Effects of dual-task training on balance, gait, dual-task performance, cognitive function, fatigue in individuals with multiple sclerosis: A randomized controlled trial: Dual-Task Training in MS

Abstract

Background: Dual-task training has gained attention in neurological rehabilitation, yet its effectiveness remains uncertain due to methodological differences, emphasizing the need for standardized assessments to clarify its impact on Multiple Sclerosis (MS)-related motor and cognitive deficits. This study aimed to examine the effects of motor-motor and motor-cognitive dual-task training on walking ability, walking speed, balance, functional mobility, dual-task difficulties, cognitive function, and fatigue in people with Multiple Sclerosis (pwMS). Method: This randomized controlled trial included 32 pwMS meeting the inclusion criteria. Participants were randomly assigned to the Dual-Task Training Group (DTTG) (n=13) or the Control Group (CG) (n=19). The CG received an 8-week home exercise program, while the DTTG underwent motor-motor and motor-cognitive dual-task training twice weekly alongside home exercises. Evaluations included the 10-Meter Walk Test (10MWT), Multiple Sclerosis Walking Scale-12 (MSWS-12), Timed Up and Go Test (TUG), Dual-Task Questionnaire (DTQ), Fatigue Severity Scale (FSS), Berg Balance Scale (BBS), Fall Index (FI) from Tetrax posturography, and Brief International Cognitive Assessment for MS (BICAMS). Results: Five participants dropped out, leaving 27 for final analysis (DTTG n=13, CG n=14). Significant improvements in the BBS (p<0.001), FSS (p=0.002), BICAMS (p<0.001), and 10MWT (p=0.019) favored the DTTG. No significant differences were observed in TUG (p=0.085), FI (p=0.616), or DTQ (p=0.402). Conclusions: An 8-week motor-motor and motor-cognitive dual-task training program combined with home exercise effectively enhances cognitive function, balance, fatigue, and walking speed in pwMS, supporting its inclusion in rehabilitation program