Dual tasking

Not good at dual tasking? Stop EVERYTHING you’re doing and read this article! 

What is dual tasking?

One’s ability to divide their attention between two or more concurrent tasks is an important aspect of function during activities of daily living. This ability to perform multiple tasks simultaneously is also known as dual tasking. 

Dual tasking in the context of balance training involves the ability to maintain ones balance in standing or walking whilst performing an additional task. Examples of this might be having a conversation as you walk or balancing a cup of coffee whilst you stand. 

Why is it important?

An important concept when discussing the importance of dual task training is one of ‘cognitive capacity’. This is the ability of our brains to process information and subsequently perform a task. This is colloquially known as ‘brain power’. Each individual has a limited cognitive capacity such that their brain is only capable of processing a certain amount of information at a time.  

Maintaining one's balance either when standing still or walking is something that requires a certain amount of cognitive attention or ‘brain power’. 

Research has suggested that in individuals with reduced balance, their brain’s ability to automatically make adjustments to their posture is reduced and as a result they must allocate more ‘brain power’ to this process1,2.. In these individuals, distractions while attempting to maintain their balance may exceed their cognitive capacity such that their performance of either task is impaired. Should the response to the distraction exceed their cognitive capacity, it may result in a loss of balance.  

Further research has indicated that a reduced ability to allocate attention to balance during dual-task situations is a strong predictor of falls. In particular, individuals who demonstrate an inability to talk while walking have been shown to be at a high risk of falls3. 

How do you practice it?

Dual tasking is an important part of our daily function and therefore often cannot be avoided, and nor should it! 

Luckily, there is evidence to support the benefit of specific training on dual-task performance. 

In order to increase cognitive capacity and improve the brain's ability to automatically make postural adjustments, one must train their balance under dual-task conditions4,5..

Here are two examples of how we can practice dual tasking:

1. Introducing an additional task which is cognitively challenging. 

Examples:

• Counting backwards from 100 in multiples of 7
• Alphabetical vegetables: Starting with A work your way through the alphabet naming a vegetable which starts with that letter. For example Aubergine, Beetroot… etc

2. Introducing an additional physical task which requires cognitive attention. 

Examples:

• Tossing a ball in one hand 
• Balancing a ball on a hardback book (we like to call this ‘nerd ball’)

For the greatest effect, these tasks should be performed whilst maintaining your balance in a challenging position. This position may be static (e.g. standing on one leg) or dynamic (e.g. whilst walking). 

References:  

1. Abernethy, B. (1988). Dual-task methodology and motor skills research: some applications and methodological constraints. Journal of human movement studies, 14(3), 101-132.
2. Hall, C. D., & Heusel-Gillig, L. (2010). Balance rehabilitation and dual-task ability in older adults. Journal of Clinical Gerontology and Geriatrics, 1(1), 22-26.
3. Verghese, J., Buschke, H., Viola, L., Katz, M., Hall, C., Kuslansky, G., & Lipton, R. (2002). Validity of divided attention tasks in predicting falls in older individuals: a preliminary study. Journal of the American Geriatrics Society, 50(9), 1572-1576.
4. Silsupadol, P., Shumway-Cook, A., Lugade, V., van Donkelaar, P., Chou, L. S., Mayr, U., & Woollacott, M. H. (2009). Effects of single-task versus dual-task training on balance performance in older adults: a double-blind, randomized controlled trial. Archives of physical medicine and rehabilitation, 90(3), 381-387.
5. Shin, S. S., & An, D. H. (2014). The effect of motor dual-task balance training on balance and gait of elderly women. Journal of physical therapy science, 26(3), 359-361.