Earticle

Objectives: This study aimed to examine the effect of cognitive-functional dual-task training on balance, gait and cognitive function in patients with mild to moderate dementia. Methods: A total 36 participants were randomly assigned to three groups: cognitive-functional dual-task training (n=11), functional training (n=13), and control group (n=12). There were given 30-minute training for 2day/week, in total 24 times over 12 weeks. Results: Participants in the cognitive-functional dual-task triaining group showed significant improvement in balance and gait than the patients in the functional training and control groups (p<.05). There was significant improvement in cognitive function in all groups (p<0.5). Conclusions: Cognitive-functional dual-task training appers to have contributed the improvement dementia patient’s physical and cognitive function. Dual-task training is necessary to preventing the progression of severity and maintaining residual function in dementia patients.

Objective: This study was to develop and verify the effects of the exercise-cognitive combined dual-task training program on cognitive function and depression of the elderly with mild cognitive impairment(MCI). Methods: The subjects were randomly assigned to the exercise-cognitive combined dual-task training group(n=32) or single-task training group(n=31). To identify the effects on cognitive function, general cognitive function, frontal lobe function, and attention/working memory were measured. Depression was evaluated using Korean version of Geriatric Depression Scale. The outcome measurements were performed before and after the 8 weeks of intervention(2 days per week). Results: After 8 weeks, general cognitive function, frontal cognitive function, attention/working memory function, depression of the dual-task training group were significantly increased than those of the single-task training group(p<0.05). Conclusion: The results indicated that an exercise-cognitive combined dual-task training for MCI was effective in improving general cognitive function, frontal /executive function, attention/working memory function and reducing depression.

Purpose: We examined the effect of dual-task and single-task training on serial reaction time (SRT) task performance to determine whether SRT is based more on motor or perception in a dual-task. Methods: Forty healthy adults were divided into two groups: the dual-task group (mean age, $21.8{\pm}1.6$ years) and the single-task group (mean age, $21.7{\pm}1.6$ years). SRT task was conducted total 480 trial. The four figures were presented randomly 16 times. A unit was set as 1 block that would repeat 10 times. Thus, there were a total of 160 trials for each of the three color conditions. The dual-task group performed an SRT task while detecting the color of a specific shape. The end of the task, subjects answered the specific shape number; the single-task group only performed the SRT task. The study consisted of three parts: pre-measurement, task performance, and post-measurement. Results: Differences of pre and post reaction time between two group was higher for the dual-task group as compared to the single task group and there was a significant interaction between time and group (p<0.05). Conclusion: Our results indicate that. short term period SRT is not quiet effective under dual-task conditions, individuals need additional cognitive processes to successfully navigate a task This suggests that dual-task training might not be appropriate for motor learning enhancement, at least when the training is over a short period.

Purpose: Dementia is a disease in which cognitive function declines, leading to deterioration of body functions and activities of daily living. The purpose of this study is to explore the effects of dual-task training, including cognitive tasks, on cognitive and body function and β-amyloid levels in Alzheimer's dementia patients. Methods: 34 inpatients diagnosed with Alzheimer's dementia at a nursing hospital located in South Korea. The patients were randomly divided into a dual-task group (n=16) and a single-task group (n=18). Each group was trained for 30 minutes three times a week for eight weeks. The MMSE-K was used to measure the patients' cognitive function. To assess the patients' static balance ability, their LOS was measured using BioRescue. while dynamic balance was measured using the BBS. The 10MWT were conducted to evaluate the patients' walking ability. Blood analysis was performed to measure levels of β-amyloid. Results: Both groups exhibited statistically significant improvements in gait function after the training (p<0.05). The dual-task group exhibited statistically significant differences in cognitive function, static and dynamic balance function, and β-amyloid levels after training (p<0.05). A significant difference was observed between the two groups (p<0.05). Conclusion: Dual-task training were found to be effective in improving cognitive and bodily functioning and reducing β-amyloid levels in Alzheimer's dementia patients. Thus, this may be suggested as an effective exercise method for the treatment and early prevention of Alzheimer's dementia.

PURPOSE: The purpose of this study was to examine the effects of dual-task training with cognitive tasks on cognitive functions and β-amyloid levels in the elderly with mild dementia. METHODS: The subjects were 36 elderly inpatients diagnosed with mild dementia at S Hospital located in Gyeongsangbuk-do, South Korea. The patients were randomly divided into a dual-task training group (DTG; n = 18) or a single-task training group (STG; n = 18). DTG performed dual-task training with cognitive tasks while STG performed only exercise tasks. These groups performed their respective exercises during a 30-minute session occurring three times a week over an 8-week period. MMSE-K and GDS were used to measure the subjects' cognitive function. To assess the subjects' dementia-related factors, their β-amyloid levels were measured by blood analysis. RESULTS: The results of the experiment were as follows: DTG showed statistically significant differences between their MMSE-K scores and β-amyloid levels before and after training (p < .05), whereas they exhibited no statistically significant differences in their GDS scores. MMSE-K scores and β-amyloid levels were significantly different between DTG and STG after training. CONCLUSION: The present study's overall results indicate that dual-task training with cognitive tasks is more effective than single-task training in improving cognitive functions and β-amyloid levels in the elderly with mild dementia. In other words, regular dual-task training can be considered as effective in improving cognitive function and dementia-related factors in the elderly with mild dementia and thus may be suggested as an effective exercise method for the treatment and early prevention of dementia.

Purpose: This study was conducted to identify the effects of dual task training on balance and functional performance in high school soccer players with functional ankle instability. Methods: Twenty high school soccer players with functional ankle instability were randomly assigned to a single task training group and a dual task training group. One participant who did not participate regularly in the training was excluded. The single task training group (n=9) received balance training on an unstable surface. The dual task training group (n=10) received balance training on an unstable surface and had to catch thrown balls during the balance training. Both groups were trained for 4 weeks, 3 days a week. The balance and functional performance of both groups was measured before and after training. Balance was measured using an anterior-posterior and medio-lateral balance. Functional performance was measured based on a figure-of-8 hop test, up-down hop test, and a single hop test. All data were analyzed by repeated two-way ANOVA tests. Results: A time by group interaction effect was not observed in the medio-lateral balance test, figure-of-8 hop test, or single hop test (p>0.05). A time by group interaction effect was observed in the anterior-posterior balance and up-down hop test (p<0.05). Conclusion: These results suggest that dual task training improved balance and functional performance better than single task training for some items.

Objective: Dual-task walking deficits impact functional daily life, which often requires walking while performing simultaneous tasks such as talking, thinking or carrying an object. This study is to find out the latest trend of dual-task training's influence on ambulatory abilities of a stroke patient. Design: Systematic review of randomized controlled trials. Methods: This literature review was conducted in Pubmed and Sciencedirect with the follwing key words:stroke, cerebro-vascular accident, hemiplegia, gait, rehabilitation, exercise. 7 studies were chosen in findings by search tool. 3 studies were case study, 3 studies were cross sectional observational study and 1 study was randomized controlled trial. Results: It was found that stroke patients have difficulties in doing 2 motor tasks simultaneously and when they do 2 tasks, one is done in a naturally preferred activity areas. Moreover, when simply applying dual-tasks, the walking speed decreased. Meanwhile, when applying them through training, the speed increased. This showed the improvement of effective task-implementation abilities after dual-task training using task-integration models. Conclusions: In the beginning of the 2000s, dual-tasks were implemented by simply combining walking and cognition or exercise task, and the results of this study suggest that subjects with stroke have difficulty performing dual task. However, the latest trend is to let patients do the dual-task training by combining it with virtual reality. Therefore, dual task training could be performed in a safe in the environment such as virtual reality or augment reality.

Objective To investigate the effect of dual-task training on the recovery of balance ability and cognitive function in patients with subacute stroke.Methods Twenty patients (12 males and eight females; average age, 59.70 years) with subacute stroke were enrolled in this study. All participants were randomly assigned to one of two groups, the dual-task group (n=10) or the control group (n=10). The dual task was simultaneous balance and cognitive training using the BioRescue. All patients were evaluated with posturographic parameters and the Berg Balance Scale for balance ability, a computerized neuropsychological test and the Korean version of the Mini-Mental State Examination for cognitive function, the Fugl-Meyer Assessment for motor function, and the Korean-Modified Barthel Index for activities of daily living (ADL) function before and after 4 weeks of rehabilitation.Results The dual-task group showed significant improvements in the pressure of the weight distribution index (WDI), surface area, and length of the stability index during the eyes-open condition; surface area of the limit of stability (LOS) on the hemiparetic and intact sides, and the auditory continuous performance test and backward visual span test after rehabilitation. Although no significant difference was observed for the changes in balance ability or cognitive, motor, and ADL functions between the groups, changes in the WDI pressure during the eyes-open condition and in the area ratio of LOS (hemiparetic/intact) showed a tendency to improve in the dual-task group.Conclusion Our findings suggest that dual-task training could be as effective as conventional balance training for improving balance and cognition in subacute post-stroke patients.

Objective: The purpose of this study was to compare the effect of ball kicking dual task gait training with the addition of a cognitive task with general treadmill gait training (TGT) on gait speed, gait endurance, functional gait, balance and balance confidence in patients with chronic hemiparetic stroke. Design: Randomized controlled trial. Methods: Fourteen stroke patients who volunteered to participate in this study were randomly divided into two groups with seven patients in each group: ball kicking dual task training (DTT) group and TGT group. The DTT group received ball kicking DTT with cognitive tasks consisted of three stages and the TGT group received TGT using normal walking speed, respectively, for 30 minutes per day 3 days per week for 4 weeks. Outcome assessments were made with the 10-meter walking test (10MWT), 6-minute walking test (6MWT), functional gait assessment (FGA), Berg balance scale (BBS), timed up and go test (TUG), and the activities-specific balance confidence (ABC) scale. Results: The DTT group showed more significant improvement in the 10MWT, 6MWT, FGA, BBS, TUG, and ABC than the TGT group (p<0.05). In addition, within groups comparison showed significant improvement in all variables (p<0.05). Conclusions: The findings suggest that both ball kicking dual task gait training and TGT improve gait performance and balance in patients with chronic hemiparetic stroke. However, ball kicking dual task gait training results showed more favorable outcomes than TGT for chronic hemiparetic stoke patients.

Objective: With the proportion of the elderly population in Korea reaching 17.5% in 2022 and projected to increase to 20.6% by 2025, 30.1% by 2035, and 43% by 2050, the accelerated aging of the population is raising societal concerns about elderly care. Maintaining mobility is crucial for a healthy and independent old age. Design: Cross-sectional study Methods: This study investigates the effects of dual-task performance on gait variables and cognitive function in older adults. This cross-sectional study involved 60 older adults aged 65 and above, categorized into a dementia group (Korean version of Montreal Cognitive Assessment (MoCA-K) score ≤ 22) and a control group (MoCA-K score ≥ 23). Cognitive and gait functions were assessed using the GAITRite system (GAITRite system, CIR Systems Inc., USA), measuring gait variables (speed, stride length, etc.) before and after dual-task performance. The assessments were conducted under a single-blind condition, and data were analyzed using SPSS (ver. 25.0, SPSS Inc., USA). Results: The dementia group scored lower on cognitive assessments compared to the control group (p<0.05). In dual-task performance evaluations, the dementia group exhibited longer total task times and lower accuracy than the control group (p<0.001), while reaction times were longer but not statistically significant. GAITRite system analysis revealed that the dementia group had reduced gait speed and stride length compared to the control group (p<0.05). However, the difference in gait time was not statistically significant. The study results indicate that older adults with dementia show significant differences in cognitive function and gait performance, with notable impacts under dual-task conditions. Conclusions: These findings underscore the effect of cognitive decline on gait and provide valuable insights for predicting gait and cognitive function deterioration in dementia, which can aid in developing fall prevention strategies.

Objective: In the present study, the effects of visual restriction and unstable base dual-task training (VUDT), stable base dual-task training (SDT), and on stroke patients' balance and concentration abilities were examined. Design: Two-group pretest-posttest design. Methods: Dual-task training was conducted for thirty persons with chronic stroke who were hospitalized or receiving physical therapy and were randomly assigned to either the VUDT group (n=15) or the SDT group (n=15). The subjects were divided into two groups of 15 participants each, the VUDT group and the SDT group. Dual-task training was administered for 30 minutes per session, three times a week for 8 weeks. The participants' balance was measured via the center of pressure migration distances, functional reach test (FRT), Berg Balance Scale (BBS), and attention was measured using the trail-making test and the Stroop test. Results: In comparisons within each group, the two groups showed significant differences before and after the training (p<0.05). In the comparisons between the groups, the VUDT group showed significant improvements in center of pressure (COP), FRT, and BBS, and TMT compared to the SDT group (p<0.05). Conclusions: It would be more effective to conduct dual-task training as a rehabilitation training program under vision restriction and unstable supporting surface conditions than to conduct the test under unstable supporting plane conditions to improve balance and attention in chronic stroke patients.

Purpose: Walking in the dual-task condition is a critical skill for hemiplegic patients to live in real-life situations. The purpose of this study was to compare the effect of dual-task gait training and general gait training on gait parameters and cognitive function in patients with chronic stroke during dual-task walking. Methods: The study included 23 patients with chronic hemiparetic stroke who were randomly divided into experimental (dual-task gait training) and control (general walking training) groups. The 11 subjects in the experimental group and nine subjects in the control group received dual-task gait training (walking while handling a ball, crossing obstacles, picking up various objects, and problem solving simple cognitive tasks and general over-ground gait training, respectively, for 30 minutes per day 5 days per week for 4 weeks. Spatiotemporal parameters and cognitive tasks in the dual-task gait condition were measured. Statistical analysis of the changes between the pre- and post-intervention measurement variables was performed using ANCOVA. Results: In the gait condition under cognitive tasks, the changes pre- and post-intervention in gait velocity, stride length, double support limb, and step symmetry were significantly greater in the dual-task gait training group; however, the dual-task gait training group showed no significant improvement compared to the general gait training group in terms of the assessment of cognitive tasks. Conclusion: The findings suggest that dual-task gait training may be beneficial for walking ability in dual-task walking condition.

Objective: To examine the effects of dual-task cognitive training combined with transcranial direct current stimulation (tDCS) on cognitive and daily functioning in older adults. Methods: Ten older adults participated in an eight-session dual-task cognitive training program combined with tDCS. Pre- and post-intervention assessments measured cognitive function, activities of daily living, attention, and brain activity using validated tools. Results: Post-intervention analyses showed significant improvements in cognitive function (measured by the Comprehensive Item Selection Test and the Korean version of the Montreal Cognitive Assessment), instrumental activities of daily living (measured by the Korean version of the Instrumental Activities of Daily Living scale), and reduced cognitive decline (measured by the Global Deterioration Scale) (all p < .05). No significant changes were observed in attentional control (measured by the Attentional Control Questionnaire) or in the accuracy and reaction times on the N-back and Stroop tasks. Conclusion: Combined dual-task cognitive training and tDCS may improve cognitive function and activities of daily living in older adults. Further research is warranted to validate and optimize this intervention.

PURPOSE: The purpose of this study was to investigate the effect of ankle dual task including motor training on the static balance, dynamic balance in the elderly. METHODS: 30 elderly people were randomly divided into 3 groups: 10 people in the single motor task group, 10 people in the double motor dual task group and 10 people in the motor-cognitive dual task group. In the double motor dual tasks group was performed ankle balance motor task additional motor task. Motor-cognitive dual task group was performed ankle balance motor task additional cognitive task. Single motor task group was performed ankle balance motor task. It was performed three times intervention a week for six weeks. Statistical analysis method was performed using one way ANOVA for comparison between groups, and the paired t-test was used for comparison pre and post intervention. RESULTS: Static and dynamic balance were significant differences between pre and post intervention by three groups (p<.05). In static balance, there was a significant difference among groups (p<.05), but there was not a significant difference between groups in dynamic balance (p>.05). CONCLUSION: The results of the research, the ankle balance dual task including motor or cognitive task was more effective than single motor task on static balance in the elderly.

Purpose: The purpose of the present study was to investigate the effects of a simultaneous dual-task and horse-riding simulator (HRS) training regime on pulmonary function and flexibility. Methods: Sixteen subjects were recruited and randomly allocated to two groups: a dual-task (DT) (n=8) or a single-task (ST) (n=8) training group. Flexibility and pulmonary function were assessed before and after HRS training. Both groups underwent HRS training for 4 weeks, 3 times/week in 15-minute training sessions. The ST group underwent HRS training and the DT group underwent dual-task HRS training, which consisted of throwing and catching a ball and ring catching while HRS training. Results: Training significantly increased flexibility and FVC (forced vital capacity) and FEV1 (forced expiratory volume in 1 second) in both groups (p<0.05), but FEV1/FVC and PEF (peak expiratory flow) were not significantly different after training in both groups (p>0.05). After the training, flexibility and FVC in the DT group were significantly greater than in the ST group (p<0.05), but FEV1, FEV1/FVC, and PEF were not significantly different (p>0.05). Conclusion: Simultaneous dual-task and HRS motor training improved flexibility, FVC, and FEV1, and our comparative analysis suggests that dual-task HRS training improved flexibility and FVC more than single-task training.

The purpose of this study was to investigate changes in dynamic bal-ance and gross motion function when dual-task training was performed on an unstable support surface by children with spastic diplegia. The subjects of this study were 14 children (experimental group n=7, con-trol group n=7) who were medical diagnosed with spastic diplegia. Both groups were administered treatment for 30 min, 2 times a week for 8 weeks, with the experimental group performing dual-task exercise in which cognitive tasks related to daily living were performed while main-taining balance on an unstable surface, and the control group being ad-ministered neuro-developmental treatment. Balance and gross motor function Assessments were conducted before intervention and after 8 weeks of intervention. Wilcoxon signed-rank test was performed to analyze changes in balance, gross motor function in the group, and the Mann–Whitney test was conducted to compare the differences be-tween the two groups before and after intervention. The results showed that there was a statistically significant difference in both groups when balance in a sitting position and gross motor function (P<0.05). There was a statistically significant difference between the two groups in bal-ance and gross motor function assessment (P<0.05). Based on the re-sults of this study, it was confirmed that dual-task training improves bal-ance, gross motor function in children with spastic diplegia. Therefore, dual-task training may be considered as an effective method of inter-vention method in the functional aspect of children with spastic diple-gia.

Purpose: This study investigated the effects of game-based dual-task training on gait and cognitive function in patients with stroke. Methods: The study included 20 patients with stroke, randomly assigned to two groups: the experimental and control groups. The experimental group received virtual reality-based dual-task training in addition to conventional physical therapy, while the control group received only conventional physical therapy. An analysis of covariance (ANCOVA) was conducted to compare gait and cognitive function between the groups, revealing significant differences. Results: The experimental group that participated in game-based dual-task training demonstrated significant improvements in gait and cognitive function compared to the control group, which received conventional physical therapy (p<.05). Conclusion: Game-based dual-task training was shown to be an effective intervention for enhancing balance, gait, and cognitive function. These findings suggest that this training can serve as an efficient intervention for patients with other conditions. Future research focusing on gait and cognitive function is warranted to evaluate the effectiveness of this intervention further.

The purpose of this study was to investigate the effects of progressive treadmill cognitive dual-task training on gait performance in individuals with chronic stroke patients. Twenty-six participants with chronic hemi-paresis were recruited to this study and randomly distributed into two groups: progressive treadmill cognitive dual-task gait training (PTCDG group, 13 patients), conventional treadmill gait training (CTG group, 13 patients). All patients underwent 20 sessions of treadmill gait training with a harness (5 times per week, for a total of 4 weeks). The GAITRite was used to analyze gait kinematics, and 10-m walking test (10MWT) wear used as the clinical evaluation indicators. After training, PTCDG group showed significant improvement in gait velocity, cadence, single support time, and 10MWT compared to the control group. However there was no significant difference between the groups in the stride lengths in the affected and unaffected sides. The study verified that progressive treadmill cognitive dual-task gait training had a positive in-fluence on the gait and clinical gait index in chronic stroke patients.

Purpose: This study investigated the effects of laser-based neck sensorimotor training on cognitive dual-task gait performance in community-dwelling older adults. Methods: Twenty-four older adults were randomly assigned to an experimental group (n = 12) or a control group (n = 12). Both groups trained three times per week for six weeks. The experimental group performed laser-based neck sensorimotor training using a head-mounted laser device, whereas the control group performed a general neck exercise program. Outcome measures included the 10-Meter Walk Test under single-task and cognitive dual-task conditions, dual-task cost (DTC), the Timed Up and Go dual-task test (TUGdt), the Functional Gait Assessment (FGA), and cervical movement sense error (MSE). Within-group changes were analyzed using the paired t-test, and between-group differences were analyzed using ANCOVA with baseline values as covariates. Results: The experimental group showed significant improvements in single-task gait speed, cognitive dual-task gait speed, DTC, TUGdt, FGA, and MSE after the intervention (all p < .001). The control group showed significant improvements in single-task gait speed and TUGdt (both p < .001), FGA (p = .003), and MSE (p = .034), whereas changes in cognitive dual-task gait speed (p = .386) and DTC (p = .831) were not significant. Between-group comparisons revealed significantly greater improvements in the experimental group for single-task gait speed, TUGdt, FGA, and MSE (all p < .001), cognitive dual-task gait speed (p = .006), and DTC (p = .003). Conclusion: Laser-based neck sensorimotor training demonstrated superior effects on cognitive dual-task gait performance, functional mobility, functional gait ability, and cervical movement sense in community-dwelling older adults relative to general neck exercise.

The purpose of this study was to evaluate the effect of dual-task training with cognitive effort on the walking and balance functions of chronic stroke patients. The study included 14 chronic stroke patients, who were randomly divided into the experimental group (EG) and control group (CG), each with 7 patients. The EG performed the dual-task training with cognitive effort 3 times a week, 30 minutes for 4 weeks, where as the CG performed single-task training three times a week, for 30 minutes for 4 weeks. Outcome assessments were made with 10 m walk test, timed up and go test, 6 minutes walk test, and Berg balance scale. In within-group comparison, subjects from the EG showed significant differences in all variables (p<.05), while subjects from the CG showed only significant differences in 6 minutes walk test, and Berg balance scale (p<.05). Further, there was significant difference in the improvement rate of 10 m walk test. The findings suggest that the dual-task with cognitive effort may be beneficial for improving walking and balance functions of patients with chronic stroke.