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

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.).