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The objective of this exploratory randomized controlled trial (RCT) was to provide evidence for the feasibility and therapeutic value of a novel game-based dual-task balance exercise program in children with cerebral palsy (CP). Twenty children with CP were recruited and randomized into two groups: (a) the conventional balance training group (CG) and (b) the experimental group (XG), which received a game-based dual-task (DT) balance exercise program. Both groups received their respective therapy programs for 12 weeks at a frequency of three sessions per week. Semi-structured interviews with the parents and children and qualitative analysis were conducted to evaluate the children’s experiences with the game-based exercise program. The quantitative analysis included (a) the Pediatric Balance Scale (PBS), (b) Gross Motor Function Measure-88 (GMFM-88), and (c) computerized measures of standing balance performance during various dual-task conditions. Compliance was 100% for all 20 participants. Four themes captured the range of each participant’s experiences and opinions: (a) reasons for participation, (b) likes and dislikes with the technologies, (c) positive effects of the program, and (d) future expectations. Children in the XG demonstrated greater improvements in PBS, GMFM, and DT balance measures as compared to children in the CG. The findings demonstrate feasible trial procedures and acceptable DT-oriented training with a high compliance rate and positive outcomes. These findings support further research and development and progression to the next phase of a full-scale RCT to evaluate the clinical effectiveness of the game-based DT balance exercise program for children with CP.

Purpose: At present, there is a controversy regarding the effect of dual-task training on improving the cognitive function of people with mild cognitive impairment (MCI). This study was to develop and verify the effects of the cognitive–physical dual-task training program on the executive function of older adults with MCI. Method: Participants were randomly allocated to the experimental group (EG) receiving cognitive–physical dual-task training (n = 21) or the control group (CG) receiving cognitive single-task training (n = 21). Results: After 16 sessions for 8 weeks, the Korean version of the Executive Function Performance Task (EFPT-K), the Frontal Assessment Battery (FAB), and Korean version of the Instrumental Activities of Daily Living (K-IADL) tests were implemented to assess people’s executive function and instrumental activities during daily living. As the result, there were no significant differences in general characteristics between both groups (p > 0.05). After 16 sessions, the EG showed greater improvements in the EFPT-K (p < 0.05; η2 = 0.133), the FAB (p < 0.001; η2 = 0.305), and the K-IADL (p < 0.01; η2 = 0.221) compared to those of the CG. Conclusion: These results indicate that cognitive–physical dual-task training is clinically beneficial to improve the executive function and daily instrumental activities of older adults with MCI. Cognitive–physical dual-task training is a promising intervention for older adults with MCI.

Everyday activities like walking and talking can put an older adult at risk for a fall if they have difficulty dividing their attention between motor and cognitive tasks. Training studies have demonstrated that both cognitive and physical training regimens can improve motor and cognitive task performance. Few studies have examined the benefits of combined training (cognitive and physical) and whether or not this type of combined training would transfer to walking or balancing dual-tasks. This study examines the dual-task benefits of combined training in a sample of sedentary older adults. Seventy-two older adults (≥60 years) were randomly assigned to one of four training groups: Aerobic + Cognitive training (CT), Aerobic + Computer lessons (CL), Stretch + CT and Stretch + CL. It was expected that the Aerobic + CT group would demonstrate the largest benefits and that the active placebo control (Stretch + CL) would show the least benefits after training. Walking and standing balance were paired with an auditory n-back with two levels of difficulty (0- and 1-back). Dual-task walking and balance were assessed with: walk speed (m/s), cognitive accuracy (% correct) and several mediolateral sway measures for pre- to post-test improvements. All groups demonstrated improvements in walk speed from pre- ( = 1.33 m/s) to post-test ( = 1.42 m/s, < 0.001) and in accuracy from pre- ( = 97.57%) to post-test ( = 98.57%, = 0.005).They also increased their walk speed in the more difficult 1-back ( = 1.38 m/s) in comparison to the 0-back ( = 1.36 m/s, < 0.001) but reduced their accuracy in the 1-back ( = 96.39%) in comparison to the 0-back ( = 99.92%, < 0.001). Three out of the five mediolateral sway variables (Peak, SD, RMS) demonstrated significant reductions in sway from pre to post test ( < 0.05). With the exception of a group difference between Aerobic + CT and Stretch + CT in accuracy, there were no significant group differences after training. Results suggest that there can be dual-task benefits from training but that in this sedentary sample Aerobic + CT training was not more beneficial than other types of combined training.

We aimed to examine the effect of 2-year cognitive–motor dual-task (DT) training on cognitive functions and motor ability of healthy elderly people without marked cognitive impairment. From the 25 participants of our 12-week DT trial conducted in 2014, we recruited 8 subjects who voluntarily participated in a new DT training program once a week for 2 years (exercise (EX) group). Their cognitive functions were evaluated by the Modified Mini-Mental State (3MS) examination and the Trail Making Test, and results were compared with those of the 11 subjects who discontinued the training and did not perform any types of exercise for 2 years (non-exercise (NO) group). Subjects in the NO group showed deterioration in the 3MS examination results, especially in the cognitive domain of attention. Meanwhile, participation in DT training maintained the scores in almost all domains of cognitive function, as well as the total 3MS scores. However, both groups had impaired quadriceps muscle strength and motor ability after the 2-year observation period. These results suggest that participating in exercise program comprising DT training for 2 years may be beneficial for maintaining the broad domains of cognitive function in healthy elderly people, although further verification is needed.

AimIn this systematic review and meta-analysis, we evaluated the effectiveness of transcranial direct current stimulation (tDCS) and transcranial alternating current stimulation (tACS) or transcranial random noise stimulation (tRNS) combined with dual task training (DTT) on physical and cognitive functions in adults with mild cognitive impairment (MCI), Parkinson’s disease (PD), and stroke disorders.MethodWe conducted a systematic search of the Web of Science, MEDLINE, Cochrane Library, PubMed, and CINAHL databases for English-language literature on randomized clinical trials (RCTs) investigating the effects of tDCS, tACS, or tRNS combined with DTT in adults with MCI, PD, and stroke. The search covered studies from the inception of each database up to November 21, 2025. The initial screening of selected articles was conducted independently by two researchers (YLQ and WLW).ResultsA total of twelve studies met the inclusion criteria, comprising individuals with stroke (n = 4), MCI (n = 3), and PD (n = 5). Meta-analysis revealed that active tDCS+DTT yielded no significant overall improvement in global cognition (Montreal Cognitive Assessment (MoCA): SMD = 0.09, 95% CI [−0.49, 0.66], p = 0.77, I2 = 72%). A large, highly homogeneous benefit was observed for executive function (TMT-B: SMD = −1.33, 95% CI [−2.39, −0.27], p = 0.01), driven exclusively by the MCI subgroup (SMD = −2.35, 95% CI [−3.20, −1.51], I2 = 0%). Timed Up and Go cognitive-motor dual-task (TUG CMDT) cadence improved overall (SMD = 0.58, 95% CI [0.09, 1.08], p = 0.02, I2 = 39%) in both MCI and stroke subgroups. TUG motor dual task (MDT) speed improved modestly (SMD = 0.42, 95% CI [0.02, 0.83], p = 0.04, I2 = 34%), and CMDT speed showed a strong trend (SMD = −0.49, p = 0.09), only significant in stroke (SMD = −1.42, p = 0.002). However, this generalized finding must be nuanced by specific efficacy observed in individual PD studies, which reported significant gains in force-tremor decoupling, postural stability, and CMDT accuracy.ConclusionThe meta-analysis suggests that the effects of tDCS combined with DTT are remarkable in certain populations and for specific outcomes. While substantial improvements are confirmed for executive function and dual-task gait in MCI and stroke, the overall limited efficacy in PD highlights the critical influence of heterogeneity and intervention specificity. Future research should prioritize disease-specific electrode montages and the integration of tACS or tRNS to optimize outcomes across diverse neurological populations.

Emerging research indicates that exercise combined with cognitive training may improve cognitive function in older adults. Typically these programs have incorporated sequential training, where exercise and cognitive training are undertaken separately. However, simultaneous or dual-task training, where cognitive and/or motor training are performed simultaneously with exercise, may offer greater benefits. This review summary provides an overview of the effects of combined simultaneous vs. sequential training on cognitive function in older adults. Based on the available evidence, there are inconsistent findings with regard to the cognitive benefits of sequential training in comparison to cognitive or exercise training alone. In contrast, simultaneous training interventions, particularly multimodal exercise programs in combination with secondary tasks regulated by sensory cues, have significantly improved cognition in both healthy older and clinical populations. However, further research is needed to determine the optimal characteristics of a successful simultaneous training program for optimizing cognitive function in older people.

Background Dual-task training in Parkinson’s disease (PD) improves spatiotemporal gait parameters, cognition, and quality of life. Virtual reality (VR) has been used as a therapeutic tool for patients to participate in activities in a safe environment, engage in multisensory experiences, and improve motivation and interest in rehabilitation. This study aimed to investigate the feasibility of fully immersive VR exergames with dual-task components in patients with PD. Methods We developed VR exergames (go/no-go punch game, go/no-go stepping game, and number punch game) to improve habitual behavior control using motor–cognitive dual-task performance in patients with PD. The participants underwent 10 sessions 2–3 times a week, consisting of 30 min per session. The Unified Parkinson’s Disease Rating Scale, Timed Up and Go test (TUG) under single- and dual-task (cognitive and physical) conditions, Berg balance scale (BBS), Stroop test, trail-making test, and digit span were evaluated before and after intervention. The Simulator Sickness Questionnaire (SSQ) was used to assess VR cybersickness. Usability was assessed using a self-reported questionnaire. Results Twelve patients were enrolled and completed the entire training session. The mean age of participants was 73.83 ± 6.09 years; mean disease duration was 128.83 ± 76.96 months. The Hoehn and Yahr stages were 2.5 in seven patients and 3 in five patients. A significant improvement was observed in BBS and Stroop color–word test ( p  = 0.047 and p  = 0.003, respectively). TUG time and dual-task interferences showed positive changes, but these changes were not statistically significant. The median SSQ total score was 28.05 (IQR: 29.92), 13.09 (IQR: 11.22), and 35.53 (IQR: 52.36) before, after the first session, and after the final session, respectively; the differences were not significant. Overall satisfaction with the intervention was 6.0 (IQR: 1.25) on a 7-point Likert-type scale. Conclusions Fully immersive VR exergames combined with physical and cognitive tasks may be used for rehabilitation of patients with PD without causing serious adverse effects. Furthermore, the exergames using dual-task components improved executive function and balance. Further development of VR training content may be needed to improve motor and dual-task performances. Trial registration NCT04787549 ( https://clinicaltrials.gov/ct2/show/NCT04787549 )

Due to severe physical impairments and reduced mobility, post-stroke cognitive impairment is often not prioritized in the acute physical therapy rehabilitation phase. This creates a need for cognitive reinforcement to be prioritized later in rehabilitation. We investigated the benefits of a cognitive reinforcement training program using exercise and performed via telehealth in people with stroke, compared to healthy older adults. A pretest/posttest cross-sectional study design with Healthy older adults (HOA, n = 9), and subjects’ post-stroke (SPS, n = 8participated in a telehealth physical therapist-led group exercise class set to music while seated, that included cognitive challenges, three times per week for five weeks. Each class involved full body strengthening with cognitive challenges (dual-tasking). Functional outcome measures performed were repeated using a dual-task paradigm. After 15 one-hour telehealth exercise sessions, the most significant results were the 2 Minute Walk Test (adjusted mean difference 18; 95% CI 204, 222) and 30 s Sit to Stand Test (30STS) (adjusted mean difference 4.2; 95% CI 10.6, 14.8) resulting in an intergroup main effect, with both groups improving ( p  < .013 and p  < .002, respectively) in the standard task as well as when combined with a cognitive Verbal Fluency Test for the 30STS (adjusted mean difference 3; 95% CI 5.8, 8.8) ( p  < .002). In individuals with stroke, a telehealth exercise program, as described in this study, is safe and efficient in improving one’s ability to perform daily functional activities with dual tasking. Clinical Trial Registration NCT05919251 (26-06-2023).

Rehabilitation is a high-potential approach to improving physical and cognitive functions in Parkinson’s disease (PD). Dual-task training innovatively combines motor and cognitive rehabilitation in a comprehensive module. Patients perform motor and cognitive tasks at the same time in dual-task training. The previous studies of dual-task training in PD had high heterogeneity and achieved controversial results. In the current review, we aim to summarize the current evidence of the effect of dual-task training on motor and cognitive functions in PD patients to support the clinical practice of dual-task training. In addition, we also discuss the current opinions regarding the mechanism underlying the interaction between motor and cognitive training. In conclusion, dual-task training is suitable for PD patients with varied disease duration to improve their motor function. Dual-task training can improve motor symptoms, single-task gait speed, single-task steep length, balance, and objective experience of freezing of gait in PD. The improvement in cognitive function after dual-task training is mild.

This study aims to investigate the effects of exercise-cognitive dual-task training on frailty status, cognitive function, physical performance, and dual-task cognitive load in older adults with Cognitive frailty (CF) over a 16-week intervention period. This randomized controlled trial enrolled older adults with CF at community health service center in Chaoyang District, Beijing, between February and March 2024. Participants were randomly assigned to either the dual-task training group or the health education group in a 1:1 ratio. The dual-task training group received an exercise-cognitive dual-task training program, while the health education group received information on CF, including its symptoms, risk factors, and non-pharmacological prevention and treatment strategies. The primary outcomes were frailty status, while the secondary outcomes included cognitive function, balance and gait function, walking ability, and dual-task cognitive load. A total of 72 participants (35 males) were enrolled, including 36 individuals (mean age: 74.81 ± 8.23 years, 17 males, mean BMI: 21.38 ± 2.83 kg/m ) in the dual-task training group, and 36 individuals (mean age: 76.50 ± 7.75 years, 18 males, mean BMI: 22.18 ± 2.12 kg/m ) in the health education group. Participants (n = 72) were 75.66 ± 7.9 years old; 48.6% (35/72) were male and 51.4% (37/72) were female. Following the intervention, the dual-task training group exhibited significant improvements compared to the health education group in the Tilburg Frailty Index (5.14 ± 0.99 vs. 7.36 ± 1.07,  < 0.001) and Montreal Cognitive Assessment scores (27.25 ± 2.41 vs. 23.47 ± 1.87,  < 0.001). Additionally, the dual-task training group demonstrated superior outcomes in the Performance-Oriented Mobility Assessment (POMA) scores (24.64 ± 5.50 vs. 17.39 ± 4.38,  < 0.001), Time Up and Go Test (TUGT) indicators (10.66 ± 1.76 vs. 12.01 ± 2.21,  < 0.05), and cognitive load measures (all  < 0.05). Exercise-cognitive dual-task training may effectively improve frailty status, cognitive function, physical performance, and dual-task cognitive load in older adults with CF, suggesting its potential for broader application in this population. http://www.chictr.org.cn/, ChiCTR2400080105.