# Dual-Tasking for Individuals with Lower Limb Amputation: Exploring the Relationship to Falls and Instrumental Activities of Daily Living

> **NIH VA IK1** · VA EASTERN COLORADO HEALTH CARE SYSTEM · 2022 · —

## Abstract

Veterans with lower limb amputation (LLA), particularly those due to vascular etiology, are at high risk to fall.
Part of this high fall risk could be due to their reported need to focus on each individual step when walking,
which makes adding a concurrent task (e.g., carrying an object) highly demanding. Everyday activities typically
require dual-tasking; therefore, problems with dual-task performance during daily life could account for the high
number of falls for individuals with dysvascular LLA. In the older adult population, dual-task training (i.e.,
practicing two simultaneous tasks) improves simulated dual-task performance. Improving dual-task
performance could reduce fall risk during every day activities (e.g., getting dressed, moving while washing
dishes, talking on the phone, or folding laundry). Veterans with dysvascular LLA need programs to improve
daily activity performance, as they often experience a myriad of comorbidities and medical complexities
impacting participation in everyday life. Before a dual-task training program can be developed, preliminary
relationships to dual-task performance need to be examined in this population. The long-term goal of this line
of research is to implement novel dual-task interventions in the context of functionally relevant and ecologically
valid tasks for Veterans with dysvascular LLA. The initial steps toward the long-term goal are proposed with
this study, in three aims, using an observational cohort and concurrent parallel mixed-methods design: (1)
compare the proportion of participants experiencing mutual interference during dual-task walking between
fall groups (Non-fall vs. Recurrent Fall), (2) identify the relationships dual-task effects have with self-reported
participation in activities of daily living, and (3) qualitatively explore the effects of dual-tasking on self-reported
fall or near-fall dual-task scenarios. The quantitative phase (Aims 1 + 2) will identify how dual-task
performance relates to falls and participation in activities of daily living (n=30 Veterans with dysvascular LLA);
dual-tasking will be measured with basic walking gait and cognitive tasks, as typically measured with other
older adult populations. Dual-task performance will be measured using dual-task effects, a calculation of the
difference in gait and cognitive performance changes between the single and dual-task conditions. Gait speed
(meters/second) will be measured and cognition will be quantified based on serial subtractions (corrected
response ratio considering total responses and mistakes). The qualitative phase (Aim 3) will engage Veterans
with LLA (n=up to 30) to explore underlying cognitive and behavioral mechanisms that contribute to increased
risk for falls. This CDA1 proposal is supported by infrastructure and resources from a parent Merit trial that is
led by the primary mentor. The data gathered from this study will inform the development of a dual-task training
intervention trial (future CDA2 stud...

## Key facts

- **NIH application ID:** 10312226
- **Project number:** 1IK1RX003640-01A1
- **Recipient organization:** VA EASTERN COLORADO HEALTH CARE SYSTEM
- **Principal Investigator:** Laura Anita Swink
- **Activity code:** IK1 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2021-12-01 → 2023-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10312226

## Citation

> US National Institutes of Health, RePORTER application 10312226, Dual-Tasking for Individuals with Lower Limb Amputation: Exploring the Relationship to Falls and Instrumental Activities of Daily Living (1IK1RX003640-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10312226. Licensed CC0.

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