The Pulse

Improving Functional Mobility with Dual-Task Training

Posted by ACP on Aug 27, 2018 10:36:47 AM

In the early phase of rehab, a therapist may elect to challenge a patient with one task at a time. However, most functional activities in everyday life occur with two or more tasks performed at once. Individuals with neurologic disorders, advanced age, muscle weakness, or cardiopulmonary compromise commonly have deficits in their ability to perform motor and cognitive dual-tasks. Dual-task (DT) training is defined as working on one task while simultaneously working on additional tasks (cognitive or motor). DT training has been shown to offer the following therapeutic benefits:

  •  In older adults, DT training can improve balance and walking speed resulting in reduced fall risk. (Varela-Vàsquez et al., 2020)
  • DT training in individuals with conditions including mild cognitive impairment, Parkinson’s disease, stroke, and multiple sclerosis has
    resulted in improved cognitive function, memory, physical performance, gait, and balance. (Pereira Olivia et al., 2020)

OmniFlow™ can be used for inspiratory and expiratory muscle training

TOTM 1-3Dual-Task Training:
•Incorporate inspiratory muscle training (motor) while simultaneously performing Diamond Mine biofeedback activity (cognitive).
•Utilize expiratory muscle training (motor) while simultaneously performing Sail Away or Pre-Historic Contest expiratory biofeedback activity (cognitive).
•Combine rhythmical breathing exercise (motor) with simultaneous performance of Starry Road biofeedback activity (cognitive).

OmniCycle® can be used for upper or lower extremity cycling therapeutic exercise

TOTM 2-3Dual-Task Training:
•Use biofeedback programs (i.e., Soccer, Bar Graph, Porcupine, Symmetry Road) to engage cognition and problem-solving.
•Engage the individual in conversation; have them tell a story or solve a riddle or math problem (cognitive) while cycling (motor).
•Have individual operate a cell phone or tablet (cognitive) while performing lower extremity cycling (motor).

OmniStand® provides dynamic support and can be used for ankle, hip, and stepping balance responses

TOTM 3-2Dual-Task training:
• Instruct the individual to sing a song (cognitive) while marching (motor) in rhythm with the tune.
• Have individual operate a cellphone or tablet (cognitive) while performing standing balance (motor).
• Use the table top to play a game of cards or checkers (cognitive) while standing (motor).
• Alter leg and foot placement (motor) while catching a ball (motor).

OmniVR® can be used for sitting and standing balance, walking, and cognitive activities

TOTM 4-2Dual-Task training:
• Use the OmniVR® alone or in combination with the OmniStand® to work on balance (motor) while simultaneously performing virtual activities with cognitive and/or motor tasks.
•Use gait activity (motor) while trying to step on a mole (cognitive) to improve forward/backward linear and diagonal gait patterns.
•Work on assessing risk/safety awareness with virtual biofeedback activity (Everyday Environments) by identifying and prioritizing potentially hazardous situations (cognitive) and adding arm movement (motor) to select items.

OmniVersa® - PENS walk protocol can be used with standing, weight shifting, marching in place, or walking

TOTM 5Dual-Task training:
•Engage the individual in conversation (cognitive) while walking (motor) and ask questions or have them tell you something they did recently.
•Direct the individual to remove specific objects placed in his/her pockets (cognitive) while weight shifting (motor).
•Provide mental challenges; for example, “In 30 seconds, say as many words as you can that start with the letter R (cognitive) while marching in place (motor)”.

References:
Pereira Oliva, H. N., Mansur Machado, F. S., Rodrigues, V. D., Leão, L. L., & Monteiro-Júnior, R. S. (2020). The effect of dual-task training on cognition of people with different clinical conditions: An overview of systematic reviews.
IBRO reports, 9, 24–31. https://doi.org/10.1016/j.ibror.2020.06.005 
Varela-Vásquez, L. A., Minobes-Molina, E., & Jerez-Roig, J. (2020). Dual-task exercises in older adults: A structured review of current literature. Journal of frailty, sarcopenia and falls, 5(2), 31–37. https://doi.org/10.22540/JFSF-05-031 

Topics: Fall Prevention & Balance, Pain Management, Clinical Tip, Cardiopulmonary, Neuro Rehab