ORIGINAL PAPER
Effect of dual-task training on postural stability in obese individuals: a randomised controlled trial
1
Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, India
Submission date: 2025-05-09
Acceptance date: 2025-11-25
Online publication date: 2026-08-05
Corresponding author
Chhavi Arora Sehgal
Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, India
Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, India
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Obesity has been linked to adverse postural stability parameters that can negatively impact balance. While studies have demonstrated the benefits of dual-task (DT) training on postural stability, these benefits have not been observed in obese individuals. Therefore, this study aims to compare the effects of DT training with different prioritisation on postural stability in obese individuals.
Methods:
35 subjects were randomised to one of 3 groups: DT – variable priority (VP), DT – fixed priority (FP), and a single-task training group. Centre of pressure (CoP) sway, CoP range, and reaction time were assessed using a Pedalo®-Sensamove balance device. Balance was determined using the timed up and go (TUG) and TUG-Cog tests, and the Berg balance scale (BBS) before and after 8 weeks of intervention programs.
Results:
The results showed a significant improvement in all outcome variables after eight weeks of intervention (effect of time, p < 0.05), with no significant difference between the groups (effect of group, p > 0.05). When comparing the mean differences in CoP sway, range, and TUG-Cog, statistically significant results were obtained in the variable priority group compared to the fixed-priority group.
Conclusions:
The findings of this research imply that engaging in DT training can enhance postural stability and balance in obese individuals, regardless of whether the instructional set is of the variable- or fixed-priority variety. Nevertheless, these outcomes were not established to surpass those achieved through conventional single-task training regimens.
Obesity has been linked to adverse postural stability parameters that can negatively impact balance. While studies have demonstrated the benefits of dual-task (DT) training on postural stability, these benefits have not been observed in obese individuals. Therefore, this study aims to compare the effects of DT training with different prioritisation on postural stability in obese individuals.
Methods:
35 subjects were randomised to one of 3 groups: DT – variable priority (VP), DT – fixed priority (FP), and a single-task training group. Centre of pressure (CoP) sway, CoP range, and reaction time were assessed using a Pedalo®-Sensamove balance device. Balance was determined using the timed up and go (TUG) and TUG-Cog tests, and the Berg balance scale (BBS) before and after 8 weeks of intervention programs.
Results:
The results showed a significant improvement in all outcome variables after eight weeks of intervention (effect of time, p < 0.05), with no significant difference between the groups (effect of group, p > 0.05). When comparing the mean differences in CoP sway, range, and TUG-Cog, statistically significant results were obtained in the variable priority group compared to the fixed-priority group.
Conclusions:
The findings of this research imply that engaging in DT training can enhance postural stability and balance in obese individuals, regardless of whether the instructional set is of the variable- or fixed-priority variety. Nevertheless, these outcomes were not established to surpass those achieved through conventional single-task training regimens.
REFERENCES (33)
1.
Chandrasekaran P, Weiskirchen R. The role of obesity in type 2 diabetes mellitus – an overview. Int J Molecular Sci. 2024;25(3):1882; doi: 10.3390/ijms25031882.
2.
Pan W-H, Yeh W-T. How to define obesity? Evidence-based multiple action points for public awareness, screening, and treatment: an extension of Asian-Pacific recommendations. Asia Pac J Clin Nutr. 2008;17(3):370–4.
3.
Misra A. Ethnic-specific criteria for classification of body mass index: a perspective for Asian Indians and American Diabetes Association Position Statement. Diabetes Technol Ther. 2015;17(9):667–71; doi: 10.1089/dia.2015.0007.
4.
Prickett C, Brennan L, Stolwyk R. Examining the relationship between obesity and cognitive function: a systematic literature review. Obes Re Clin Pract.2015;9(2):93–113; doi: 10.1016/j.orcp.2014.05.001.
5.
Meng H, Gorniak SL. Effects of adiposity on postural control and cognition in older adults. Gait Posture. 2020;82:147–52; doi: 10.1016/j.gaitpost.2020.09.004.
6.
Prieto TE, Myklebust JB, Myklebust BM. Characterization and modeling of postural steadiness in the elderly: a review. IEEE Transactions on rehabilitation engineering. 2002;1(1):26–34; doi: 10.1109/86.242405.
7.
Simoneau M, Teasdale N. Balance control impairment in obese individuals is caused by larger balance motor commands variability. Gait Posture. 2015;41(1):203–8; doi: 10.1016/j.gaitpost.2014.10.008.
8.
Teasdale N, Simoneau M, Corbeil P, Handrigan G, Tremblay A, Hue O. Obesity alters balance and movement control. Curr Obes Rep. 2013;2:235–40; doi: 10.1007/s13679-013-0057-8.
9.
Wu X, Madigan ML. Impaired plantar sensitivity among the obese is associated with increased postural sway. Neurosci Lett. 2014;583:49–54; doi: 10.1016/j.neulet.2014.09.029.
10.
Son SM. Influence of obesity on postural stability in young adults. Osong Public Health Res Perspect. 2016;7(6):378–81; doi: 10.1016/j.phrp.2016.10.001.
11.
Small GH, Brough LG, Neptune RR. The influence of cognitive load on balance control during steady-state walking. J Biomech. 2021;122:110466; doi: 10.1016/j.jbiomech.2021.110466.
12.
Elias MF, Elias PK, Sullivan LM, Wolf PA, D’Agostino RB. Lower cognitive function in the presence of obesity and hypertension: the Framingham heart study. Int J Obes Relat Metab Disord. 2003;27(2):260–8; doi: 10.1038/sj.ijo.802225.
13.
Da Conceicao ARR, Vieira MNN, De Felice FG. Structural changes in the obese brain. Neural Regen Res. 2024;19(12):2561–2; doi: 10.4103/NRR.NRR-D-23-01123.
14.
Silsupadol P, Lugade V, Shumway-Cook A, van Donkelaar P, Chou LS, Mayr U, Woollacott MH. Training-related changes in dual-task walking performance of elderly persons with balance impairment: a double-blind, randomized controlled trial. Gait Posture. 2009;29(4):634–9; doi: 10.1016/j.gaitpost.2009.01.006.
15.
Noohu MM, Moiz JA, Dey AB, Hussain ME. A balance device reliability for reaction time and proprioception measurement in older adults. Indian J Gerontol. 2016;30(3):396–403.
16.
Pasco JA, Sui SX, Tembo MC, Holloway-Kew KL, Rufus PG, Kotowicz MA. Sarcopenic obesity and falls in the elderly. J Gerontol Geriatr Res. 2018;7(2); doi: 10.4172/2167-7182.1000465.
17.
Hofheinz M, Schusterschitz C. Dual task interference in estimating the risk of falls and measuring change: a comparative, psychometric study of four measurements. Clin Rehabil. 2010;24(9):831–42; doi: 10.1177/0269215510367993.
18.
Springer BA, Marin R, Cyhan T, Roberts H, Gill NW. Normative values for the unipedal stance test with eyes open and closed. J Geriatr Phys Ther. 2007;30(1):8–15; doi: 10.1519/00139143-200704000-00003.
19.
Wang Y, Zhang C, Wang B, Zhang D, Song X. Comparative effects of cognitive and instability resistance training versus instability resistance training on balance and cognition in elderly women. Sci Rep. 2024;14(1):26045; doi: 10.1038/s41598-024-77536-x.
20.
Bamidis PD, Vivas AB, Styliadis C, Frantzidis C, Klados M, Schlee W, Siountas A, Papageorgiou SG. A review of physical and cognitive interventions in aging. Neurosci Biobehav Rev. 2014;44:206–20; doi: 10.1016/j.neubiorev.2014.03.019.
21.
Fraser SA, Li KZ-H, Berryman N, Desjardins-Crépeau L, Lussier M, Vadaga K, Lehr L, Vu TTM, Bosquet L, Bherer L. Does combined physical and cognitive training improve dual-task balance and gait outcomes in sedentary older adults?. Front Hum Neurosci. 2017;10; doi: 10.3389/fnhum.2016.00688.
22.
Erickson KI, Colcombe SJ, Wadhwa R, Bherer L, Peterson MS, Scalf PE, Kim JS, Alvarado M, Kramer AF. Training-induced functional activation changes in dual-task processing: an fMRI study. Cerebral Cortex. 2007;17(1):192–204; doi: 10.1093/cercor/bhj137.
23.
Rezaie S, Goharpey S, Ghanavati T, Yadollah Poor N, Moradi L, Zade MHH. Effect of cognitive dual-task training on postural stability in older adults with diabetic peripheral neuropathy: a randomized control trial. J Biochem Tech. 2020;Spec Issue 1:127–33.
24.
Choi JH, Kim BR, Han EY, Kim SM. The effect of dual-task training on balance and cognition in patients with subacute post-stroke. Ann Rehabil Med. 2015;39(1):81–90; doi: 10.5535/arm.2015.39.1.81.
25.
Elhinidi EI, Ismaeel MM, El-Saeed TM. Effect of dual-task training on postural stability in children with infantile hemiparesis. J Phys Ther Sci. 2016;28(3):875–80; doi: 10.1589/jpts.28.875.
26.
An H-J, Kim J-I, Kim Y-R, Lee K-B, Kim D-J, Yoo K-T, Choi J-H. The effect of various dual task training methods with gait on the balance and gait of patients with chronic stroke. J Phys Ther Sci. 2014;26(8):1287–9; doi: 10.1589/jpts.26.1287.
27.
Kim D, Ko J, Woo Y. Effects of dual task training with visual restriction and an unstable base on the balance and attention of stroke patients. J Phys Ther Sci. 2013;25(12):1579–82; doi: 10.1589/jpts.25.1579.
28.
Hyndman D, Ashburn A, Yardley L, Stack E. Interference between balance, gait and cognitive task performance among people with stroke living in the community. Disabil Rehabil. 2006;28(13–14):849–56; doi: 10.1080/09638280500534994.
29.
Pellecchia GL. Dual-task training reduces impact of cognitive task on postural sway. J Mot Behav. 2005;37(3):239–46; doi: 10.3200/JMBR.37.3.239-246.
30.
Ruthruff E, Van Selst M, Johnston JC, Remington R. How does practice reduce dual-task interference: integration, automatization, or just stage-shortening?. Psychol Res. 2006;70(2):125–42; doi: 10.1007/s00426-004-0192-7.
31.
Kramer AF, Larish JF, Strayer DL. Training for attentional control in dual task settings: a comparison of young and old adults. J Exp Psychol Appl. 1995;1(1):50–76; doi: 10.1037/1076-898X.1.1.50.
32.
Buragadda S, Alyaemni A, Melam GR, Alghamdi MA. Effect of dual-task training (fixed priority-versus-variable priority) for improving balance in older adults. World Appl Sci J. 2012;20(6):884–8.
33.
Trombini-Souza F, de Moura VTG, da Silva LWN, dos Santos Leal IDS, Nascimento CA, Silva PST, Perracini MR, Sacco IC, de Araújo RC, Nascimento MM. Effects of two different dual-task training protocols on gait, balance, and cognitive function in community-dwelling older adults: a 24-week randomized controlled trial. PeerJ. 2023;11:e15030; doi: 10.7717/peerj.15030.
| eISSN: | 2544-4395 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
