Search Results (43)

Background and Objectives: Dual-task training (DTT) is an innovative therapeutic approach that involves the simultaneous application of two tasks, which can be motor, cognitive, or a combination of both. Children with cerebral palsy (CP) often exhibit impairments in balance, motor skills, and gait, conditions that may be amenable to improvement through DTT. The aim of this study was to determine the effectiveness of DTT in enhancing balance, walking speed, and gross motor function-related balance in children with CP. Materials and Methods: In accordance with PRISMA guidelines, a comprehensive systematic review with meta-analysis (SRMA) was conducted. Electronic databases like PubMed Medline, Scopus, Web of Science, CINAHL, and PEDro were searched up to March 2025, with no language or publication date restrictions. Only randomized controlled trials (RCTs) examining the effectiveness of DTT on balance, gross motor function, and walking speed in children with CP were included. The methodological quality and risk of bias of the included RCTs were assessed using the PEDro scale. Pooled effects were calculated using Cohen’s standardized mean difference (SMD) and its 95% confidence interval (95% CI) within random-effects models. Results: Eight RCTs, providing data from 216 children, were included. Meta-analyses suggested that DTT was more effective than conventional therapies for increasing functional (SMD = 0.65; 95% CI 0.18 to 1.13), dynamic (SMD = 0.61; 95% CI 0.15 to 1.1), and static balance (SMD = 0.46; 95% CI 0.02 to 0.9), as well as standing (SMD = 0.75; 95% CI 0.31 to 1.18; p = 0.001) and locomotion dimensions (SMD = 0.65; 95% CI 0.22 to 1.08) of the Gross Motor Function Measure (GMFM) and walking speed (SMD = 0.46; 95% CI 0.06 to 0.87). Subgroup analyses revealed that a motor–cognitive dual task is better than a motor single task for functional, dynamic, and static balance and standing and locomotion dimensions for the GMFM. Conclusions: This SRMA, including the major number of RCTs to date, suggests that DTT is effective in increasing balance, walking and gross motor function-related balance in children with CP. Full article

Background/Objectives: Dual task (DT) training consists of practicing exercises while simultaneously performing a concurrent motor or cognitive task. This training modality seems to have beneficial effects on both domains. Various forms of DT training have been implemented for older adults in recent years, but no official guidelines currently exist. This review sought to analyze the studies published on this topic in the last ten years and provide a standard operating procedure (SOP) for healthy older adults in this context. Methods: The review collected articles from PubMed, Web of Science, and Scopus, adopting a designated set of keywords. Selected manuscripts and relevant information were selected, extrapolated, including information related to the training frequency, intensity, time, and type, and secondary tasks adopted. The secondary tasks were grouped according to previously published studies, and the SOP was created based on the frequency of the parameters collected from the included articles. Results: A total of 44 studies were included in the review. Based on the results, the SOP recommends postural balance or resistance training as primary tasks, combined with a mental tracking task as a secondary component. Two 60-min sessions per week for at least 12 weeks are required to achieve measurable results. Conclusions: Despite heterogeneity in the literature reviewed, the findings support the proposal of a SOP to guide future research on DT training in healthy older adults. Given its feasibility and positive effects on both motor and cognitive functions, this type of training can also be implemented in everyday settings. Full article

Background: Motoric Cognitive Risk Syndrome (MCR), defined by the co-occurrence of subjective cognitive complaints and slow gait, is recognized as a preclinical risk state for cognitive decline. However, not all individuals with MCR experience cognitive deterioration, making early and individualized prediction critical. Methods: This study included 80 participants aged 60 and older with MCR who underwent baseline assessments including plasma biomarkers (β-amyloid, tau), dual-task gait measurements, and neuropsychological tests. Participants were followed for one year to monitor cognitive changes. Support Vector Machine (SVM) classifiers with different kernel functions were trained to predict cognitive decline. Feature importance was evaluated using the weight coefficients of a linear SVM. Results: Key predictors of cognitive decline included plasma β-amyloid and tau concentrations, gait features from dual-task conditions, and memory performance scores (e.g., California Verbal Learning Test). The best-performing model used a linear kernel with 30 selected features, achieving 88.2% accuracy and an AUC of 83.7% on the test set. Cross-validation yielded an average accuracy of 95.3% and an AUC of 99.6%. Conclusions: This study demonstrates the feasibility of combining biomarker, motor, and cognitive assessments in a machine learning framework to predict short-term cognitive decline in individuals with MCR. The findings support the potential clinical utility of such models but also underscore the need for external validation. Full article

Given the high postural control demands of sport Jiu-Jitsu, prolonged training in this discipline may result in sport-specific adaptations, particularly in positions closely related to combat scenarios. This study aimed to evaluate the differences in reaction time and postural control between elite Jiu-Jitsu athletes and untrained individuals, highlighting the potential influence of specialized training on these critical performance attributes. This study was conducted on thirty-one young participants (fifteen Brazilian Jiu-Jitsu athletes and sixteen non-athletes). Reaction time was measured using the Fit Light Trainer system in two positions. Postural control was assessed during 30 s bipedal and single-leg standing, both with and without a dual task involving tracking a randomly moving point on a screen. Results indicated that athletes demonstrated significantly faster reaction times (p = 0.0242) and greater complexity in postural control mechanisms, as evidenced by higher fractal dimension values during single-leg standing with dual tasks in the anterior–posterior direction (p = 0.0011). These findings suggest that Brazilian Jiu-Jitsu athletes possess enhanced neuromuscular and cognitive–motor integration, crucial for managing the complex demands of martial arts. This study highlights the importance of incorporating dual-task scenarios in training to optimize athletic performance and postural control in high-demand sport contexts. Full article

Background: Current research on Alzheimer’s Disease has progressively focused on Mild Cognitive Impairment (MCI) as a pre-dementia state, as well as on Subjective Memory Complaint (SMC), as a potential early indicator of cognitive change. Consequently, timely interventions to prevent cognitive decline are essential and are most effective when combined with motor training. Nevertheless, motor-cognitive dual-task training often employs non-ecological tasks and is confined to clinical contexts lacking generalizability to daily life. The integration of 360° media could overcome these limitations. Therefore, the aim of the current work is twofold: (a) to present a dual-task training using 360° technology for its interactivity, versatility, and ecological validity, and (b) to propose a protocol to test its efficacy through a randomized clinical trial. Methods: This study will recruit 90 older adults (MCI and SMC). Participants will follow two phases of training: in-hospital rehabilitation and at-home rehabilitation. The experimental design will follow a 2 × 3 × 2 structure with 3 factors: type of treatment (360° training vs. traditional rehabilitation), time (baseline, post in-hospital training, and post at-home training), and group (SMC vs. MCI). Results: The expected outcome is an improvement in cognitive and motor functioning after the experimental training. Conclusion: This study will advance the literature on non-pharmacological interventions and innovative technological tools for cognitive trainings in the early stages of cognitive decline. Full article

Background/Objectives: Vestibular Physical Therapy (VPT) plays a crucial role in the rehabilitation of patients with vestibular disorders by promoting vestibular compensation through adaptation, habituation, and substitution mechanisms. While traditional VPT approaches have demonstrated effectiveness in restoring balance and gaze stability, some patients with chronic vestibular dysfunction continue to experience persistent deficits. Methods: review of recent advancements in neuroplasticity research suggest the need for updated rehabilitation strategies that integrate sensorimotor substitution, saccadic training, optokinetic stimulation, and cognitive–motor dual-task training to optimize vestibular compensation. Results: This perspective article explores innovative VPT approaches aimed at improving dynamic gaze and postural stability in a more challenging way. We emphasize the importance of personalized rehabilitation strategies that leverage multisensory integration to enhance neuroplastic recovery. Conclusions: By refining VPT interventions, we can maximize functional outcomes and improve the quality of life for individuals with vestibular disorders. Full article

Background and Objectives: The aim of this study was to determine the effect of immersive virtual reality used as a short-term multifaceted activity with a focus on motor and cognitive function in patients with Parkinson’s Disease. The sub-objective focused on quality of life in the study group of patients. Materials and Methods: Nineteen patients (64.2 ± 12.8 years) were included in this study. Inclusion criteria for this study: adult patients in Hoehn and Yahr’s stage 1–3, cooperative, with stable health status, independent and mobile. IVR therapy was performed twice a week for 20 min for one month. Input and output measurements were taken within 14 days of starting or ending therapy. The 10 Meter Walk test was used to examine and assess both comfortable and fast walking, and the Timed Up and Go (TUG) + s dual task was applied to quickly assess the highest possible level of functional mobility. The Berg Balance Scale test (BBS) was used to assess balance with a 14-item balance scale containing specific movement tasks. The standardized Parkinson’s Disease Questionnaire (PDQ-39) was used to assess quality of life. Data were processed in the PAST program using a nonparametric paired Wilcoxon test. The significance level was set at α = 0.05. The value of the r score was used to evaluate the effect size. Results: A significant reduction in the time in the fast walk 10MWT (p = 0.006; r = 0.63) and TUG (p < 0.001; r = 0.80) parameter were found after therapy. Significant improvement in the BBS score was found after applied therapy (p = 0.016; r = 0.55). In the PDQ-39 questionnaire, significant improvements were found in the study group after therapy in the domains of mobility (p = 0.027; r = 0.51) and emotional well-being (p = 0.011; r = 0.58). Conclusions: The results of this study indicate a positive effect of virtual reality therapy on balance and gait, which is also good in terms of reducing the risk of falls in the study group. Therapy also promoted quality of life in the study group. Full article

Introduction: Parkinson’s disease (PD) is characterized by motor and cognitive impairments that often manifest as distinct motor subtypes: Postural Instability Gait Difficulty (PIGD) and Tremor-Dominant (TD). Motor–cognitive interference, especially under dual-task (DT) walking conditions, may vary by subtype, providing insights into specific impairments. This study explored DT interference effects in PD subtypes, focusing on the potential impact of self-reported physical activity, which may help mitigate subtype-specific impairments and improve motor–cognitive function. Methods: PD patients classified as PIGD or TD and healthy controls completed single-task (ST) and DT walking assessments involving different cognitive tasks (Serial Subtraction, Auditory Stroop, and Clock Task). Physical activity levels were evaluated using the CHAMPS questionnaire, analyzing the self-reported frequency and duration of weekly exercise-related activities. Results: Interference effects were significantly different between PD patients and controls, with the PIGD group showing greater motor impairment under high cognitive load, primarily affecting gait, than the TD and control groups. Performance differences between groups diminished as cognitive load increased. Self-reported physical activity does not significantly moderate motor performance under DT conditions, suggesting that activity levels in this sample are insufficient to offset motor–cognitive interference. However, like group affiliation, physical activity directly influences motor performance during DT conditions, indicating that both factors independently impact motor–cognitive function in PD. Discussion: These findings suggest that DT assessments help differentiate PD motor subtypes, as group differences were minimal in ST conditions. While physical activity is associated with general improvements in motor ST and DT performance in PD and controls, the lack of a significant moderating effect from self-reported exercise-related physical activity indicates that current activity levels may not be high enough to counter motor–cognitive interference. More intensive or DT-specific exercise may be required to reduce interference effects. Future research should examine the role of structured physical activity programs, potentially incorporating DT training, to evaluate their impact on motor–cognitive interference in PD. Full article

Background/Objectives: Parkinson’s disease (PD) is a neurodegenerative disorder, characterised by cardinal motor features and a multitude of non-motor manifestations. Among them, cognitive impairment in PD has been recognised as a defined clinical entity, and it might lead to an increased risk of developing dementia. Consequently, the present review aimed to ascertain the available interventions for the training of cognitive abilities in persons with PD (PwPD). Methods: PRISMA guidelines were followed to select studies in the following databases: PubMed, PsycINFO, and Web of Science. Two independent reviewers conducted the different phases of the review, and a third expert was called in to address any doubts/conflicts. Randomised controlled trials and randomised clinical trials concerning cognitive training with cognitive outcomes in PwPD were selected. Results: A total of 28 articles were included. The considered studies applied various experimental interventions for the training of cognitive functions in PwPD: computer-based platforms, exergames, paper-and-pencil programmes, dual-task or treadmill training with action observation therapy, motor imagery, and virtual reality components, interventions targeting precise cognitive domain, tele-rehabilitation, transcranial direct current stimulation, structured cognitive training, and multimodal treatments. Cognitive functions were assessed employing neuropsychological tests, self-report questionnaires, and computerised batteries. Conclusions: Overall, the review reported better performances in the experimental groups compared to the control groups, in several cognitive domains. Structured cognitive training emerged as the most effective strategy to enhance cognitive functioning in PwPD. However, further studies are necessary to determine the most appropriate and useful training and to develop interventions that also consider patients’ quality of life. Full article

The aim of this study was to assess the effects of an 8-week cognitive-motor training program on postural control and knee proprioception under single and dual task conditions. Design: Randomized clinical trial. Methods: The present study was registered with the ID number NCT04786132. A total of 20 healthy and physically active older adults (73.25 ± 5.98 years) volunteered to participate and were randomly assigned into an experimental and a control group (EG and CG). Postural control was measured with the Romberg test, with open (RBOE) and closed eyes (RBCE) and under unipodal dominant side (RUDL) conditions. Proprioception was assessed by measuring participants’ ability to reposition their dominant knee at 45°. Finally, performance of the cognitive task was measured through a subscale of the Barcelona Test called “categorical evocation in associations”. The EG and the CG completed 8-week training programs with two sessions, 30 min per week, of postural control and proprioception exercises. The EG additionally included music in each session. Results: The analysis using a mixed ANOVA model revealed no significant group × time interaction effects (p < 0.05) for any of the assessments. However, a significant main effect for the time factor was observed, with both the control and experimental groups showing improved outcomes in the post-intervention measurements. Specifically, significant results were found for RBOE (F (4,15) = 11.87, p < 0.001, η²p = 0.76), RBCE (F (4,15) = 11.62, p < 0.001, η²p = 0.75), and proprioception (F (1,18) = 11.53, p < 0.003, η²p = 0.39). Conclusions: The 8-week training program had a positive impact on the post-intervention results for motor control and proprioception, but not on the results of the cognitive task. There were no significant differences between the groups that carried out sessions with or without music. Full article

Training in team sports such as soccer requires advanced technical and tactical skills for effective decision-making, particularly when executing a shot. This study validates an innovative instrument, a training platform (TP), designed to measure and enhance decision-making in dual-task scenarios. The TP aims to improve visual–motor reactions in multitask environments that simulate real game conditions. Equipped with an LED panel, main circuitry, ball sensor, and targets, the TP challenges players to kick the ball in response to the illumination of the final LED array on the panel while hitting a designated target. The study evaluated three parameters: reaction time (RT), ball speed (BS) and accuracy. To validate the TP against a gold standard (GS), we conducted correlation analyses. The results exhibited very strong correlations for both RT (r = 0.997) and BS (r = 0.994). The mean differences between TP and GS measurements were 13 ± 15 ms for RT and 0.1 ± 0.5 km/h for BS. Bland–Altman plots revealed trend lines obtained by a simple linear regression of r = −0.507, p = 0.307 for RT and r = 0.134, p = 0.077 for BS. The TP effectively simulates game scenarios, offering advantages such as low-cost components, installation flexibility, test variability, instant feedback, and integration of physical and cognitive components of sports performance. Full article

Background: Parkinson’s disease is primarily characterized by the degeneration of motor neurons, leading to significant impairments in movement. Initially, physical therapy was predominantly employed to address these motor issues through targeted rehabilitation exercises. However, recent research has indicated that cognitive training can enhance the quality of life for patients with Parkinson’s. Consequently, some researchers have posited that the simultaneous engagement in computer-assisted motor and cognitive dual-task (CADT) may yield superior therapeutic outcomes. Methods: A comprehensive literature search was performed across various databases, and studies were selected following PRISMA guidelines, focusing on CADT rehabilitation interventions. Results: Dual-task training enhances Parkinson’s disease (PD) rehabilitation by automating movements and minimizing secondary task interference. The inclusion of a sensor system provides real-time feedback to help patients make immediate adjustments during training. Furthermore, CADT promotes more vigorous participation and commitment to training exercises, especially those that are repetitive and can lead to patient boredom and demotivation. Virtual reality-tailored tasks, closely mirroring everyday challenges, facilitate more efficient patient adaptation post-rehabilitation. Conclusions: Although the current studies are limited by small sample sizes and low levels, CADT rehabilitation presents as a significant, effective, and potential strategy for PD. Full article

Increasing evidence shows that virtual reality (VR) training is highly effective in cognitive and motor rehabilitation. Another modern form of training is cognitive–motor dual-task training (CMDT), which has been demonstrated to rapidly improve physical and cognitive functions in real environments. This study aims to test whether a VR-based CMDT protocol can be used for motor and cognitive skill enhancement in young, healthy subjects. For this aim, 24 university students participated in a randomized control trial. The experimental group participated in a 5-week virtual reality reaction training (VRRT), performing 30 min sessions once a week. The control group did not receive any training but was tested twice with the same measures and temporal distance as the experimental group. Before and after the intervention, motor, cognitive, and electrophysiological measures were assessed. The results showed that following VRRT, the response time for both physical and cognitive tests was improved by about 14% and 12%, respectively, while the control group did not show significant changes. Moreover, electrophysiological data revealed a significant increase in anticipatory motor readiness in premotor brain areas in the experimental group only; however, cognitive top–down control tended to be increased in prefrontal areas after VRRT. This training protocol in a VR modality seems to be as effective as other CMDT methodologies carried out in a real modality. Still, it has the advantages of being more flexible and more user-friendly compared to standard training. The VRRT’s efficacy on physical and cognitive functions indicates that virtual reality applications can be used by the young population, not only for entertainment purposes but also in the form of cognitive–motor training. Full article

Sport Vision is a speciality of multidisciplinary interest aimed at improving the performance of the visual system to achieve benefits in practiced sports, as well as in daily life and in preventive care. The type of training practiced by the athlete, his or her physical condition, cognitive level, and level of fatigue condition affects the speed of the reaction time and, consequently, the speed of motor response. Specific orthoptic exercises, the use of technological devices, the recovery of static and dynamic postural stability by using unstable platforms and the dual-task paradigm can help to achieve the expected results. The aim of this systematic review of Sport Vision was to assess the overall existing literature on Sport Vision, paying particular attention to the effects of visual training and its application in different sports and in rehabilitation and preventive settings. We analysed published English language studies about the role of sport vision in athletic performance from 1950 to 2023. We searched through the Medline database. The PRISMA 2020 checklist was used to assess the transparency and reproducibility of this review. The enrolled papers were evaluated with the Jadad Scale, Amstar 2 Scale and Newcastle–Ottawa Scale. 25 (16 studies, 5 reviews, 2 comments, 1 editorial, 1 descriptive paper) out of 476 studies met the inclusion criteria. Due to the variability in the age of the samples, the different techniques, the treatments among the participants in the studies and the finding of non-evaluable articles, a meta-analysis was not conducted. The limitations of this review are the single database research, the studies analyzed contain a non-statistically representative sample size and the lack of a control group. There is no standardized test to measure performance. It was shown that the development of visual skills can benefit athletes in injury prevention, and can lead to improved sports performance and motor function at any age, acquiring adaptive motor behaviour even when the visual system is impaired, due to task repetition and familiarity of the gesture. We intended to identify a multidisciplinary approach and a manual treatment scheme to optimize the circuitry involved in sport vision in order to increase the results that are achieved, but further studies will be needed to this end. Full article