.6)1. Arithmetic task
Walking + subtracting 7 from 100
2. Verbal fluency task:
Walking + naming words starting with a certain letter
SR: auditory verbal
Springer et al., 2006 [82]Dual-tasking effects on gait variability: The role of aging, falls, and executive functionCross-sectional studyTest if the DT effect on gait variability is larger
1) in healthy older people vs healthy young people;
2) in idiopathic older fallers vs healthy older people;
3) and if DT has effects on gait variability are correlated with executive function
YA (n = 19), Non- fallers (n = 24), Fallers (n = 17)
Falls assessment of previous falls in the last 6 months
YA (29,4 ± 4,4),
Non-Fallers (71.0 ± 5.9),
Fallers (76.1 ± 4.8)
1. Listening memory task
Walking + listening to a text; answering questions afterwards
SR: auditory verbal
2. Arithmetic task
Walking + subtracting 7 from 500
SR: auditory verbal
Toulotte et al., 2006a [83]Effects of training and detraining on the static and dynamic balance in elderly fallers and non-fallersPilot studyEvaluate the effects of training on static and dynamic balance in ST and DT conditions to analyze the effects of detraining on static and dynamic balance in healthy older fallers and non-fallers.Fallers (n = 8), Non-Fallers (n = 8)
Falls assessment of previous falls in the last 24 months
Fallers (71.1 ± 5.0), Non-Fallers (68.4 ± 4.5)Secondary motor task:
Walking + carrying a glass
SR: auditory-manual
Toulotte et al., 2006b [84]Identification of healthy elderly fallers and non-fallers by gait analysis under dual-task conditionsCase comp-arison studyCompare healthy older fallers and non-fallers to identify balance disorders associated with falling under ST and DT conditionsFallers (n = 21), Non-Fallers (n = 19)
Falls assessment of previous falls in the last 24 months
Fallers (70.43 ± 6.43), Non-Fallers (67.05 ± 4.81)Secondary motor task:
Walking + carrying a glass
SR: auditory-manual
Verghese et al., 2017 [85]Brain activation in high-functioning older adults and fallsProspective cohort studyTo determine whether brain activity over the prefrontal cortex measured in real time during walking predicts falls in high-functioning older people166
71 fallers
95 non-fallers
Falls were prospectively ascertained over a 50-month period
74.95 ± 6.07Letter memory task:
Walking + reciting alternate letters
SR: auditory-manual
Yamada et al., 2011 [86]The reliability and preliminary validity of game-based fall risk assessment in community-dwelling older adultsRandomized controlled trialExamine whether the Nintendo Wii Fit program could be used for fall risk assessment in healthy, community-dwelling older peopleFaller (n = 16), Non-Fallers (n = 28)
Previous falls in the last 12 months assessed by question-naire
Fallers (84.8 ± 10.1),
Non-Fallers (80.2 ± 6.4)
Arithmetic task:
Walking + counting backwards from 50
SR: auditory-manual
Asai et al. 2014 [87]Effects of dual-tasking on control of trunk movement during gait: respective effect of manual- and cognitive-taskCross-sectional study1. to assess the effects of a cognitive task and a manual task on trunk movements during gait.
2. to examine the effect of FoF on trunk movement in both dual-task walking conditions: cognitive task and manual-task gaits.
Overall (n = 117), nFoF (n = 85), FoF (n = 32)
Previous falls in the last 12 months assessed by questionnaire
FOF was assessed by one question
Overall (73.7 ± 4.0), nFoF (73.7 ± 4.0), FoF (74.5 ± 4.0)1. Arithmetic task:
Walking + subtracting 1 s from 100
SR: auditory-manual
2. Secondary motor task:
Walking + motor task carrying a ball on a tray
SR: auditory-manual
Donoghue et al., 2013 [88]Effects of fear of falling and activity restriction on normal and dual task walking in community dwelling older adultsProspective cohort study1. to examine the relationship between FOF, activity restriction and gait characteristics in normal and dual task walking and
2. to determine if these relationships persist after adjusting for potentially underlying factors
No FOF (n = 961), FOF-NAR (n = 250), FOF-AR (n = 96)
FOF was assessed by one question
No FOF (72.3 ± 5.6), FOF-NAR (74.9 ± 5.8), FOF-AR (73.9 ± 5.6)Verbal memory task:
Walking + recite alternate letters of the alphabet (A-C-E, etc.)
SR: auditory-manual
Reelick et al., 2009 [89]The influence of fear of falling on gait and balance in older peopleCross-sectional studyThe purpose of this study was to examine the association between FoF and gait and balance in older people during walking with and without dual-tasking.FoF (n = 29) vs NFOF (n = 65)
FOF was assessed by the ABC-NL scale
FOF (80.6 ± 4.2) vs. NFOF (80.5 ± 3.7)Arithmetic task:
Walking + subtracting 7 s from 100
SR: auditory-manual
Wollesen et al., 2017 [90]Does dual task training improve walking performance of older adults with concern of falling?Single blind randomized controlled trialThe primary aim of this study was to compare the effects of a DT training integrating task managing strategies for independent living older people with and without concern about falling to a non-training control group on walking performance under ST and DT conditions.Intervention with FES-I < 20 (n = 26) vs Intervention with FES-I > 20 (n = 30) vs Control group with FES-I < 20 (n = 19) vs Control group with FES-I (n = 20)Intervention with FES-I < 20 (72.2 ± 4.6) vs
Intervention with FES-I > 20 (69.8 ± 5.7) vs
Control group with FES-I < 20 (72.9 ± 4.4) vs
Control group with FES-I (72.7 ± 5.3)
Discrimination task:
Walking + Stroop task (colors)
SR: visual-verbal
  1. Legend: SR Stimulus-reponse condition, YA Young adults, nFOF No fear of falling, FOF Fear of falling, FOF NAR=, ABC-NL Advanced balance scale Netherlands, FES-I Falls efficacy scale- international