Cognitive-Motor dual-task assessments in people with multiple sclerosis: A scoping review

Dual-task paradigms are increasingly recognized as critical measures of functional impairment in people with multiple sclerosis (PwMS). Although dual-task assessments offer valuable insights into real-life functioning, methodological inconsistencies limit their interpretability and clinical applicability. This scoping review systematically mapped cognitive-motor dual-task assessments used in MS research to identify methodological trends and gaps and guide future research and clinical practice.

We conducted a scoping review following Arksey and O'Malley's framework, searching PubMed, CINAHL, PEDro, and PsycINFO databases from inception to June 1, 2025. Included studies employed performance-based dual-task paradigms involving walking or standing tasks in PwMS. Data were extracted regarding study design, participant characteristics, cognitive and motor tasks, single-task assessments, task prioritization instructions, and dual-task interference calculations. Results were synthesized descriptively.

Of the 493 initially identified records, 128 studies involving 5944 PwMS met the inclusion criteria. Walking-based tasks predominated, with standard and complex gait assessments widely used. Cognitive tasks frequently included serial subtraction, verbal fluency, and alphabet recitation. Only 39 % of studies assessed both cognitive and motor single-task performance, highlighting the extent of shortcomings in the accurate interpretation of cognitive-motor dual-task interference in PwMS. Standardized dual-task tools were seldom used, and task prioritization instructions were inconsistently reported.

There is substantial variability and methodological inconsistency in current cognitive-motor dual-task assessments in MS research. Future research should standardize dual-task protocols and measure single-task performance of both tasks. Improved rigor in dual-task assessment will enhance the validity and comparability of dual-task assessments, benefiting intervention strategies and outcome assessment for PwMS.