Structured Cognitive-Motor Dual Task Training Compared to Single Mobility Training in Persons with Multiple...

Area of Science:

• Neurorehabilitation
• Motor Control
• Cognitive Neuroscience

Background:

• Persons with Multiple Sclerosis (pwMS) often experience deficits in dual-task walking, impacting mobility and independence.
• Dual-tasking requires simultaneous execution of cognitive and motor tasks, which is particularly challenging for pwMS.
• Current rehabilitation strategies for pwMS need to address dual-tasking impairments effectively.

Purpose of the Study:

• To compare the effectiveness of dual-task training (DTT) versus single mobility training (SMT) in improving dual-task walking, mobility, and cognition in pwMS.
• To evaluate the durability of training effects at a 4-week follow-up.
• To determine if DTT offers superior benefits over SMT for dual-task performance in pwMS.

Main Methods:

• Forty pwMS were randomized into either a DTT group or an SMT group.
• The DTT group used an interactive tablet-based application for dual-task exercises.
• The SMT group underwent conventional walking and balance exercises over 8 weeks (20 sessions).
• Dual-task cost (DTC) for gait speed was the primary outcome, with mobility and cognition assessed secondarily.
• Mixed-effects models analyzed group, time, and interaction effects.

Main Results:

• Significant improvements in dual-task walking, specifically reduced dual-task cost (DTC) in gait speed for the digit-span walk and subtraction walk conditions, were observed in the DTT group, with effects maintained at follow-up.
• Absolute dual-task gait speed during obstacle negotiation improved only in the DTT group.
• Both groups showed improvements in various motor and cognitive measures, but DTT demonstrated superior outcomes in dual-task walking performance compared to SMT.

Conclusions:

• Dual-task training (DTT) is more effective than single mobility training (SMT) for enhancing dual-task walking abilities in persons with Multiple Sclerosis (pwMS).
• The benefits of DTT on dual-task walking performance are sustainable up to 4 weeks post-intervention.
• DTT represents a promising therapeutic approach for improving functional mobility and cognitive-motor integration in pwMS.