Mapping the evidence on dual-task training in musculoskeletal injury rehabilitation: a systematic review.
Cansu Akkus, Busra Pakoz, Birgul Dingirdan Gultekinler et al.
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In 30 seconds
This systematic review assessed dual-task training (DTT), which combines motor and/or cognitive tasks, in adults rehabilitating from musculoskeletal injuries. Eight randomised controlled trials involving 224 participants were included, with methodological quality assessed using the Cochrane Risk-of-Bias-2 tool. After anterior cruciate ligament reconstruction, strong evidence indicated comparable improvements in postural control and patient-reported outcomes with DTT and single-task training (STT). Findings in other conditions varied by outcome: DTT sometimes outperformed STT or no intervention, while evidence for proprioception in chronic ankle instability remained conflicting.
Key findings
- Across eight RCTs (n =224), DTT and STT produced comparable postural-control and patient-reported outcome improvements after anterior cruciate ligament reconstruction.
- For ankle instability, DTT was equivalent to STT and superior to no intervention for postural control; it was also equivalent to STT and superior to no intervention for jump-landing kinetics in chronic ankle instability.
- In elbow fractures, DTT was superior to STT for flexor strength and pain, but equivalent for range of motion, patient-reported outcomes, and kinesiophobia.
- Evidence on proprioception in chronic ankle instability was conflicting; limited evidence favoured DTT over comparators for selected biomechanical outcomes and peroneus longus activation.
Why it matters
The review suggests that adding concurrent tasks to rehabilitation can yield outcomes comparable to conventional single-task training for some conditions and measures, with possible advantages for selected outcomes. However, effects differ across injuries and outcomes, and evidence is limited or conflicting in some areas. These distinctions matter when interpreting DTT as a rehabilitation approach rather than assuming a general benefit across musculoskeletal conditions.
What to keep in mind
The evidence base comprised eight RCTs with 224 participants, and findings varied by injury and outcome; evidence was limited or conflicting for some measures.