Effects of Gait Self-Efficacy and Lower-Extremity Physical Function on Dual-Task Performance in Older Adults

Abstract EN

Objectives.

Despite evidence of self-efficacy and physical function’s influences on functional limitations in older adults, few studies have examined relationships in the context of complex, real-world tasks.

The present study tested the roles of self-efficacy and physical function in predicting older adults’ street-crossing performance in single- and dual-task simulations.

Methods.

Lower-extremity physical function, gait self-efficacy, and street-crossing success ratio were assessed in 195 older adults (60–79 years old) at baseline of a randomized exercise trial.

During the street-crossing task, participants walked on a self-propelled treadmill in a virtual reality environment.

Participants crossed the street without distraction (single-task trials) and conversed on a cell phone (dual-task trials).

Structural equation modeling was used to test hypothesized associations independent of demographic and clinical covariates.

Results.

Street-crossing performance was better on single-task trials when compared with dual-task trials.

Direct effects of self-efficacy and physical function on success ratio were observed in dual-task trials only.

The total effect of self-efficacy was significant in both conditions.

The indirect path through physical function was evident in the dual-task condition only.

Conclusion.

Physical function can predict older adults’ performance on high fidelity simulations of complex, real-world tasks.

Perceptions of function (i.e., self-efficacy) may play an even greater role.

The trial is registered with United States National Institutes of Health ClinicalTrials.gov (ID: NCT01472744; Fit & Active Seniors Trial).