# Effect of dual-task exercises on balance, risk for fall and activities of daily living dependency of patients with stroke: a quasi-experimental study

## TL;DR

This study shows that dual-task exercises improve balance, reduce fall risk, and increase independence in daily activities for stroke patients.

## Contribution

The study demonstrates the effectiveness of dual-task exercises in stroke rehabilitation, particularly in resource-limited settings.

## Key findings

- Dual-task exercises significantly improved balance in stroke patients.
- Fall risk decreased from 68.5% high risk pre-intervention to 40.7% low risk post-intervention.
- ADL dependency dropped from 75.9% severe pre-intervention to 9.3% post-intervention.

## Abstract

Stroke survivors often experience impaired balance, increased fall risk, and dependency in activities of daily living (ADLs). Dual-task exercises, combining motor and cognitive challenges, may improve these outcomes. This study was conducted to evaluate the effects of dual-task exercise intervention on balance, fall risk, and ADLs dependency in stroke patients.

A quasi-experimental single-group pretest–posttest design was used with 54 stroke patients recruited from Ain Shams University Hospitals, Cairo. Participants underwent 16- sessions of individualized dual-task exercises over 8 weeks. Follow-up assessments were conducted immediately post-intervention (two months). Balance was measured at follow-up using the Postural Assessment Scale for Stroke (PASS); fall risk was assessed at follow-up using the Timed Up and Go Test (TUGT); and ADLs dependency was evaluated at follow-up using the Barthel Index (BI). Data were analyzed using SPSS version 27.

Before intervention, 75.9% of participants had low ability to maintain posture, which improved post-intervention to 61.1% with high ability (p < 0.05). Similarly, the ability to change posture improved significantly (81.5% low to 63.0% high; p < 0.05). Pre-intervention 68.5% of patients were at high risk of falling, which decreased post-intervention, with 40.7% classified as low risk and 46.3% as no risk (p < 0.001). Severe ADLs dependency reduced markedly from 75.9% to 9.3% (p < 0.001). Across time points, higher PASS scores (better balance) were negatively associated with fall risk (TUGT) and ADL dependence, while higher BI scores (better ADL independence) were negatively correlated with fall risk and positively correlated with PASS (p = 0.001 for all).

Dual-task exercise training significantly improves balance, reduces fall risk, and enhances independence in ADLs among stroke patients. These findings support integrating dual-task interventions into stroke rehabilitation protocols, especially in resource-limited settings.