Dual-task assessments for predicting future falls in neurologic conditions: A systematic review

Abstract

Abstract This review investigated the ability of dual-task tests to predict falls in people with neurological disorders (ND). Databases were searched to identify prospective cohort studies that analyzed dual-task testing and falls in people with NDs. Reviewers screened studies for eligibility and extracted key information like participant characteristics, intervention details, outcome measures, and significant outcomes. Reviewers assessed methodological quality of eligible studies using the Standard Quality Assessment Criteria. 18 studies of strong methodological qualified with 1750 participants were included in the review. Dual-task performances was predictive of future falls in people with Huntington’s disease, spinal cord injury, and moderate cognitive impairment, although only one independent study was included for each disability type. In people with stroke, thirty-seven percent of eligible studies showed dual-task assessments to be predictive of future falls. No dual-task tests predicted prospective falling in people with Alzheimer’s or Parkinson’s disease. Complex dual-tasks appeared to be more predictive of fall risk than simpler dual-tasks. Results suggest that disability type, severity of disability, and task complexity play a role in the predictive ability of dual-task assessments and future falling in NDs. Future studies may benefit from using this review to guide the design of effective dual-task assessments and fall interventions.