Motor-Cognitive Dual-Task Training in Persons With Neurologic Disorders

Abstract

Background and Purpose Deficits in motor-cognitive dual-tasks (e.g., walking while talking) are common in individuals with neurological conditions. This review was conducted to determine the effectiveness of motor-cognitive dual-task training (DTT) compared to usual care on mobility and cognition in individuals with neurologic disorders. Methods Databases searched were Biosis, CINAHL, ERIC, PsychInfo, EBSCO Psychological & Behavioral, PubMed, Scopus, and Web of Knowledge. Eligibility criteria were studies of adults with neurologic disorders that included DTT and outcomes of gait or balance were included. Fourteen studies met inclusion criteria. Participants were individuals with brain injury, Parkinson’s disease (PD) and Alzheimer’s disease (AD). Intervention protocols included cued walking, cognitive tasks paired with gait, balance, and strength training and virtual reality or gaming. Quality of the included trials was evaluated with a standardized rating scale of clinical relevance. Results Results show that DTT improves single-task gait velocity and stride length in PD and AD, dual-task gait velocity and stride length in PD, AD and brain injury, and may improve balance and cognition in PD and AD. The inclusion criteria limited the diagnostic groups included. Discussion and Conclusions The range of training protocols and outcome assessments in available studies limited comparison of the results across studies. Improvement of dual-task ability in individuals with neurologic disorders holds potential for improving gait, balance and cognition. Motor-cognitive dual-task deficits in individuals with neurologic disorders may be amenable to training. Video Abstract available for additional insights from the authors (See Supplemental Digital Content).

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“…In the present study, the initial phase of learning is suggested to be more cognitively driven as compared to the later stages of learning, which in a dual-task training setting might get more fluent and independent. Our results are in line with previously conducted systematic reviews, where dual-task training has been reported to enhance postural stability and cognitive performance 38,49,50,52. However, this review is the first to reveal beneficial effects of dual-task training in a meta-analysis and a level of evidence analysis.…”

“…This training maneuver has recently drawn a lot of interest as compared to its older counterpart and speculations persist as to which protocol overlays beneficial effects on postural stability among different population groups 47,48. Recent review studies evaluating the effects of dual-task training in elderly38,49 and population groups with neurological diseases50,51 conclusively report the beneficial effects of dual-task training for enhancing cognitive abilities and stability, whereas some review studies report no identifiable benefits 33,52. The studies also mentioned the increased heterogeneity of the training protocols within the studies to cause difficulties in identifying a specific method’s effectiveness.…”

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