Effects of a Multimodal Exercise Intervention on Single- and Dual-Task Gait Performance in Older Patients with Open-Angle Glaucoma: A Pilot Study

Background/Objectives: To investigate the effects of a 12-week multimodal intervention (MMI [resistance + motor-cognitive dual-task training]) versus a unimodal intervention (UMI [resistance training]) on gait and cognitive performance in people with glaucoma during single-task (ST) and dual-task (DT) walking. Methods: In this randomized controlled pilot study, fifteen glaucoma patients (MMI: n=8, UMI: n=7) completed 24 supervised intervention sessions over 12-weeks. Spatio-temporal gait parameters (stride length, gait velocity, minimum toe clearance [MTC], and their respective coefficient of variance [CoV]) were assessed using inertial measurement units (sampling frequency 100Hz) during ST and DT walking. During DT walking, the participants performed three cognitive tasks: reaction time task, N-Back task, and letter fluency task. Each cognitive task was performed with two levels of difficulty. Repeated measures analysis of covariance (TIME x INTERVENION x CONDITION) was conducted to analyze the data. Results: No significant group or time effects were observed for ST gait or cognitive performance. Independent of intervention, dual-task costs (DTC) improved for MTC (p=0.188,η_p²=0.205) and MTCCoV (p=0.021, η_p²=0.713) over time. UMI showed greater improvements over time than MMI for DTC MTC (p=0.168,η_p²=0.223) and DTC MTCCoV (p=0.047,η_p²=0.407).Conclusion: This pilot study revealed that both MMI and UMI decreased DTC MTC and DTC MTCCoV in glaucoma patients. However, UMI appeared more effective than MMI to improve gait performance in glaucoma patients. Thus, resistance training might be a promising intervention to improve gait performance in glaucoma patients, with the ultimate aim to reduce the risk of falls.