Dual-Task Gait Analysis: Combined Cognitive-Motor Demands Most Severely Impact Walking Patterns and Joint Kinematics

Cognitive tasks significantly influence automated acts, such as walking. This study included 41 healthy individuals, who were over 65 years of age. We examined dual-task effects on the spatiotemporal and kinematic parameters of gait in older adults during four tasks carried out in single-task, cognitive, motor, and combined cognitive-motor conditions. An analysis of walking according to spatiotemporal and kinematic parameters was performed using an inertial movement analysis system. The combined task showed the most significant impairments, with substantially reduced gait speed (p < 0.001, r = -0.80), shorter stride length (p < 0.001, r = -0.82), and decreased hip flexion (p < 0.001, r = -0.80) compared to single-task walking. Cognitive tasks alone significantly affected gait speed (p = 0.001) and stride length (p = 0.001), while motor tasks showed minimal effects. The combined task also significantly increased double-support time (p < 0.001) and reduced single-support time (p = 0.001), indicating compensatory walking strategies. These findings demonstrate that concurrent cognitive-motor demands disproportionately impair gait, suggesting that clinical assessments should prioritize combined-task evaluation. The observed kinematic and spatiotemporal changes highlight the profound interdependence between cognitive function and automatic locomotor control during walking. It is likely that dual-task gait analysis may offer clinical utility for the early detection of cognitive-motor deficits.