Reactive Turning During Walking Improves in Healthy Older Adults with a Novel Task-switching Step Exercise

Purpose : Older adults often experience difficulty maintaining balance during reactive turning while walking, which can occur suddenly and unpredictably. These challenges become more pronounced when the turning direction suddenly switches from the pre-planned side to the opposite side, a phenomenon known as task-switching. This study examined whether Task-Switching Step Exercise (TSSE) designed to enhance reactive turning without requiring turning and even walking—could improve reactive turning performance under a task-switching paradigm in healthy older adults. Methods : Sixty healthy older adults (69.9 ± 4.0 years) were randomly assigned to three groups. The TSSE group prepared a step with the foot indicated by an illuminated arrow and switched feet when the arrow direction changed alongside an auditory cue. The Single-Task Step Exercise group performed pre-planned steps as quickly as possible without task-switching. The Task-Switching Control Exercise group pushed a button while seated, following the task-switching paradigm. All participants completed a single 20-minute exercise session. Pre- and post-tests involved 90-degree reactive turning while walking under the task-switching paradigm. Results : The TSSE group demonstrated significant improvement in center of mass (COM) control, with a reduction in COM acceleration peak from pre- to post-test (p = 0.025). Correlation analyses suggested that some TSSE participants executed COM movement more smoothly and safely during the post-test ( r = -0.56, p = 0.01). Conclusion : Although the effect of TSSE was modest, the exercise may still contribute to improved reactive turning performance in healthy older adults by supporting COM control, even without walking or turning practice.