Dual-task involves performing cognitive and motor tasks together, which requires executive functions that may be impaired in individuals with neurological conditions. Therefore, it is important to accurately assess executive functions to plan a therapeutic intervention.
OBJECTIVE:
To characterize the use of upper extremity-cognitive dual-task assessment and to describe variables correlated with dual-task ability.
METHODS:
An electronic search of databases (MEDLINE, EMBASE, CINAHL, and PsycINFO) was carried out using a combination of the following terms: upper-extremity, dual/concurrent task, and cognitive/motor tasks. Two reviewers independently completed data extraction and assessed study quality.
RESULTS:
1,946 studies were identified; 25 studies met the inclusion criteria. The purpose of using an upper extremity-cognitive dual-task assessment varied between studies as well as the upper extremity motor tasks used: pegboard (N = 14), arm curl (N = 9), finger-tapping (N = 3), and reaching (N = 1) tests. Dual-task ability was reported as the motor-cognitive interference (N = 15) and as motor cost (N = 12). Dual-task ability was correlated to cognition, brain activity, and daily function, and was significantly different between healthy and neurological individuals.
CONCLUSION:
Upper extremity cognitive dual-task paradigm is gaining popularity in clinical research, but lacks standardized tools, testing procedures, and calculations. A structured assessment procedure is needed for clinical use and future research.
Al-Yahya,E., Dawes,H., Smith,L., Dennis,A., Howells,K., Cockburn,J. (2011). Cognitive motor interference while walking: A systematic review and meta-analysis. Neuroscience and Biobehavioral Reviews35(3), 715–728. https://doi.org/10.1016/j.neubiorev.2010.08.008
2.
Asghari,M., Ehsani,H., Cohen,A., Tax,T., Mohler,J., Toosizadeh,N. (2021). Nonlinear analysis of the movement variability structure can detect aging-related differences among cognitively healthy individuals. Human Movement Science78(November 2020), 102807–102807. https://doi.org/10.1016/j.humov.2021.102807
3.
Bank,P. J. M., Marinus,J., van Tol, R. M., Groeneveld,I. F., Goossens,P. H., de Groot, J. H., van Hilten,J. J., Meskers,C. G. M. (2018). Cognitive-motor interference during goal-directed upper-limb movements. European Journal of Neuroscience48(10), 3146–3158. https://doi.org/10.1111/ejn.14168
4.
Bayot,M., Dujardin,K., Tard,C., Defebvre,L., Bonnet,C. T., Allart,E., Delval,A. (2018). The interaction between cognition and motor control: A theoretical framework for dual-task interference effects on posture, gait initiation, gait and turning. Neurophysiologie Clinique48(6), 361–375. https://doi.org/10.1016/j.neucli.2018.10.003
5.
Bishnoi,A., Hernandez,M. E. (2021). Dual task walking costs in older adults with mild cognitive impairment: A systematic review and meta-analysis. Aging and Mental Health25(9), 1618–1629. https://doi.org/10.1080/13607863.2020.1802576
6.
Bootsma-van der Wiel,A., Gussekloo,J., De Craen,A. J. M., Van Exel,E., Bloem,B. R., Westendorp,R. G. J. (2003). Walking and talking as predictors of falls in the general population: The Leiden 85-plus study. Journal of the American Geriatrics Society51(10), 1466–1471. https://doi.org/10.1046/j.1532-5415.2003.51468.x
7.
Candan,S. A., Özcan,T. Ş. (2019). Dual-task interference during hand dexterity is a predictor for activities of daily living performance in Parkinson’s disease. Parkinsonism and Related Disorders, 66(December 2018), 100–104. https://doi.org/10.1016/j.parkreldis.2019.07.017
8.
Crombie,I. K., Harvey,B. (1996). The pocket guide to critical appraisal: A handbook for health care professionals. Group157, 66–66.
9.
Dan,X., Liu,J., Doyon,J., Zhou,Y., Ma,J., Chan,P. (2019). Impaired fine motor function of the asymptomatic hand in unilateral Parkinson’s disease. Frontiers in Aging Neuroscience, 11. https://doi.org/10.3389/fnagi.2019.00266
10.
Dayalu,V., Teulings,H. L., Bowers,A., Crawcour,S., Saltuklaroglu,T. (2013). Manual disfluency in drawing while producing and listening to disfluent speech. Human Movement Science32(4), 677–690. https://doi.org/10.1016/j.humov.2012.12.003
11.
Doron,N., Rand,D. (2019). Is unilateral spatial neglect associated with motor recovery of the affected upper extremity poststroke?Asystematic review. Neurorehabilitation and Neural Repair. https://doi.org/10.1177/1545968319832606
12.
Downs,S. H., Black,N. (1998). The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. Journal of Epidemiology and Community Health52(6), 377–384. https://doi.org/10.1136/jech.52.6.377
13.
Ehsani,H., Mohler,M. J., O’connor,K., Zamrini,E., Tirambulo,C., Toosizadeh,N. (2019). The association between cognition and dual-tasking among older adults: The effect of motor function type and cognition task difficulty. Clinical Interventions in Aging14, 659–669. https://doi.org/10.2147/CIA.S198697
14.
Ehsani,H., Parvaneh,S., Mohler,J., Wendel,C., Zamrini,E., O’Connor,K., Toosizadeh,N. (2020). Can motor function uncertainty and local instability within upper-extremity dual-tasking predict amnestic mild cognitive impairment and early-stage Alzheimer’s disease? Computers in Biology and Medicine, 120. https://doi.org/10.1016/j.compbiomed.2020.103705
15.
Goverover,Y., Sandroff,B. M., DeLuca,J. (2018). Dual task of fine motor skill and problem solving in individuals with multiple sclerosis: A pilot study. Archives of Physical Medicine & Rehabilitation99(4), 635–640. https://doi.org/10.1016/j.apmr.2017.10.012
16.
Grijalva,C., Toosizadeh,N., Sindorf,J., Chou,Y. h., Laksari,K. (2021). Dual-task performance is associated with brain MRI Morphometry in individuals with mild cognitive impairment. Journal of Neuroimaging31(3), 588–601. https://doi.org/10.1111/jon.12845
17.
Hyndman,D., Ashburn,A., Yardley,L., Stack,E. (2006). Interference between balance, gait and cognitive task performance among people with stroke living in the community. Disability and Rehabilitation28(13-14), 849–856. https://doi.org/10.1080/09638280500534994
18.
Jokinen,H., Melkas,S., Ylikoski,R., Pohjasvaara,T., Kaste,M., Erkinjuntti,T., Hietanen,M. (2015). Post-stroke cognitive impairment is common even after successful clinical recovery. European Journal of Neurology22(9), 1288–1294. https://doi.org/10.1111/ene.12743
19.
Kimberley,J., Lewis,S. M., Strand,C., Rice,B. D., Hall,S., Slivnik,P. (2008). Neural substrates of cognitive load changes during a motor task in subjects with stroke. Journal of Neurologic Physical Therapy32(3), 110–117. https://doi.org/10.1097/npt.0b013e318183d716
20.
Kizony,R., Levin,M. F., Hughey,L., Perez,C., Fung,J. (2010). Cognitive load and dual-task performance during locomotion poststroke: A feasibility study using a functional virtual environment. Physical Therapy90(2).
21.
Kudlicka,A., Clare,L., Hindle,J. V. (2011). Executive functions in Parkinson’s disease: Systematic review and meta-analysis. Movement Disorders26(13), 2305–2315. https://doi.org/10.1002/mds.23868
22.
LaBarba,R. C., Bowers,C. A., Kingsberg,S. A., Freeman,G. (1987). The effects of concurrent vocalization on foot and hand motor performance: A test of the functional distance hypothesis. Cortex23(2), 301–308. https://doi.org/10.1016/S0010-9452(87)80040-0
Langhanns,C., Muller,H. (2018). Empirical support for ‘hastening-through-re-automatization’ by contrasting two motor-cognitive dual tasks. Front Psychol9, 714. https://doi.org/10.3389/fpsyg.2018.00714
25.
Lee,Y., Goyal,N., Aruin,A. S. (2018). Effect of a cognitive task and light finger touch on standing balance in healthy adults. Experimental Brain Research236(2), 399–407. https://doi.org/10.1007/s00221-017-5135-9
26.
Lemmens,J., Ferdinand,S., Vandenbroucke,A., Ilsbroukx,S., Kos,D. (2018). Dual-task cost in people with multiple sclerosis: A case–control study. British Journal of Occupational Therapy81(7), 384–392. https://doi.org/10.1177/0308022618757936.
27.
Leone,C., Patti,F., Feys,P. (2015). Measuring the cost of cognitive-motor dual tasking during walking in multiple sclerosis. Multiple Sclerosis Journal21(2), 123–131. https://doi.org/10.1177/1352458514547408
28.
Lin,K. C., Wu,Y. F., Chen,I. C., Tsai Prof,P. L., Wu,C. Y., Chen,C. L. (2015). Dual-task performance involving hand dexterity and cognitive tasks and daily functioning in people with schizophrenia: A pilot study. American Journal of Occupational Therapy69(3), 6903250020–6903250020. https://doi.org/10.5014/ajot.2014.014738
29.
Liu,Y. C., Huang,P. C., Lee,Y. C., Chu,C. L., Yang,Y. K., Chen,P. S., Lin,K. C. (2020). Effects of adding a concurrent cognitive task on manual dexterity in people with schizophrenia: Implications for performance of daily life activities. Asian J Psychiatr54, 102456. https://doi.org/10.1016/j.ajp.2020.102456
30.
Ljubisavljevic,M. R., Oommen,J., Filipovic,S., Bjekic,J., Szolics,M., Nagelkerke,N. (2019). Effects of tDCS of dorsolateral prefrontal cortex on dual-task performance involving manual dexterity and cognitive task in healthy older adults. Front Aging Neurosci11, 144. https://doi.org/10.3389/fnagi.2019.00144
31.
Maes,P. J., Giacofci,M., Leman,M. (2015). Auditory and motor contributions to the timing of melodies under cognitive load. Journal of Experimental Psychology Human Perception and Performance41(5), 1336–1352. https://doi.org/10.1037/xhp0000085
32.
McIsaac,T. L., Fritz,N. E., Quinn,L., Muratori,L. M. (2018). Cognitive-motor interference in neurodegenerative disease: A narrative review and implications for clinical management. Frontiers in psychology, 9(OCT), 1–9. https://doi.org/10.3389/fpsyg.2018.02061
33.
Milnik,A., Nowak,I., Müller,N. G. (2013). Attentiondependent modulation of neural activity in primary sensorimotor cortex. Brain and Behavior3(2), 54–66. https://doi.org/10.1002/brb3.114
34.
Ownsworth,T., Shum,D. (2008). Relationship between executive functions and productivity outcomes following stroke. Disability and Rehabilitation30(7), 531–540. https://doi.org/10.1080/09638280701355694
35.
Ozcan Gulsen, E., Tunca Yilmaz,O. (2023). Dual task effect on upper and lower extremity skills in different stages of Parkinson’s disease. Acta Neurol Belg123(3), 865–872. https://doi.org/10.1007/s13760-022-02007-x
36.
Ozkul,C., Guclu-Gunduz,A., Eldemir,K., Apaydin,Y., Gulsen,C., Yazici,G., Soke,F., Irkec,C. (2021). Dual-task cost and related clinical features in patients with multiple sclerosis. Motor Control25(2), 211–233. https://doi.org/10.1123/mc.2020-0035
37.
Pardhan,S., Zuidhoek,S. (2013). Dual cognitive task affects reaching and grasping behavior in subjects with macular disorders. Investigative Ophthalmology andVisual Science54(5), 3281–3288. https://doi.org/10.1167/iovs.12-11045
38.
Petrigna,L., Pajaujiene,S., Iacona,G. M., Thomas,E., Paoli,A., Bianco,A., Palma,A. (2020). The execution of the Grooved Pegboard test in a Dual-Task situation: A pilot study. Heliyon, 6(8), e04678. https://doi.org/10.1016/j.heliyon.2020.e04678
39.
Petrillo,K., Javed,B., Toosizadeh,N. (2023). Association between dual-task function and neuropsychological testing in older adults with cognitive impairment. Exp Gerontol178, 112223. https://doi.org/10.1016/j.exger.2023.112223
40.
Plummer,P., Eskes,G. (2015). Measuring treatment effects on dual-task performance: A framework for research and clinical practice. Frontiers in Human Neuroscience, 9(APR), 1–7. https://doi.org/10.3389/fnhum.2015.00225
41.
Plummer,P., Eskes,G., Wallace,S., Giuffrida,C., Fraas,M., Campbell,G., Clifton,K. L., Skidmore,E. R., American Congress of Rehabilitation Medicine Stroke Networking Group Cognition Task, F. (2013). Cognitivemotor interference during functional mobility after stroke: State of the science and implications for future research. Arch Phys Med Rehabil, 94(12), 2565–2574e2566. https://doi.org/10.1016/j.apmr.2013.08.002
42.
Poulin,V., Korner-Bitensky,N., Dawson,D. R. (2013). Strokespecific executive function assessment: A literature review of performance-based tools. Australian Occupational Therapy Journal, 60(1), 3–19.
43.
Proud,E. L., Morris,M. E. (2010). Skilled hand dexterity in Parkinson’s disease: Effects of adding a concurrent task...[corrected] [published erratum appears in ARCH PHYS MED REHABIL 2011; 92(12):2098]. Archives of Physical Medicine&Rehabilitation91(5), 794–799. https://doi.org/10.1016/j.apmr.2010.01.008
44.
Raats,J., Lamers,I., Baert,I., Willekens,B., Veldkamp,R., Feys,P. (2019). Cognitive-motor interference in persons with multiple sclerosis during five upper limb motor tasks with different complexity. Mult Scler25(13), 1736–1745. https://doi.org/10.1177/1352458518808194
45.
Scholten,M., Govindan,R. B., Braun,C., Bloem,B. R., Plewnia,C., Krüger,R., Gharabaghi,A., Weiss,D. (2016). Cortical correlates of susceptibility to upper limb freezing in Parkinson’s disease. Clinical Neurophysiology127(6), 2386–2393. https://doi.org/10.1016/j.clinph.2016.01.028
46.
Stolwyk,R. J., Mihaljcic,T., Wong,D. K., Chapman,J. E., Rogers,J. M. (2021). Poststroke cognitive impairment negatively impacts activity and participation outcomes: A systematic review and meta-analysis. Stroke (1970)52(2), 748–760. https://doi.org/10.1161/STROKEAHA.120.032215
47.
Teasell,R., Salbach,N. M., Foley,N., Mountain,A., Cameron,J. I., Jong,A. d., Acerra,N. E., Bastasi,D., Carter,S. L., Fung,J., Halabi,M. L., Iruthayarajah,J., Harris,J., Kim,E., Noland,A., Pooyania,S., Rochette,A., Stack,B. D., Symcox,E., Lindsay, M. P. (2020). Canadian stroke best practice recommendations: Rehabilitation, recovery, and community participation following stroke. Part one: Rehabilitation and recovery following stroke; 6th Edition update 2019. International Journal of Stroke15(7), 763–788. https://doi.org/10.1177/1747493019897843
48.
Toosizadeh,N., Ehsani,H., Wendel,C., Zamrini,E., Connor,K. O., Mohler,J.(2019). Screening older adults for amnestic mild cognitive impairment and early-stage Alzheimer’s disease using upper-extremity dual-tasking. Scientific Reports9(1), 10911–10911. https://doi.org/10.1038/s41598-019-46925-y
49.
Toosizadeh,N., Najafi,B., Reiman,E. M., Mager,R. M., Veldhuizen,J. K., O’Connor,K., Zamrini,E., Mohler,J. (2016). Upper-extremity dual-task function: An innovative method to assess cognitive impairment in older adults. Front Aging Neurosci8, 167. https://doi.org/10.3389/fnagi.2016.00167
50.
Villafaina,S., Polero,P., Collado-Mateo,D., Fuentes-García,J. P., Gusi,N. (2019). Impact of adding a simultaneous cognitive task in the elbow’s range of movement during arm curl test in women with fibromyalgia. Clinical Biomechanics65, 110–115. https://doi.org/10.1016/j.clinbiomech.2019.04.006
51.
Wang,C., Zahiri,M., Vaziri,A., Najafi,B. (2023). Dualtask upper extremity motor performance measured by video processing as cognitive-motor markers for older adults. Gerontology69(5), 650–656. https://doi.org/10.1159/000528853
52.
Winstein,C. J., Stein,J., Arena,R., Bates,B., Cherney,L. R., Cramer,S. C., Deruyter,F., Eng,J. J., Fisher,B., Harvey,R. L., Lang,C. E., MacKay-Lyons,M., Ottenbacher,K. J., Pugh,S., Reeves,M. J., Richards,L. G., Stiers,W., Zorowitz,R. D. (2016). Guidelines for Adult Stroke Rehabilitation and Recovery: A Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association (Vol. 47). https://doi.org/10.1161/STR.0000000000000098
53.
Yogev,G., Giladi,N., Peretz,C., Springer,S., Simon,E. S., Hausdorff,J. M. (2005). Dual tasking, gait rhythmicity, and Parkinson’s disease: Which aspects of gait are attention demanding?European Journal of Neuroscience22(5), 1248–1256. https://doi.org/10.1111/j.1460-9568.2005.04298.x
