Measuring treatment effects on dual-task performance: a framework for research and clinical practice

TLDR

Dual‑task walking is crucial for daily ambulation, yet interference—shaped by task interaction and spontaneous prioritization—often impairs functional recovery, and reciprocal dual‑task effects are routinely overlooked, underscoring the need to assess both single and dual‑task performance and their relative changes over time. This perspective proposes a framework to assess treatment effects on dual‑task interference by accounting for task interactions and revealing whether overall dual‑task capacity improves or attentional strategies shift. The framework evaluates single and dual‑task performance in both tasks and their relative outcomes, thereby quantifying reciprocal dual‑task effects. The authors illustrate the framework’s clinical utility with examples and offer explicit recommendations for research and practice.

Abstract

The relevance of dual-task walking to everyday ambulation is widely acknowledged, and numerous studies have demonstrated that dual-task interference can significantly impact recovery of functional walking in people with neurological disorders. The magnitude and direction of dual-task interference is influenced by the interaction between the two tasks, including how individuals spontaneously prioritize their attention. Therefore, to accurately interpret and characterize dual-task interference and identify changes over time, it is imperative to evaluate single and dual-task performance in both tasks, as well as the tasks relative to each other. Yet, reciprocal dual-task effects (DTE) are frequently ignored. The purpose of this perspective paper is to present a framework for measuring treatment effects on dual-task interference, specifically taking into account the interactions between the two tasks and how this can provide information on whether overall dual-task capacity has improved or a different attentional strategy has been adopted. In discussing the clinical implications of using this framework, we provide specific examples of using this method and provide some explicit recommendations for research and clinical practice.