Motor-Cognitive Dual-Task Training in Persons With Neurologic Disorders: A Systematic Review.

Abstract

Deficits in motor-cognitive dual tasks (eg, walking while talking) are common in individuals with neurologic conditions. This review was conducted to determine the effectiveness of motor-cognitive dual-task training (DTT) compared with usual care on mobility and cognition in individuals with neurologic disorders. 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 subjects with brain injury, Parkinson disease (PD), and Alzheimer 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 show that DTT improves single-task gait velocity and stride length in subjects with PD and AD, dual-task gait velocity and stride length in subjects with PD, AD, and brain injury, and may improve balance and cognition in those with PD and AD. The inclusion criteria of the studies reviewed limited the diagnostic groups included. While the range of training protocols and outcome assessments in available studies limited comparison of the results across studies motor-cognitive dual-task deficits in individuals with neurologic disorders appears to be amenable to training. Improvement of dual-task ability in individuals with neurologic disorders holds potential for improving gait, balance, and cognition.Video Abstract available for additional insights from the authors (Supplemental Digital Content, http://links.lww.com/JNPT/A104).