{"id":3314,"date":"2026-10-24T19:33:26","date_gmt":"2026-10-24T19:33:26","guid":{"rendered":"https:\/\/remotion.rehab\/?p=3314"},"modified":"2026-10-24T19:40:17","modified_gmt":"2026-10-24T19:40:17","slug":"falls-prevention-balance-dual-task-rehabilitation","status":"publish","type":"post","link":"https:\/\/remotion.rehab\/fr\/falls-prevention-balance-dual-task-rehabilitation\/","title":{"rendered":"Pr\u00e9vention des chutes, \u00e9quilibre et double t\u00e2che : quelle place pour les activit\u00e9s num\u00e9riques ?"},"content":{"rendered":"

Moving around everyday environments often involves more than movement alone. A person may walk while talking, look for a familiar doorway or decide where to go next. Rehabilitation can therefore involve questions about how movement and attention work together, alongside the person's strength, balance and environment.<\/p>\n

Interactive activities can offer structured ways to practise selected demands. Their purpose needs to be explicit: a better game score, a successful reaching task or a convincing body-tracking display does not, by itself, demonstrate a reduction in falls.<\/p>\n

Start with the person's falls history and daily activities<\/h2>\n

Falls prevention is broader than training balance on a screen. NICE's 2025 guideline includes comprehensive assessment of relevant factors such as mobility, medicines, vision, footwear and concerns about falling. It addresses older people and people aged 50 and over at higher risk; its scope should not be extended automatically to every age group. [1]<\/p>\n

Ask which activities matter to the person and what currently limits participation. Has the person fallen or nearly fallen? Do they avoid particular situations? What support or mobility aid do they use? These questions help the appropriate professional decide what needs assessment and which intervention components are relevant.<\/p>\n

A digital exercise cannot replace medication review, assessment of a possible medical cause or changes needed in the home environment. It may contribute to one part of a broader plan.<\/p>\n

What is a dual task?<\/h2>\n

A dual task involves performing two tasks at the same time. In a motor\u2013cognitive activity, one component involves movement or postural control and another involves attention, a decision, memory or communication. For example, a clinician might examine standing while selecting a target according to a simple rule, if this is appropriate after assessment.<\/p>\n

Adding sound, animation or difficulty does not automatically create a meaningful dual task. The therapist should be able to state both tasks, their relationship to the goal and what will be observed in each.<\/p>\n

The response may involve a change in either task. A person might answer accurately while moving less steadily, or maintain movement while making more selection errors. Observing only the digital response can miss the more important change.<\/p>\n

Build the activity around an assessed need<\/h2>\n

The World Falls Guidelines support individually targeted interventions and exercises connected with relevant daily activities. They also describe dual-task performance as one possible assessment consideration. This does not make dual-task training compulsory or suitable for every person. [2]<\/p>\n

Before combining demands, understand how the person performs each component in an appropriate, supported setting. Explain the instructions and how to request help or stop. If device operation is difficult, resolve access problems before treating the result as evidence about balance or divided attention.<\/p>\n

The therapist should decide whether simultaneous practice is useful now, whether the tasks should remain separate or whether another approach better serves the goal.<\/p>\n

An illustrative supervised activity<\/h2>\n

The following is an original planning example for a qualified clinician. It concerns an adult assessed as suitable for the activity. It is not a home-exercise prescription or a validated fall-prevention protocol.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
Planning element<\/th>\nIllustrative approach<\/th>\n<\/tr>\n<\/thead>\n
Everyday objective<\/td>\nParticipate in a relevant activity that involves remaining upright while attending to a simple choice.<\/td>\n<\/tr>\n
Intended context<\/td>\nAn individual, supervised rehabilitation session, with support based on assessment.<\/td>\n<\/tr>\n
Motor component<\/td>\nAn individually selected standing or movement task; a seated alternative may be needed but changes the objective.<\/td>\n<\/tr>\n
Cognitive component<\/td>\nIdentify a target using one clear selection rule, with an accessible response method.<\/td>\n<\/tr>\n
Configuration<\/td>\nAdjust display position, choices, prompts, timing and input only where available and clinically relevant.<\/td>\n<\/tr>\n
Observable information<\/td>\nPerformance in both components, actual assistance, comfort, pauses and unintended inputs; record software events separately.<\/td>\n<\/tr>\n
Easier version<\/td>\nSimplify the choice, reduce distractions, increase support or separate the tasks. Document what changed.<\/td>\n<\/tr>\n
Possible progression<\/td>\nChange one relevant demand when justified; avoid increasing physical and cognitive demands together without a clear reason.<\/td>\n<\/tr>\n
Cautions<\/td>\nMaintain appropriate guarding and support; stop or pause for loss of safe control, concerning symptoms, fatigue or a request to stop.<\/td>\n<\/tr>\n
Documentation<\/td>\nRecord the task instructions, support, settings, observed response and the next clinical decision.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Equipment and software may not offer all these adjustments. The presence of a touchscreen or tracking system does not establish that the setup is appropriate.<\/p>\n

Use digital feedback to support a clear task<\/h2>\n

A screen can present targets, choices or a contextual scene. A compatible tracking system may register movement events. Neither should distract from direct observation of the person, their strategy and the help they need.<\/p>\n

If the interface rewards speed, check whether speed is relevant to the clinical goal. Completing more targets is not a useful progression if it is achieved with loss of safe control or substantially more assistance. Pausing, simplifying or ending the task can be the appropriate decision.<\/p>\n

An immersive headset is not required for dual-task practice. When a headset is considered, its impact on visibility, communication, comfort and supervision needs a separate assessment. Screen-based and real-world activities remain options.<\/p>\n

What does the evidence about virtual environments show?<\/h2>\n

The V-TIME randomised trial found fewer falls after treadmill training combined with non-immersive VR than after treadmill training alone in the studied older adults at high risk. It used a specific supervised setup and followed falls after training. [3]<\/p>\n

This finding does not establish the same effect for a standing screen game, an immersive headset, ankle trackers or a Remotion product. The population, task, equipment, programme and outcome all matter when interpreting a study.<\/p>\n

Measure both performance and what matters outside the session<\/h2>\n

Record both task components rather than one combined score. For example, note the selection accuracy and the observed movement response, together with instructions, assistance and any change in strategy. If conditions differ between sessions, make those differences visible.<\/p>\n

Use clinical assessments appropriate to the question and within the professional's competence. A headset position, avatar movement or number of successful targets is not automatically a validated measure of balance or fall risk.<\/p>\n

To evaluate falls themselves, define an appropriate follow-up method and period, with a consistent way of recording falls and relevant context. Absence of a fall during a supervised session does not demonstrate reduced falls in daily life. The person's activity, confidence and support needs also deserve attention; a lower falls count should be interpreted alongside changes in participation.<\/p>\n

Keep the activity connected to the broader plan<\/h2>\n

Dual-task practice can be one component of rehabilitation when its purpose is clear and the demands are appropriate. It should not become a test of how much distraction or instability the person can tolerate.<\/p>\n

Review what was observed with the person and decide what comes next: repeat comparable conditions, adjust the support, practise a daily activity more directly or reconsider the digital component. The aim is meaningful participation within a coordinated falls-prevention plan.<\/p>\n

Discuss your rehabilitation goals and setting with the Remotion team through the website contact page<\/a>. Confirm the capabilities and intended use of the specific configuration; this article does not establish a product-specific claim of fall reduction or validated fall-risk prediction.<\/p>\n

References<\/h2>\n
    \n
  1. NICE. Falls: assessment and prevention in older people and in people 50 and over at higher risk. NG249 (2025). Recommendations<\/a>.<\/li>\n
  2. Montero-Odasso M et al. World guidelines for falls prevention and management for older adults. Age and Ageing (2022). doi:10.1093\/ageing\/afac205<\/a>.<\/li>\n
  3. Mirelman A et al. Addition of a non-immersive virtual reality component to treadmill training to reduce fall risk in older adults (V-TIME). Lancet (2016). doi:10.1016\/S0140-6736(16)31325-3<\/a>.<\/li>\n<\/ol>\n

    Related reading<\/h2>\n