Dual Tasking: Strengths and Limits
In the first two articles, we looked at the many meanings of balance and at how complex, representative tasks can help people develop balance skills in ways that carry over to daily life. Another approach that has gained huge attention in rehabilitation and aging research is dual tasking.
What is dual tasking?
Dual tasking means performing two tasks at once, most often a motor task and a cognitive task, though sometimes two motor tasks. The classic research example is asking someone to walk while counting backwards by sevens. Another might be standing on one leg while reciting a list of words. The key feature is that the tasks are defined as separate: one physical, one mental.
Researchers often measure dual-task cost, which is the decline in performance when tasks are combined compared to when each is done alone (Montero-Odasso et al., 2012). A large dual-task cost can indicate difficulties in attention or executive function, and it is strongly associated with fall risk in older adults.
Why researchers like it
Dual tasking has become popular in clinical research for several reasons:
Ease of measurement: It is simpler to combine and score two discrete tasks than to analyse performance in a complex, messy game.
Relevance: Everyday life often does require handling two things at once, such as walking while talking, or carrying groceries while scanning for traffic.
Sensitivity: Declines in dual-task ability often appear earlier than other signs of impairment, so dual-task testing is a useful marker of cognitive or mobility decline (Montero-Odasso et al., 2012).
What the evidence shows
Systematic reviews report that dual-task training can improve both gait and cognition in older adults. Ghai et al. (2017) found that combining motor and cognitive tasks in training reduced dual-task costs and improved executive function. Wollesen and Voelcker-Rehage (2014) showed that older adults benefit from dual-task training, though effects vary depending on the type of task pairing and the level of challenge.
The limitations
Dual tasking is useful, but it is not the whole story. The approach comes from a cognitive load model, where physical and mental tasks compete for limited attentional resources. This framing does not always align with ecological dynamics, which sees movement and cognition as integrated and emerging together from interactions with the environment (Li, Krampe, & Bondar, 2005; Davids et al., 2015).
In practice, dual-task drills can improve performance on similar laboratory tasks, but evidence for transfer to the messy, unpredictable situations of daily life is mixed. Real-world challenges are rarely two neat tasks bolted together. They are dynamic, context-rich, and often social.
How this fits with complex tasks
Dual tasking and representative task design are not mutually exclusive. Dual-task training has value for identifying impairments, for providing structured challenges, and for giving researchers clear data. But complex, game-based, and representative tasks build skills in environments that look more like the world outside the clinic.
At Nature Moves and WildStrong, we sometimes incorporate dual-task elements into games, but we are not trying to “force” a cognitive puzzle into every activity. Instead, we design tasks that already ask people to coordinate, adapt, and remember while moving. For example, in the Waiter Game, participants balance objects on a tray while remembering an order and navigating an obstacle course. From one angle, this could be described as dual tasking. From another, it is better seen as a naturally integrated, representative challenge.
The bigger picture
Dual tasking has helped researchers understand the links between cognition and mobility, and it offers a practical way to measure progress in clinical settings. But when the goal is preparing people for real-world movement, we also need approaches that go beyond two-task combinations and embrace the full complexity of human activity.
You can read the other two articles in this series here:
Designing balance that transfers to real life
References
Davids, K., Araújo, D., Vilar, L., Renshaw, I., & Pinder, R. (2015). An ecological dynamics perspective on skill acquisition: Implications for development of talent in sport. Talent Development & Excellence, 7(1), 21–34.
Ghai, S., Ghai, I., & Effenberg, A. O. (2017). Effects of dual-task training on gait and balance. Neuroscience & Biobehavioral Reviews, 75, 147–159.
Li, K. Z. H., Krampe, R. T., & Bondar, A. (2005). An ecological approach to studying aging and dual-task performance: Commentary. Cognitive Science, 29(3), 475–484.
Montero-Odasso, M., Verghese, J., Beauchet, O., & Hausdorff, J. M. (2012). Gait and cognition: A complementary approach to understanding brain function and the risk of falling. Journal of the American Geriatrics Society, 60(11), 2127–2136.
Wollesen, B., & Voelcker-Rehage, C. (2014). Training effects on motor–cognitive dual-task performance in older adults: A systematic review. European Review of Aging and Physical Activity, 11(1), 5–24.
