The Impact of Dual-Task Training Versus Single-Task Training on Cognitive and Physical Function in Neurologically Impaired Individuals: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Abstract

Background

Dual-task training (DTT), which integrates simultaneous cognitive and motor or balance activities, has gained prominence in neurorehabilitation as a means to improve both physical and cognitive function. However, its comparative efficacy relative to single-task training (STT) remains uncertain.

Objective

This systematic review provides a narrative synthesis of cognitive and physical outcomes from DTT versus STT across neurologically impaired populations and conducts a focused meta-analysis on gait speed; the only consistently reported physical outcome across studies.

Methods

A comprehensive search of Web of Science, PubMed, Scopus, and the Cochrane Library (up to 26 July 2024) identified seven eligible randomized controlled trials (n = 207). Study quality was evaluated using the Cochrane Risk of Bias 2.0 tool. Narrative synthesis was conducted for all outcomes, and a meta-analysis was performed on studies reporting post-intervention gait speed, a common indicator of physical function.

Results

Narrative synthesis indicated that DTT consistently improved executive function, attention, memory, gait performance, balance, and quality of life across studies. Nevertheless, the meta-analysis of five RCTs revealed a small, non-significant pooled effect on gait speed (Hedges’ g = 0.12; 95% CI: −0.57 to 0.82; p = .74) with substantial heterogeneity (I² = 69.05%). Egger’s test showed no evidence of publication bias (p = .5227). Diagnosis-specific patterns emerged: participants with Parkinson’s disease demonstrated notable gains in gait and quality of life, whereas those with mild cognitive impairment improved in executive function and instrumental activities of daily living (IADLs).

Conclusions

DTT appears to offer condition-dependent benefits for gait and executive function but does not demonstrate overall superiority to STT based on current evidence. Its multidomain effects likely reflect improvements in attentional control, motor automaticity, and cognitive–motor integration. Future large-scale, diagnosis-specific trials using standardized outcomes and mechanistic endpoints are needed to clarify DTT’s efficacy and guide implementation.