Effectiveness of Self-Administered Dual-Task Training in Improving Balance and Reducing Falls Among Older Adults: A Multicenter Randomized Control Trial

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BACKGROUND: Dual-task training helps improve balance and reduce falls among older adults, but self-administration of such training has yet to be explored. This study investigates the effectiveness of self-administered dual-task (sDT) compared with single-task training for improving balance and reducing falls. METHODS: Participants were 216 community-dwelling adults aged 65 years or over who had experienced at least 1 fall in the previous 6 months. Participants were assigned randomly to the sDT (n = 99) or self-administered single-task training (n = 117) group. Both groups completed 36 training sessions over 12 weeks, including 6 supervised workshops. The primary outcome was frequency of falls, while secondary outcomes included dynamic balance, dual-tasking ability, fear of falls, general health, global cognition, and quality of life. Assessment timelines included baseline, 12 weeks postintervention, and 6-month follow-up. RESULTS: The number of falls decreased in both groups. Compared with the self-administered single-task training group, the sDT group had a significantly lower fall rate (incidence rate ratio: 0.47; 95% CI, 0.34-0.64; P < .001). Immediate between-group effects showed that the sDT group had improved general health and global cognition. Immediate and long-term within-group effects in the sDT group included improved dynamic balance, standard Time Up and Go, and global cognition. No adverse events were recorded. CONCLUSION: Twelve weeks of sDT intervention was found to be safe and effective for reducing falls among at-risk participants. Future studies should evaluate the effects of sDT interventions, including a usual care control group.