Cognitive-motor dual-task training improves dynamic stability during straight and curved gait in patients with multiple sclerosis: a randomized controlled trial.
Marco Tramontano, Ornella Argento, Amaranta S Orejel Bustos and 7 others
PMID 37997324WHAT IT FOUND
Adding cognitive-motor dual-task training to conventional therapy improved dynamic balance and head stability during walking in people with multiple sclerosis.
These gains persisted two months after training ended, offering a concrete way to enhance gait safety beyond standard exercises.
Key findings
01The dual-task group showed significant improvement in Mini-BESTest scores immediately after training, while the conventional group did not.
02Sensor data revealed the dual-task group had better head stability and smoother walking during straight-line tests compared to the conventional group, both immediately after training and two months later.
03During curved walking, the dual-task group demonstrated significantly less head movement variability and better stability than the conventional group after training.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The sample size was smaller than planned (39 vs 30+ minimum) due to the COVID-19 pandemic, which may affect the reliability of the findings. The study did not assess fatigue or psychological factors, which are common in MS and could influence participation and outcomes. Blinding was only single-blind (assessor blinded), so participants knew which group they were in, potentially influencing their effort. The conventional therapy group received a substantial amount of dynamic postural stability training, so the effect is specifically from adding the cognitive dual-task, not from the conventional therapy being ineffective.
Declared interests
The authors declare no conflicts of interest. Funding was provided by the Italian Ministry of Health and Fondazione Baroni.
The easy way to misread this
Do not assume dual-task training replaces conventional gait therapy. The dual-task group received all conventional exercises plus the additional cognitive-motor task. The benefit came from adding this specific layer to standard care, not from swapping one for the other.