The Effects of Dual-Task Exercises on Balance, Gait Performance, and Fall Risk in Healthy Older Individuals

Authors

DOI:

https://doi.org/10.5281/zenodo.21001906

Keywords:

Healthy older adults, balance, postural control, fall risk, dual-task exercise.

Abstract

Purpose: The aim of this review is to examine the effects of dual-task based exercise interventions on balance, postural control, and gait performance in healthy elderly individuals, in light of current literature, and to evaluate the potential role of these approaches in reducing the risk of falls.

Methods: In line with the study's objective, a literature review was conducted using PubMed and Google Scholar databases. The review process examined English-language studies published between 2016 and 2026. The keywords used were “dual-task training”, “dual-task exercise”, “older adults”, “postural control”, “balance”, “gait performance”, “fall risk”, and “fall prevention”. Clinical studies investigating the effects of dual-task exercises on balance, gait, or postural control in healthy older individuals were included in the evaluation. Studies involving neurological disease populations were excluded.

Results:    Most studies reviewed suggest that the simultaneous application of motor and cognitive tasks can have positive effects on balance performance, gait parameters, and functional mobility in older adults. Dual-task exercises are highlighted as particularly effective in improving dynamic balance, gait speed, and inter-task coordination; additionally, they support the integration of cognitive processes with motor performance. Some studies have also reported that such interventions can reduce fear of falling and contribute to safer movement in daily living activities.

Conclusions:   Current findings suggest that dual-task-based exercises may be an effective approach to improving balance and gait performance in healthy older adults. These interventions, reflecting common multitasking situations in daily life, are considered a potential exercise strategy that can contribute to reducing the risk of falls.

References

Al-Yahya, E., Dawes, H., Smith, L., Dennis, A., Howells, K., & Cockburn, J. (2011). Cognitive motor interference while walking: A systematic review and meta-analysis. Neuroscience & Biobehavioral Reviews, 35(3), 715-728. https://doi.org/10.1016/j.neubiorev.2010.08.008

Aragão-Santos, J. C., Behm, D. G., de Moura, T. R., & Da Silva-Grigoletto, M. E. (2024). Dual-task training is as effective as functional training on the functional fitness of older women: A randomized clinical trial. BMC Geriatrics, 24(1), 607. https://doi.org/10.1186/s12877-024-05204-w

Arif, Z., Tanveer, H. M., Bibi, M., Bibi, A., Akhtar, A., & Sadaqat, S. (2025). Effects of dual-task balance and gait training on fear of falling and functional independence in older adults: A randomised controlled trial. The Healer Journal of Physiotherapy and Rehabilitation Sciences, 5(2), 467-474. https://doi.org/10.55735/gpw2fj74

Balcı, L. A., Soğukkanlı, K., Burcu, S., & Hanoğlu, L. (2022). Effects of single-task, dual-task and successive physical-cognitive training on fall risk and balance performance in older adults: A randomized trial. Journal of Exercise Therapy and Rehabilitation, 9(1), 1-11. https://doi.org/10.15437/jetr.675975

Bayot, M., Dujardin, K., Dissaux, L., Tard, C., Defebvre, L., Bonnet, C. T., Allart, E., Allali, G., & Delval, A. (2020). Can dual-task paradigms predict Falls better than single task? - A systematic literature review. Neurophysiologie Clinique, 50(6), 401-440. https://doi.org/10.1016/j.neucli.2020.10.008

Bayot, M., Dujardin, K., Tard, C., Defebvre, L., Bonnet, C. T., Allart, E., & Delval, A. (2018). The interaction between cognition and motor control: A theoretical framework for dual-task interference effects on posture, gait initiation, gait and turning. Neurophysiologie Clinique, XXVe congrès SOFPEL, 48(6), 361-375. https://doi.org/10.1016/j.neucli.2018.10.003

Beauchet, O., Allali, G., Berrut, G., Hommet, C., Dubost, V., & Assal, F. (2008). Gait analysis in demented subjects: Interests and perspectives. Neuropsychiatric Disease and Treatment, 4(1), 155-160. https://doi.org/10.2147/ndt.s2070

Bergamin, M., Gobbo, S., Zanotto, T., Sieverdes, J. C., Alberton, C. L., Zaccaria, M., & Ermolao, A. (2014). Influence of age on postural sway during different dual-task conditions. Frontiers in Aging Neuroscience, 6, 271. https://doi.org/10.3389/fnagi.2014.00271

Bronstein, A. M., & Pavlou, M. (2013). Balance. Handbook of Clinical Neurology, 110, 189-208. https://doi.org/10.1016/B978-0-444-52901-5.00016-2

Dziechciaż, M., & Filip, R. (2014). Biological psychological and social determinants of old age: Bio-psycho-social aspects of human aging. Annals of Agricultural and Environmental Medicine: AAEM, 21(4), 835-838. https://doi.org/10.5604/12321966.1129943

Ebaid, D., & Crewther, S. G. (2020). Time for a systems biological approach to cognitive aging?-A critical review. Frontiers in Aging Neuroscience, 12, 114. https://doi.org/10.3389/fnagi.2020.00114

Fasano, A., Plotnik, M., Bove, F., & Berardelli, A. (2012). The neurobiology of falls. Neurological Sciences: Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 33(6), 1215-1223. https://doi.org/10.1007/s10072-012-1126-6

Gerards, M. H. G., Marcellis, R. G. J., Poeze, M., Lenssen, A. F., Meijer, K., & de Bie, R. A. (2021). Perturbation-based balance training to improve balance control and reduce falls in older adults – study protocol for a randomized controlled trial. BMC Geriatrics, 21(1), 9. https://doi.org/10.1186/s12877-020-01944-7

Ghai, S., Ghai, I., & Effenberg, A. O. (2017). Effects of dual tasks and dual-task training on postural stability: A systematic review and meta-analysis. Clinical Interventions in Aging, 12, 557-577. https://doi.org/10.2147/CIA.S125201

Guzmán, D. E., Rengifo, C. F., Guzmán, J. D., & Garcia Cena, C. E. (2024). Virtual reality games for cognitive rehabilitation of older adults: A review of adaptive games, domains and techniques. Virtual Reality, 28(2), 92. https://doi.org/10.1007/s10055-024-00968-3

Hamacher, D., Liebl, D., Hödl, C., Heßler, V., Kniewasser, C. K., Thönnessen, T., & Zech, A. (2018). Gait stability and its influencing factors in older Adults. Frontiers in Physiology, 9, 1955. https://doi.org/10.3389/fphys.2018.01955

Hirono, T., Ikezoe, T., Yamagata, M., Kato, T., Umehara, J., Yanase, K., Nakao, S., Tsuboyama, T., Tabara, Y., Matsuda, F., Ichihashi, N., & Nagahama Study Group. (2021). Age-related changes in gait speeds and asymmetry during circular gait and straight-line gait in older individuals aged 60-79 years. Geriatrics & Gerontology International, 21(5), 404-410. https://doi.org/10.1111/ggi.14150

Hu, K., Zhou, Q., Jiang, Y., Shang, Z., Mei, F., Gao, Q., Chen, F., Zhao, L., Jiang, M., & Ma, B. (2021). Association between frailty and mortality, falls, and hospitalization among patients with hypertension: A systematic review and Meta-Analysis. BioMed Research International, 2690296. https://doi.org/10.1155/2021/2690296

Khan, M. J., Fong, K. N. K., Wong, T. W.-L., Tsang, W. W.-N., Chen, C., Chan, W.-C., & Winser, S. J. (2025). Effectiveness of dual-task exercise in improving balance and preventing falls among older adults: Systematic review with meta-analysis and meta-regression. European Geriatric Medicine, 16(6), 2047-2083. https://doi.org/10.1007/s41999-025-01328-3

Khan, M. J., Kannan, P., Wong, T. W.-L., Fong, K. N. K., & Winser, S. J. (2022). A Systematic Review Exploring the Theories Underlying the Improvement of Balance and Reduction in Falls Following Dual-Task Training among Older Adults. International Journal of Environmental Research and Public Health, 19(24), 16890. https://doi.org/10.3390/ijerph192416890

Kueper, J. K., Lizotte, D. J., Montero-Odasso, M., Speechley, M., & Alzheimer’s Disease Neuroimaging Initiative. (2020). Cognition and motor function: The gait and cognition pooled index. PloS One, 15(9), e0238690. https://doi.org/10.1371/journal.pone.0238690

Lai, X., Zhu, H., Cai, Y., Chen, B., Li, Y., Du, H., Zhang, L., Wang, W., Li, S., & Huo, X. (2025). Effects of exercise-cognitive dual-task training on cognitive frailty in older adults: A randomized controlled trial. Frontiers in Aging Neuroscience, 17. https://doi.org/10.3389/fnagi.2025.1639245

MacPherson, S. E. (2018). Definition: Dual-tasking and multitasking. Cortex; a Journal Devoted to the Study of the Nervous System and Behavior, 106, 313-314. https://doi.org/10.1016/j.cortex.2018.06.009

Manckoundia, P., Mourey, F., Larosa, F., & Renoncourt, T. (2025). Balance and Gait Disorders in the Aged Population. Causes, Assessment and Management: A Literature Review. Clinical Interventions in Aging, 20, 1945-1962. https://doi.org/10.2147/CIA.S531235

McIsaac, T. L., Lamberg, E. M., & Muratori, L. M. (2015). Building a Framework for a Dual Task Taxonomy. BioMed Research International, 591475. https://doi.org/10.1155/2015/591475

Melzer, I., Kurz, I., & Oddsson, L. I. E. (2010). A retrospective analysis of balance control parameters in elderly fallers and non-fallers. Clinical Biomechanics, 25(10), 984-988. https://doi.org/10.1016/j.clinbiomech.2010.07.007

Montero-Odasso, M., Almeida, Q. J., Burhan, A. M., Camicioli, R., Doyon, J., Fraser, S., Li, K., Liu-Ambrose, T., Middleton, L., Muir-Hunter, S., McIlroy, W., Morais, J. A., Pieruccini-Faria, F., Shoemaker, K., Speechley, M., Vasudev, A., Zou, G. Y., Berryman, N., Lussier, M., … Bherer, L. (2018). Synergic trial (SYNchronizing Exercises, Remedies in Gait and Cognition) a multi-Centre randomized controlled double blind trial to improve gait and cognition in mild cognitive impairment. BMC Geriatrics, 18(1), 93. https://doi.org/10.1186/s12877-018-0782-7

Montero-Odasso, M., Verghese, J., Beauchet, O., & Hausdorff, J. M. (2012). Gait and cognition: A complementary approach to understanding brain function and the risk of falling. Journal of the American Geriatrics Society, 60(11), 2127-2136. https://doi.org/10.1111/j.1532-5415.2012.04209.x

Muir-Hunter, S. W., & Wittwer, J. E. (2016). Dual-task testing to predict falls in community-dwelling older adults: A systematic review. Physiotherapy, 102(1), 29-40. https://doi.org/10.1016/j.physio.2015.04.011

Nascimento, M. de M., Maduro, P. A., Rios, P. M. B., Nascimento, L. dos S., Silva, C. N., Kliegel, M., & Ihle, A. (2023). The effects of 12-week dual-task physical–cognitive training on gait, balance, lower extremity muscle strength, and cognition in older adult women: A randomized study. International Journal of Environmental Research and Public Health, 20(8), 5498. https://doi.org/10.3390/ijerph20085498

Oschwald, J., Guye, S., Liem, F., Rast, P., Willis, S., Röcke, C., Jäncke, L., Martin, M., & Mérillat, S. (2019). Brain structure and cognitive ability in healthy aging: A review on longitudinal correlated change. Reviews in the Neurosciences, 31(1), 1-57. https://doi.org/10.1515/revneuro-2018-0096

Park, J.-H. (2022). Is dual-task training clinically beneficial to improve balance and executive function in community-dwelling older adults with a history of falls? International Journal of Environmental Research and Public Health, 19(16), 10198. https://doi.org/10.3390/ijerph191610198

Phirom, K., Kamnardsiri, T., & Sungkarat, S. (2020). Beneficial effects of interactive physical-cognitive game-based training on fall risk and cognitive performance of older adults. International Journal of Environmental Research and Public Health, 17(17), 6079. https://doi.org/10.3390/ijerph17176079

Promsri, A. (2023). Age and visual contribution effects on postural control assessed by principal component analysis of kinematic marker data. Sports, 11(5), 98. https://doi.org/10.3390/sports11050098

Rabinovici, G. D., Stephens, M. L., & Possin, K. L. (2015). Executive dysfunction. Continuum: Lifelong Learning in Neurology, 21(3 Behavioral Neurology and Neuropsychiatry), 646-659. https://doi.org/10.1212/01.CON.0000466658.05156.54

Ramkhalawansingh, R., Keshavarz, B., Haycock, B., Shahab, S., & Campos, J. L. (2017). Examining the effect of age on visual-vestibular self-motion perception using a driving paradigm. Perception, 46(5), 566-585. https://doi.org/10.1177/0301006616675883

Rezola-Pardo, C., Irazusta, J., Mugica-Errazquin, I., Gamio, I., Sarquis-Adamson, Y., Gil, S. M., Ugartemendia, M., Montero-Odasso, M., & Rodriguez-Larrad, A. (2022). Effects of multicomponent and dual-task exercise on falls in nursing homes: The AgeingOn Dual-Task study. Maturitas, 164, 15-22. https://doi.org/10.1016/j.maturitas.2022.06.006

Roman-Liu, D. (2018). Age-related changes in the range and velocity of postural sway. Archives of Gerontology and Geriatrics, 77, 68-80. https://doi.org/10.1016/j.archger.2018.04.007

Ruffieux, J., Keller, M., Lauber, B., & Taube, W. (2015). Changes in standing and walking performance under dual-task conditions across the lifespan. Sports Medicine (Auckland, N.z.), 45, 1739-1758. https://doi.org/10.1007/s40279-015-0369-9

Sasagawa, S., Arakawa, A., Furuyama, A., & Matsumoto, Y. (2024). Age-related changes in static balance in older women aged in their early sixties to their late eighties: Different aging patterns in the anterior–posterior and mediolateral directions. Frontiers in Aging Neuroscience, 16. https://doi.org/10.3389/fnagi.2024.1361244

Shu, Y., Bi, M. M., Zhou, T. T., Liu, L., & Zhang, C. (2022). Effect of dual-task training on gait and balance in stroke patients: An updated meta-analysis. American Journal of Physical Medicine & Rehabilitation, 101(12), 1148-1155. https://doi.org/10.1097/PHM.0000000000002016

Trombini-Souza, F., de Moura, V. T. G., da Silva, L. W. N., Leal, I. dos S., Nascimento, C. A., Silva, P. S. T., Perracini, M. R., Sacco, I. C., de Araújo, R. C., & Nascimento, M. de M. (2023). 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, 11, e15030. https://doi.org/10.7717/peerj.15030

van der Veen, S. M., & Thomas, J. S. (2021). A Pilot Study Quantifying Center of Mass Trajectory during Dynamic Balance Tasks Using an HTC Vive Tracker Fixed to the Pelvis. Sensors, 21(23), 8034. https://doi.org/10.3390/s21238034

Varela-Vásquez, L. A., Minobes-Molina, E., & Jerez-Roig, J. (2020). Dual-task exercises in older adults: A structured review of current literature. Journal of Frailty, Sarcopenia and Falls, 5(2), 31-37. https://doi.org/10.22540/JFSF-05-031

Viswanathan, A., & Sudarsky, L. (2012). Balance and gait problems in the elderly. Handbook of Clinical Neurology, 103, 623-634. https://doi.org/10.1016/B978-0-444-51892-7.00045-0

Wang, J., Li, Y., Yang, G.-Y., & Jin, K. (2024). Age-related dysfunction in balance: A comprehensive review of causes, consequences, and interventions. Aging and Disease, 16(2), 714-737. https://doi.org/10.14336/AD.2024.0124-1

Wang, Q., Li, L., Mao, M., Sun, W., Zhang, C., Mao, D., & Song, Q. (2022). The relationships of postural stability with muscle strength and proprioception are different among older adults over and under 75 years of age. Journal of Exercise Science & Fitness, 20(4), 328-334. https://doi.org/10.1016/j.jesf.2022.07.004

Winser, S. J., Chan, A. Y. Y., Whitney, S. L., Chen, C. H., & Pang, M. Y. C. (2023). Effectiveness and cost of integrated cognitive and balance training for balance and falls in cerebellar ataxia: A blinded two-arm parallel group RCT. Frontiers in Neurology, 14, 1267099. https://doi.org/10.3389/fneur.2023.1267099

Xiao, Y., Yang, T., & Shang, H. (2023). The impact of motor-cognitive dual-task training on physical and cognitive functions in parkinson’s disease. Brain Sciences, 13(3), 437. https://doi.org/10.3390/brainsci13030437

Yogev-Seligmann, G., Hausdorff, J. M., & Giladi, N. (2008). The role of executive function and attention in gait. Movement Disorders: Official Journal of the Movement Disorder Society, 23(3), 329-342; quiz 472. https://doi.org/10.1002/mds.21720

Yuzlu, V., Oguz, S., Timurtas, E., Aykutoglu, E., & Polat, M. G. (2022). The effect of 2 different dual-task balance training methods on balance and gait in older adults: A randomized controlled trial. Physical Therapy, 102(3), pzab298. https://doi.org/10.1093/ptj/pzab298

Published

2026-06-27

How to Cite

ASLAN KOLUKISA, S. (2026). The Effects of Dual-Task Exercises on Balance, Gait Performance, and Fall Risk in Healthy Older Individuals. InHealth Theory, 3(1), 50–62. https://doi.org/10.5281/zenodo.21001906

Issue

Section

Review Articles