Daniela Pereira, Filipe Rodrigues
Background/Objectives: Institutionalized aging is associated with severe physical deconditioning, a high risk of falls, and a pervasive fear of falling. Physical exercise mitigates these factors, but the comparative efficacy of different training methodologies in this specific population remains unclear. The objective of this study was to compare the impact of a multicomponent exercise program versus a dual-task (cognitive-motor) training program on reducing fall risk, decreasing the fear of falling, and improving physical performance in institutionalized older adults. Methods: A randomized, parallel group controlled trial involving 21 older adults residing in a nursing home (Mean age = 83.67 ± 6.17 years). Participants were allocated to either a Multicomponent Group (n = 11) or a Dual-Task Group (n = 10) for a 12-week intervention (2 sessions/week). Fall risk, fear of falling, and global physical performance were assessed at baseline and post-intervention. Results: No significant improvements were observed in fall risk assessment execution time for either group. The Multicomponent Group showed a significant reduction in the fear of falling (−29.1%; 95% CI [−17.27, −1.27], p = 0.025) and a clinically significant improvement in physical performance (+40.9%; 95% CI [1.11, 3.43], p < 0.001), supported by large time effects (FES-I: F(1, 19) = 4.52, η2p = 0.192; SPPB: F(1, 19) = 13.68, η2p = 0.419). The Dual-Task Group achieved no significant changes in these dimensions. Furthermore, a marginally significant time-by-group interaction was observed for physical performance, favoring the multicomponent approach (F(1, 19) = 3.83, p = 0.065, η2p = 0.168 [large effect]). Conclusions: Multicomponent training proved superior in improving physical performance and reducing the fear of falling. In a frail, institutionalized population, the attentional cost demanded by dual-task training appears to limit the physical and psychological benefits of exercise.