Walking and talking therapy: Improving cognitive–motor dual-tasking in neurological illness

Abstract

Using randomized control trial methodology, we evaluated the effectiveness of a 5-week cognitive-motor dual-tasking training program developed to improve performance of a group of people with dual-tasking difficulties arising from acquired brain injury. Training involved twice-daily practice on exercises involving walking being combined with tasks which increased in cognitive demand over the course of the intervention. A treatment group (n = 10) was compared with a control group (n = 9). The primary outcome measure was a task requiring participants to walk and carry out a spoken sentence verification task simultaneously. Secondary outcome measures were measures of dual-tasking involving either two motor tasks or two cognitive tasks. A questionnaire measure relating to activities of daily living requiring dual-tasking was also completed. Compliance with the training program was good. We found evidence of improvement in performance on the primary outcome measure, but little evidence of generalization to other measures. There was some evidence that participants believed that their dual-tasking performance in everyday life was improved after the intervention. The study was limited in terms of sample size, was not blinded and did not control fully for therapist contact time, but has produced valuable data relating to effect sizes associated with this form of intervention. (JINS, 2009, 15, 112-120.).

Dual task training as a therapeutic strategy in neurologic physical therapy: a literature review

“…Among the nine articles included, eight were published in the last 5 years. [19][20][21][22][23][24][25][26] The composition of samples ranged between 12 and 92 individuals [20][21][22] with a total of 303 subjects. The neurological conditions varied, with the most prevalent being stroke and brain injury, with 4 and 2 studies, respectively.…”

“…The neurological conditions varied, with the most prevalent being stroke and brain injury, with 4 and 2 studies, respectively. [19][20][21][25][26][27] Regarding the interventions to which the individuals were submitted, most authors used gait as the main task, and one article evaluated the control of trunk, with the patients seated. 25 In six studies at least one cognitive activity was applied as a secondary task.…”

“…25 In six studies at least one cognitive activity was applied as a secondary task. [19][20][21][22][23][24] Only three studies used motor dual tasking. [25][26][27] The time of each session varied between 30 minutes 23 and 1 hour per day, 21,23,24 and between 4 weeks 27 and 4 months.…”

“…Some studies evaluated the gait parameters 22,24,26,27 and five studies also evaluated executive functions. 19,[21][22][23][24] Other variables evaluated were postural control, 21,24,26 the number of falls, 24 and the performance in tasks of everyday living. 19,21 All the studies presented improvement of the variables analyzed post-training in experimental groups.…”

“…19,[21][22][23][24] Other variables evaluated were postural control, 21,24,26 the number of falls, 24 and the performance in tasks of everyday living. 19,21 All the studies presented improvement of the variables analyzed post-training in experimental groups. Only one study evaluated retention of the results obtained and the transference to other tasks not included in the intervention.…”