Exploring Dual-Task Performance Relationships for Veterans with Lower-Limb Amputation.

Only 24 people were analysed, and the authors say the study was likely underpowered, so a real difference between fall groups could have been missed. Everything was measured at one point in time, so the study shows associations only. It cannot show that dual-tasking difficulty causes falls. Falls and daily activity were both self-reported. People may misremember falls over a 12-month window, and how accurately someone rates their own daily activity depends on self-awareness, which was not measured. The tasks were lab-style: counting backwards by sevens while walking a clear oval walkway. The authors say this may not translate into the motor and thinking skills that real daily activities demand. Everyone could already walk around the home, so the study says nothing about patients who need more help to get about. All participants were Veterans and mostly men. The authors note that being male is a protective factor against fear of falling, so this group may be less cautious than other patients. Very few people landed in each tradeoff category, and the fall groups compared were small (10 low fallers and 14 recurrent fallers).

The authors report no conflicts of interest. They note that some authors work for the Veterans Administration, or did at the time of the study, and that the contents of the manuscript are their sole responsibility and do not necessarily represent the views of the US Department of Veterans Affairs or the US Government. No external funder is named.

Do not conclude that worse dual-tasking is what makes these patients fall. The recurrent fall group did slow down more on average than the low fall group (27.89% versus 16.86%) and had more people who kept counting while their walking suffered, but neither difference was statistically significant and only 24 people took part. Nothing here identifies which patient will fall.