Dual task performance can be defined as an individual’s capability to complete two tasks concurrently (Pashler, 1994; O’Shea, Morris & Iansek, 2002; Yang, Wang, Chen & Kao, 2007; Kizony et al, 2010). The ability to dual task affects activities of daily living on a vast scale (O’Shea, Morris & Iansek, 2002; Sethi & Raja, 2012), with reduced dual task performance defined as a dual task cost (McCulloch, 2007). Dual task costs (DTC) have greater functional decrement in persons with neurological impairment (Kizony et al, 2010), which may result from pathology, such as Multiple Sclerosis (MS) (Sosnoff et al, 2013) and Parkinson’s Disease (PD) (O’Shea, Morris & Iansek, 2002; Mak, Yu & Hui-Chan, 2013), or natural aging processes (Beauchet et al, 2009; Yogev-Seligmann, Giladi, Brozgol & Hausdorff, 2010). However, the application of dual task theories is relevant to the wider patient population, with few studies researching the effect of dual task costs on a young, healthy population. Therefore, further research in this area may facilitate development of dual task strategies applicable to a wider spectrum of clinical specialities.
Previous research has looked at the benefits of using dual task strategies as part of assessment, for example post-stroke (Yang, Wang, Chen & Kao, 2007) and to predict risk of falls (Beauchet et al, 2009). Additionally, dual tasks can be used as part of rehabilitation to improve safety in functional performance (Albinet, Bernard & Palut, 2006), for example by reducing dual task costs in persons with dementia (Schwenk, Zieschang, Oster & Hauer, 2010), improving balance in persons with a history of falls (Silsupadol, Siu, Shumway-Cook & Woollacott, 2006) and improving gait in older adults for safer road crossing (Silsupadol et al, 2009) and poststroke (Salbach et al, 2005; Yang, Wang, Chen & Kao, 2007). Furthermore, the use of traffic lights as an audio-visual cue can be utilised to enhance dual task walking performance in persons with PD (Mak, Yu & Hui-Chan, 2013). The frontal lobes are the areas of the brain most affected by the natural aging process, thereby implicating co-ordination and management functions (Kramer & Larish, 1995). This may partially explain why dual task decrement is reduced in a younger population compared to in an older population.
Dual task theories can be used to understand how the interaction between cognitive, perceptual, mechanical, and neurological components of dual task performance results in a dual task cost (Huang & Mercer, 2001). The bottleneck theory suggests that when two tasks are performed simultaneously, they require the use of the same neural machinery at the same point in time. The critical operations are carried out sequentially (Pashler, 1994), with one task delayed until the other task has been processed. For example, the bottleneck theory can be used to explain why some older adults stop walking in order to talk (Beauchet et al, 2009). The capacity-sharing model suggests that two tasks can be processed in parallel by dividing capacity between two or more resource pools. For example, an individual can walk and talk simultaneously but the speed or accuracy of one or both tasks will decrease. According to Pashler (1994) the crosstalk model assumes that similar tasks are easier to perform concurrently as use of the same pathway utilises less attentional resources and therefore increases the efficiency of processing. Navon & Miller (1987) state that crosstalk refers to the features or stimuli of two tasks overlapping. All three theories suggest that when more than one task is performed at any given instant, there is reduced capacity for individual tasks, resulting in a decline in performance in one or both tasks.
Dual tasks strategies are commonly used in falls assessment and rehabilitation as a progressive tool that facilitates functional training. It is additionally used in vestibular rehabilitation to train the components of balance to compensate for vestibular dysfunction. This can be transferred to neurological rehabilitation or musculoskeletal function to deal with reduced vision, central inputs or proprioception (for example with an ACL injury).
Previous research has looked at the benefits of using dual task strategies as part of assessment, for example post-stroke (Yang, Wang, Chen & Kao, 2007) and to predict risk of falls (Beauchet et al, 2009). Additionally, dual tasks can be used as part of rehabilitation to improve safety in functional performance (Albinet, Bernard & Palut, 2006), for example by reducing dual task costs in persons with dementia (Schwenk, Zieschang, Oster & Hauer, 2010), improving balance in persons with a history of falls (Silsupadol, Siu, Shumway-Cook & Woollacott, 2006) and improving gait in older adults for safer road crossing (Silsupadol et al, 2009) and poststroke (Salbach et al, 2005; Yang, Wang, Chen & Kao, 2007). Furthermore, the use of traffic lights as an audio-visual cue can be utilised to enhance dual task walking performance in persons with PD (Mak, Yu & Hui-Chan, 2013). The frontal lobes are the areas of the brain most affected by the natural aging process, thereby implicating co-ordination and management functions (Kramer & Larish, 1995). This may partially explain why dual task decrement is reduced in a younger population compared to in an older population.
Dual task theories can be used to understand how the interaction between cognitive, perceptual, mechanical, and neurological components of dual task performance results in a dual task cost (Huang & Mercer, 2001). The bottleneck theory suggests that when two tasks are performed simultaneously, they require the use of the same neural machinery at the same point in time. The critical operations are carried out sequentially (Pashler, 1994), with one task delayed until the other task has been processed. For example, the bottleneck theory can be used to explain why some older adults stop walking in order to talk (Beauchet et al, 2009). The capacity-sharing model suggests that two tasks can be processed in parallel by dividing capacity between two or more resource pools. For example, an individual can walk and talk simultaneously but the speed or accuracy of one or both tasks will decrease. According to Pashler (1994) the crosstalk model assumes that similar tasks are easier to perform concurrently as use of the same pathway utilises less attentional resources and therefore increases the efficiency of processing. Navon & Miller (1987) state that crosstalk refers to the features or stimuli of two tasks overlapping. All three theories suggest that when more than one task is performed at any given instant, there is reduced capacity for individual tasks, resulting in a decline in performance in one or both tasks.
Dual tasks strategies are commonly used in falls assessment and rehabilitation as a progressive tool that facilitates functional training. It is additionally used in vestibular rehabilitation to train the components of balance to compensate for vestibular dysfunction. This can be transferred to neurological rehabilitation or musculoskeletal function to deal with reduced vision, central inputs or proprioception (for example with an ACL injury).
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