Attention and Dual-Task Conditions: Physical Therapy Implications for Individuals With Acquired Brain Injury

Abstract

The aim of this article is to consider how impairments in attention may affect the performance of two tasks during balance or walking in individuals recovering from acquired brain injury (ABI). Guidelines from the experimental dual-task paradigm from cognitive psychology are reviewed. In this paper, dual-task conditions are described as the use of two tasks performed simultaneously, but not necessarily following all the experimental guidelines of the dual-task paradigm. How and why dual-task costs may emerge are discussed as well as considerations for task selection. Review of literature that describes dual-task performance problems in older adults is summarized briefly as a foundation for considering how similar conditions may affect individuals with ABI. Studies of individuals with ABI of dual-task performance in balance or walking are reviewed in detail. Examination approaches including observational measures of attention as well as clinical measures of dual-task performance during walking are reviewed. Intervention concepts and approaches are described by review of intervention designs used with older adults and individuals with ABI that describe task selection and use of instructional set for dual-task training. Two intervention strategies described in the literature for treating attention problems are contrasted: (1) an explicit focus on cognitive impairments with the expectation that function will improve as a result and (2) an implicit focus on functional tasks through errorless learning with the expectation that cognition (and attention) will improve. An illustration of the use of both of these strategies in a complementary fashion to improve attention in a patient with ABI is reviewed. Current literature is limited in clearly directing assessment and intervention to improve attention after ABI, but strategies are presented and areas for future research are identified.

Relating motor and cognitive interventions in animals and humans

“…The introduction of a second task during cognitive or motor performance leads to a decline in performance in at least one of the tasks. This phenomenon can be observed in healthy individuals and, to a higher degree, in individuals with neurological disorders [5,6].…”

Concussion and Concurrent Cognitive and Sport-specific Task Performance in Youth Ice Hockey Players: A Single-case Pilot Study

“…DTC was calculated by comparing verbal response reaction times to the visual interference task stimuli during concurrent task performance trials to verbal response reaction time for the visual interference task stimuli during the baseline (static) trial using the following equation: As this equation allows dual task costs to be interpreted as a percentage, controlling for variable baseline performance amongst participants and allowing for comparison across individuals is possible [23]. The single task response reaction time value was generated by taking the mean reaction time across verbal responses to each stimulus presented during the baseline (static) trial.…”

Desempenho em atividades de simples e dupla tarefas de idosos institucionalizados que realizam e não realizam fisioterapia

“…Dual task execution involves carrying out a main task -the simple task, which is the main center of attentionand a secondary task developed simultaneously, thus becoming a dual task activity 6 . As age advances, there is a decline in the dual task performance, which can lead to loss in the number of moves in a specific period of time, an increase in the quantity of execution errors, and may not complete the task 7 .…”

“…A study conducted in a long-stay institution from southern Brazil revealed that 79.4% of elders presented a performance decrease of at least one activity of daily living 7,8 . Besides, it is estimated that 40% of the institutionalized elders fall at least once a year 9 .…”