Dual-task Training Research Articles

Structuralist mental representation of dual-action demands: Evidence for compositional coding from dual tasks with low cross-task dimensional overlap

The present study asks how behavioral (dual-action) demands in dual tasks are mentally represented and whether changes in representation might govern practice-related dual-task performance improvements. Three different representation accounts were empirically tested based on the idea that dual-action demands required in a dual-task trial might be represented in different ways. According to a compositional (Structuralist) account, component tasks remain structurally intact when combined with another task. In contrast, a holistic (Gestalt) account posits that dual-action requirements in dual tasks are represented holistically and entirely distinct from its component action requirements. Finally, a contextual change account assumes that a change in context (e.g., from single- to dual-action requirement) generally impedes response retrieval, similar to repeating a response while the task context switches. To address this issue, we analyzed trial-by-trial effects in a single/dual switch paradigm (SDS paradigm, involving a randomized mix of single- and dual-task trials within blocks). Specifically, we analyzed performance in an extensive dual-task training setting (involving training sessions across several days) combining an auditory-vocal task and a visual-manual task. The results indicated that, throughout practice, nearly all relevant comparisons of performance between complete switch trials (e.g., between the two single tasks) and partial repetition trials (e.g., from dual to single task) revealed partial repetition benefits, that is, for both the auditory-vocal and the visual-manual task, and for both single- and dual-task performance analyses. Therefore, dual-action requirements in the present dual-task setting are mentally represented in a compositional, Structuralist fashion, probably due to low between-task dimensional overlap.

Α Virtual Reality App for Physical and Cognitive Training of Older People With Mild Cognitive Impairment: Mixed Methods Feasibility Study.

BackgroundTherapeutic virtual reality (VR) has emerged as an effective treatment modality for cognitive and physical training in people with mild cognitive impairment (MCI). However, to replace existing nonpharmaceutical treatment training protocols, VR platforms need significant improvement if they are to appeal to older people with symptoms of cognitive decline and meet their specific needs.ObjectiveThis study aims to design and test the acceptability, usability, and tolerability of an immersive VR platform that allows older people with MCI symptoms to simultaneously practice physical and cognitive skills on a dual task.MethodsOn the basis of interviews with 20 older people with MCI symptoms (15 females; mean age 76.25, SD 5.03 years) and inputs from their health care providers (formative study VR1), an interdisciplinary group of experts developed a VR system called VRADA (VR Exercise App for Dementia and Alzheimer’s Patients). Using an identical training protocol, the VRADA system was first tested with a group of 30 university students (16 females; mean age 20.86, SD 1.17 years) and then with 27 older people (19 females; mean age 73.22, SD 9.26 years) who had been diagnosed with MCI (feasibility studies VR2a and VR2b). Those in the latter group attended two Hellenic Association Day Care Centers for Alzheimer’s Disease and Related Disorders. Participants in both groups were asked to perform a dual task training protocol that combined physical and cognitive exercises in two different training conditions. In condition A, participants performed a cycling task in a lab environment while being asked by the researcher to perform oral math calculations (single-digit additions and subtractions). In condition B, participants performed a cycling task in the virtual environment while performing calculations that appeared within the VR app. Participants in both groups were assessed in the same way; this included questionnaires and semistructured interviews immediately after the experiment to capture perceptions of acceptability, usability, and tolerability, and to determine which of the two training conditions each participant preferred.ResultsParticipants in both groups showed a significant preference for the VR condition (students: mean 0.66, SD 0.41, t29=8.74, P<.001; patients with MCI: mean 0.72, SD 0.51, t26=7.36, P<.001), as well as high acceptance scores for intended future use, attitude toward VR training, and enjoyment. System usability scale scores (82.66 for the students and 77.96 for the older group) were well above the acceptability threshold (75/100). The perceived adverse effects were minimal, indicating a satisfactory tolerability.ConclusionsThe findings suggest that VRADA is an acceptable, usable, and tolerable system for physical and cognitive training of older people with MCI and university students. Randomized controlled trial studies are needed to assess the efficacy of VRADA as a tool to promote physical and cognitive health in patients with MCI.

The effects of dual-task training on balance and gross motor function in children with spastic diplegia.

The purpose of this study was to investigate changes in dynamic balance and gross motion function when dual-task training was performed on an unstable support surface by children with spastic diplegia. The subjects of this study were 14 children (experimental group n=7, control group n=7) who were medical diagnosed with spastic diplegia. Both groups were administered treatment for 30 min, 2 times a week for 8 weeks, with the experimental group performing dual-task exercise in which cognitive tasks related to daily living were performed while maintaining balance on an unstable surface, and the control group being administered neurodevelopmental treatment. Balance and gross motor function Assessments were conducted before intervention and after 8 weeks of intervention. Wilcoxon signed-rank test was performed to analyze changes in balance, gross motor function in the group, and the Mann–Whitney test was conducted to compare the differences between the two groups before and after intervention. The results showed that there was a statistically significant difference in both groups when balance in a sitting position and gross motor function (P<0.05). There was a statistically significant difference between the two groups in balance and gross motor function assessment (P<0.05). Based on the results of this study, it was confirmed that dual-task training improves balance, gross motor function in children with spastic diplegia. Therefore, dual-task training may be considered as an effective method of intervention method in the functional aspect of children with spastic diplegia.

Effects of Dual-Task Gait Treadmill Training on Gait Ability, Dual-Task Interference, and Fall Efficacy in People With Stroke: A Randomized Controlled Trial.

This study aimed to investigate the effects of dual-task gait training using a treadmill on gait ability, dual-task interference, and fall efficacy in people with stroke. Patients with chronic stroke (N=34) were recruited and randomly allocated to the experimental or control group. Both groups underwent gait training on a treadmill and a cognitive task. In the experimental group, gait training was conducted in conjunction with the cognitive task, whereas in the control group, the training and the cognitive task were conducted separately. Each intervention was provided for 60minutes, twice a week, for a period of 6weeks for both groups. The primary outcomes were as follows: gait parameters (speed, stride, variability, and cadence) under single-task and dual-task conditions, correct response rate (CRR) under single-task and dual-task conditions, and dual-task cost (DTC) in gait parameters and CRR. The secondary outcome was the Fall Efficacy Scale. Dual-task gait training using a treadmill improved all gait parameters in the dual-task condition, speed, stride, and variability in the single-task condition, and CRR in both conditions. A difference between the groups was observed in speed, stride, and variability in the dual-task condition. Furthermore, dual-task gait training on a treadmill improved DTC in speed, variability, and cadence along with that in CRR, indicating true improvement of DTC, which led to significant improvement in DTC in speed and variability compared with single-task training. Dual-task gait treadmill training was more effective in improving gait ability in dual-task training and dual-task interference than single-task training involving gait and cognitive task separately in people with chronic stroke.

Dual-Task Exercise to Improve Cognition and Functional Capacity of Healthy Older Adults.

BackgroundIt has been suggested that physical inactivity and lack of stimulating cognitive activity are the two most significant modifiable risk factors to impair cognitive function. Although many studies that investigated the cognitive effects of physical exercise and cognitive stimuli in dual-task conditions showed improved cognitive performance, others have not confirmed these findings. The main aim of the present work is to analyze the effects of a dual-task multimodal physical exercise training, at moderate intensity, and cognitive stimulation on cognitive and physical function in healthy older adults.MethodsThis clinical trial was registered on the Brazilian Registry of Clinical Trials (RBR-9zrx3d). Here we tested the effects of a dual-task multimodal physical exercise training, at moderate intensity, on cognitive and physical function and quality of life in community dwelling older adults. The training protocol included 24 group sessions, 2/week, per 75 min. Cognition was assessed using CANTAB automated neuropsychological tests and Functional Capacity to Exercise tests. Performance was compared from baseline to post intervention and to a non-exercise control group using Mixed Linear Model for repeated measures.ResultsControl (CG) and dual-task (DTEx) groups progressed differentially over time on performance of episodic memory, sustained visual attention, functional mobility, cardiorespiratory fitness, lower limbs strength resistance, agility, quality of life and dual-task performance with significant improved DTEx performance. Control group did not show any significant changes on these tests except for showing a reduction in dual-task performance.ConclusionWe suggest that the dual-task combination of multisensory cognitive stimulation and multimodal moderate physical exercise training, twice a week, may be adopted as an effective program to reduce progression of age-related cognitive decline and improve physical fitness and quality of life on healthy older adults.Clinical Trial RegistrationBrazilian Registry of Clinical Trials: https://ensaiosclinicos.gov.br/rg/RBR-9zrx3d -UTN code: U1111-1233-6349.

Implementation and effectiveness of a multi-domain program for older adults at risk of cognitive impairment at neighborhood senior centres

To address the paucity of research investigating the implementation of multi-domain dementia prevention interventions, we implemented and evaluated a 24-week, bi-weekly multi-domain program for older adults at risk of cognitive impairment at neighborhood senior centres (SCs). It comprised dual-task exercises, cognitive training, and mobile application-based nutritional guidance. An RCT design informed by the Reach, Effectiveness, Adoption, Implementation, Maintenance framework was adopted. Outcome measures include cognition, quality of life, blood parameters, and physical performance. Implementation was evaluated through questionnaires administered to participants, implementers, SC managers, attendance lists, and observations. The program reached almost 50% of eligible participants, had an attrition rate of 22%, and was adopted by 8.7% of the SCs approached. It was implemented as intended; only the nutritional component was re-designed due to participants’ unfamiliarity with the mobile application. While there were no between-group differences in cognition, quality of life, and blood parameters, quality of life reduced in the control group and physical function improved in the intervention group after 24 weeks. The program was well-received by participants and SCs. Our findings show that a multi-domain program for at-risk older adults has benefits and can be implemented through neighborhood SCs. Areas of improvement are discussed.Trial registration: ClinicalTrials.gov NCT04440969 retrospectively registered on 22 June 2020.

Dual n-back working memory training evinces superior transfer effects compared to the method of loci

Working memory (WM) training is a prevalent intervention for multiple cognitive deficits, however, the transfer effects to other cognitive tasks from gains in WM induced by different training techniques still remains controversial. Therefore, the current study recruited three groups of young adults to investigate the memory training transference, with N-back group (NBG) (n = 50) training on dual n-back task, Memory Palace group (MPG) (n = 50) on method of loci, and a blank control group (BCG) (n = 48) receiving no training. Our results showed that both training groups separately improved WM capacity on respective trained task. For untrained tasks, both training groups enhanced performance on digit-span task, while on change detection task, significant improvement was only observed in NBG. In conclusion, while both techniques can be used as effective training methods to improve WM, the dual n-back task training method, perhaps has a more prominent transfer effect than that of method of loci.

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Neural Correlates of Single-Task Versus Cognitive-Motor Dual-Task Training

Single-task and cognitive-motor dual-task training (CMDT) has been extensively studied for the post-stroke function rehabilitation. However, little is known about the difference between the brain activities when these two types of tasks are being implemented. Therefore, neural correlates of single-cognitive/motor-task training (SCT/SMT) versus CMDT are investigated in this study. Specifically, a pure mathematical problem-solving task and a pure cycling task were designed for the SCT and SMT paradigms, respectively. For the CMDT, subjects should perform these two tasks simultaneously. Electroencephalography signals acquired during performing these two types of training are used to analyze the brain dynamic properties by event-related potential and event-related (de-)synchronization analyses. It can be seen from the results that compared with the SCT, theta event-related synchronization can be increased significantly by the CMDT (frontal theta: <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$p$ </tex-math></inline-formula> -value <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$= 5.44e-05 &lt; 0.0001$ </tex-math></inline-formula> and temporal theta: <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$p$ </tex-math></inline-formula> -value <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$= 9.18e-06 &lt; 0.0001$ </tex-math></inline-formula> ) and, meanwhile, the mu and central beta event-related desynchronization induced by the CMDT is significantly lower than that induced by the SMT (mu: p-value <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$= 2.28e-06 &lt; 0.0001$ </tex-math></inline-formula> and central beta: p-value <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$= 4.37e-06 &lt; 0.0001$ </tex-math></inline-formula> ). Therefore, it is proved in this study that the SMT can induce higher motor neural engagement than the CMDT and, meanwhile, compared with the SCT, higher cognitive neural activity can be induced by the CMDT, which can be explained by that the multitask coordination induces more neural activities. In addition, it is found that more attention has been paid on the relatively difficult task during the dual-task training. Therefore, the difficulty level of each task in the CMDT paradigm can be designed subject specific to implement the personalized training.

Ways to Improve Multitasking: Effects of Predictability after Single- and Dual-Task Training.

In this study we investigated the effect of predictability on dual-task performance in two experiments. In the first experiment 33 participants separately practiced a continuous tracking task and an auditory reaction time task. Both tasks had a repeating element that made them predictable; in the tracking task this was a repeating segment, and in the auditory task this was an auditory sequence. In addition, one group obtained explicit knowledge about the repeating sequence in the tracking task while the other group trained implicitly. After training, single- and dual-task performance was tested at a post test and retention test. Results showed that predictability only improved performance in the predictable tasks themselves and dual-task costs disappeared for the tracking task. To see whether the task-specific effect of predictability was the results of task prioritization, or because task representations did not have much chance to interact with each other, we conducted a second experiment. Using the same tasks as in Experiment 1, 39 participants now trained both tasks simultaneously. Results largely mirrored those of the first experiment, demonstrating that freed-up resources due to predictability in one task could not be re-invested to improve in the other task. We conclude that predictability has a positive but task-specific effect on dual-task performance.

Do motor-cognitive and motor-motor dual task training effect differently balance performance in older adults?

Dual-task training (DTT) have been showed that have satisfying effects on older adults. The aim of this study was to compare the effect of motor-cognitive DTT (mCdtt) and motor-motor DTT (mMdtt) on balance, fear of falling, walking functionality and muscle strength in older adults. A total of 50 participants aged 60 and over (mean age: 67.72 ± 7.33years), having a score ≥ 24 on the Mini-Mental State Exam (MMSE), being in the category of walking ability ≥ 4 according to the Functional Ambulation Category (FAC), having no problem in visual ability and hearing were included for this study. The participants who received mCdtt (Group 1) counted back from the two-digit number; and the participants who received mMdtt (Group 2) held half-filled glasses with both hands near the trunk with 90° flexion of elbow while performing exercises. The intervention program had lasted for 8weeks. To assess balance, fear of falling, walking functionality and muscle strength of participants; Berg Balance Scale (BBS), Falls Efficacy Scale International (FES-I), Timed Up and Go (TUG) and the Hand-held dynamometer were used, respectively. The results of our study showed that 8-week mCdtt and mMdtt program did not differ in balance fear of falling, walking functionality and muscle strength in older adults, although both trainings had improved balance ability. It can be interpreted that both training programs can be suggested to enhance abovementioned parameters in older adults. Further studies are needed to elucidate the difference of clinical outcomes between the mCdtt and mMdtt program in older adults. NCT04577092. 09/30/2020 "Retrospectively registered".

Effects of Cognitive-Physical Dual-Task Training on Executive Function and Activity in the Prefrontal Cortex of Older Adults with Mild Cognitive Impairment.

Effects of cognitive-physical dual-task training on prefrontal cortex (PFC)-dependent function remain unclear. This study investigated the effects of dual-task training on executive function and activity in the PFC of older adults with mild cognitive impairment (MCI). Thirty-six older adults with MCI randomly assigned to the experimental group (EG) performing cognitive-physical dual-task training requiring for simultaneous cognitive tasks and physical exercise (n = 18) or the control group (CG) receiving sing-cognitive training using the computerized cognitive training program focusing on executive function (n = 18) for 16 sessions lasting 40 minutes a session. For the primary outcomes, the Trail Making Test Part B (TMT-B) was used, and for the secondary outcome, activity in the PFC using functional near infrared spectroscopy and the Korean version of instrumental activities of daily living (K-IADL) were evaluated at pre-and post-intervention. After the intervention, the EG achieved a significantly higher improvement in the TMT-B and decreased activity in the PFC during TMT-B testing than the CG. However, there were no significant differences in the K-IADL in both groups. These findings indicate that dual-task training is more effective in improving executive process and decreasing activity in the PFC during cognitive testing than single-cognitive training with limitations of its transfer effect to daily life.

The Effects of Dual Task Training According to Variability of Walking Environment on Balance, Gait and Function of Stroke Patients

The Effects of Dual Task Training According to Variability of Walking Environment on Balance, Gait and Function of Stroke Patients

Effect of Dual Task Training on Balance and Gait Over Regular and Diversified Land Surfaces in Independent Elderly

Effect of Dual Task Training on Balance and Gait Over Regular and Diversified Land Surfaces in Independent Elderly

Effect of Motor Dual-Task Training Over Progressive Resisted Exercises on Balance and Mobility in Elderly People

Effect of Motor Dual-Task Training Over Progressive Resisted Exercises on Balance and Mobility in Elderly People

Effect of BCI-Controlled Pedaling Training System With Multiple Modalities of Feedback on Motor and Cognitive Function Rehabilitation of Early Subacute Stroke Patients.

Brain-computer interfaces (BCIs) are currently integrated into traditional rehabilitation interventions after stroke. Although BCIs bring many benefits to the rehabilitation process, their effects are limited since many patients cannot concentrate during training. Despite this outcome post-stroke motor-attention dual-task training using BCIs has remained mostly unexplored. This study was a randomized placebo-controlled blinded-endpoint clinical trial to investigate the effects of a BCI-controlled pedaling training system (BCI-PT) on the motor and cognitive function of stroke patients during rehabilitation. A total of 30 early subacute ischemic stroke patients with hemiplegia and cognitive impairment were randomly assigned to the BCI-PT or traditional pedaling training. We used single-channel Fp1 to collect electroencephalography data and analyze the attention index. The BCI-PT system timely provided visual, auditory, and somatosensory feedback to enhance the patient's participation to pedaling based on the real-time attention index. After 24 training sessions, the attention index of the experimental group was significantly higher than that of the control group. The lower limbs motor function (FMA-L) increased by an average of 4.5 points in the BCI-PT group and 2.1 points in the control group (P = 0.022) after treatments. The difference was still significant after adjusting for the baseline indicators ( β = 2.41 , 95%CI: 0.48-4.34, P = 0.024). We found that BCI-PT significantly improved the patient's lower limb motor function by increasing the patient's participation. (clinicaltrials.gov: NCT04612426).

Integration of dual-task training into occupation in community-dwelling older adults

Integration of dual-task training into occupation in community-dwelling older adults

Investigation of the Relationship of Recommended Home Exercises with Dual-Task Training for the Elderly with Physical Activity Level, Life Quality and Kinesiophobia

Aim: To examine the effect of home exercises combined with dual-task training on physical activity level and quality of life in the elderly, and to investigate the impact of home exercises on fear of movement.Material and Methods: 60 volunteer participants over the age of 65 were included in the study. The average age of the participants was 81 years, and 70% of the participants were women. Participants were randomly divided into two equal groups called single and dual-task groups. While standard home exercise protocol was applied to both groups, additional cognitive tasks were assigned to the dual-task group. Participants were given 45 minutes of exercise under a physiotherapist monitor in a home environment three days a week for four weeks. Before the first session and after the last session, the participants were evaluated with the World Health Organization Quality of Life Scale Elderly Module, Berg Balance Scale, Fall Efficiency Scale, Tampa Kinesiophobia Scale, Physical Activity Scale for Elderly, Timed Up and Go Test, and Montreal Cognitive Assessment Scales.Results: In the analysis performed between the groups, the results of the Berg Balance Scale, the Physical Activity Scale for the Elderly, and the Montreal Cognitive Assessment Scales were found to be statistically significant (p&amp;lt;0.05). It was found that home exercises performed with single and dual-task training did not significantly affect movement anxiety (p&amp;gt; 0.05).Conclusions: Home exercises with dual-task training; It is more successful in improving balance, increasing physical activity level, and increasing cognitive performance compared to home exercises performed with single-task training.

The Effects of Horse-riding Simulator Training with Dual-task on Pulmonary Function and Flexibility in Healthy Adults

Purpose: The purpose of the present study was to investigate the effects of a simultaneous dual-task and horse-riding simulator (HRS) training regime on pulmonary function and flexibility. Methods: Sixteen subjects were recruited and randomly allocated to two groups: a dual-task (DT) (n=8) or a single-task (ST) (n=8) training group. Flexibility and pulmonary function were assessed before and after HRS training. Both groups underwent HRS training for 4 weeks, 3 times/week in 15-minute training sessions. The ST group underwent HRS training and the DT group underwent dual-task HRS training, which consisted of throwing and catching a ball and ring catching while HRS training. Results: Training significantly increased flexibility and FVC (forced vital capacity) and FEV1 (forced expiratory volume in 1 second) in both groups (p 0.05). After the training, flexibility and FVC in the DT group were significantly greater than in the ST group (p 0.05). Conclusion: Simultaneous dual-task and HRS motor training improved flexibility, FVC, and FEV1, and our comparative analysis suggests that dual-task HRS training improved flexibility and FVC more than single-task training.

Investigation and Motivation of Impact of Motor Dual Task Training on Post Stroke Patients

The motivation of investigation was to discover the impact of motor dual task training (MDTT) vs single task training (STT) on useful parity in post stroke patients. Thirty first beginning of one-sided ischemic “Middle Cerebral Artery (MCA)” domain stroke patients are haphazardly designated into 2 gatherings the STT gathering (n=15) got single task strengthening and balance practices and MDTT (n=11) got strengthening &amp;balance practice alongside an optional engine task. Intercession is provided 45 minutes for every session, once in a day, 5 days of week for about fourteen days. The parity was dissected utilizing Berg Balance Scale (BBS).In 2 groups, balance expressively enhanced in BBS. Compared with STT group; MDTT group reached much statistically important development. The MDTT exercises efficiently promote balance initial in stroke patients. How parity is influenced relies upon a few variables, comprising the degree of sensory system harm, the number and degree of tactile misfortunes, and the accessibility of different faculties for pay. In numerous occurrences, greater than one tactile framework is hindered.