Dual-task training in geriatric physiotherapy: improving balance, mobility, and cognitive-motor function

Ageing is accompanied by progressive changes in postural control, gait, muscle strength, sensory integration, attention, executive function, and the ability to manage simultaneous motor and cognitive demands. These changes become particularly important during everyday mobility because older adults frequently walk while talking, carrying objects, navigating obstacles, responding to environmental cues, or making decisions. Dual-task training (DTT), which combines a motor activity with a concurrent cognitive or secondary motor task, has therefore emerged as an important approach within geriatric physiotherapy. Unlike conventional singletask exercise, DTT attempts to reproduce the cognitive-motor demands encountered during realworld activities while progressively challenging balance, gait adaptability, attention, and executive control. Evidence from recent systematic reviews and meta-analyses indicates that DTT can improve dynamic balance, functional mobility, gait performance, and selected cognitive outcomes in older adults, although the magnitude of benefit varies according to intervention design, participant characteristics, task complexity, training dose, and outcome measures. DTT may be particularly relevant for individuals with increased fall risk, mild cognitive impairment, and Parkinson’s disease, frailty, and mobility limitations. However, DTT should complement rather than replace conventional strength, balance, gait, and aerobic exercise. This review examines the physiological and neurocognitive basis of DTT and discusses assessment, intervention design, progression, safety, fall prevention, technology-assisted rehabilitation, homebased applications, and future research directions in geriatric physiotherapy