10 sources: 4 meta-analyses, 1 randomised controlled trial, 5 systematic reviews
Physical · Practice
Dual-Task Balance & Gait Drills
Balancing or walking while performing a mental task: one way to carry out what the sources on the concept entry report, improved gait speed and balance from exercise-cognitive combined training (Li 2022) and a small but significant cognitive benefit of exercise games that Qian 2026 calls preliminary.
2 of 10 sources behind this entry were read from the abstract only; they are marked in the sources list.
25 min · 2–3×/week
Any levelHome or group
Before you start
Stop or simplify if the mental task makes movement unsteady; keep support nearby.
When to seek a professional
- Two or more falls in the past 12 months, or any fall with injury
- Dizziness, lightheadedness, or fainting during standing or movement
- New or worsening unsteadiness, neurological symptoms, or numbness in the feet
- Fear of falling severe enough to restrict daily activity
How to do it
- Dual-task drills pair a balance or walking task with a cognitive one, counting backward, naming words, catching a ball.
- Begin with easy combinations near support and increase either the motor or mental load gradually, never both to the point of unsteady movement.
2–3×/week, 20–40 min, ≥8–12 weeks
The research behind this entry establishes something about dose, but not these exact parameters; treat them as a practical way to apply the finding rather than as the finding itself.
None; optional ball, number/word promptsOlder adultsFor most adultsAt risk of falls
What the evidence says
What the sources say
This practice is one way to carry out what the sources on the concept entry (phys.neuromotor.concept-dual-task) studied: combined motor-cognitive and dual-task training in older adults, with gait, balance and cognition as the outcomes. Li 2022 (meta-analysis, 22 studies, 1,091 participants) reports that exercise-cognitive combined training improved gait speed (MD 0.06 m/s) and balance (SMD 0.38), with simultaneous training also improving functional mobility. Yu 2023 (systematic review, 23 studies, 1,585 participants) reports significant improvements in gait, strength, mobility and balance and reduced fear of falling compared with general physical or cognitive training alone. Levin 2017 (systematic review, 19 studies) reports that its evidence suggests combined exercise and cognitive training, particularly as a dual task, could improve basic cognitive and motor functions. Qian 2026 (meta-analysis, 10 trials, 690 participants) reports a small but significant overall cognitive benefit of exercise games (g 0.135) and calls the evidence preliminary, with the evidence base for clinical populations limited and inconclusive. The full account, source by source, is on the concept entry this practice links to (phys.neuromotor.concept-dual-task).
Common misconceptions
- 'Focus only on your feet' (training to move while distracted is the goal)
- 'Harder mental tasks are always better' (safety of movement comes first)
What we won't claim
- Does not guarantee prevention of any fall or injury
- Not a substitute for medical evaluation of dizziness, syncope, or unexplained falls
- Not a treatment for cognitive decline
10 sources: 4 meta-analyses, 1 randomised controlled trial, 5 systematic reviews
- Agreement
- Direction recorded for 1 of 10 sources; not yet recorded for the rest.
- The claim's outcome
- Outcome not yet recorded
- Certainty
- No source states a certainty rating.
- How the sources were read
- Some sources are based on abstracts, not full texts.
What each source measured and concluded (10)
randomised controlled trial · 2024
Hars et al. (2024) — Effects of Dalcroze Eurhythmics Exercise Versus Multicomponent Exercise on Physical and Cognitive Function, and Falls in Older Adults: The EPHYCOS Randomized Controlled Trial
- What it measured
- Gait variability under dual-task conditions at 12 months.
- How it measured it
- Electronic pressure sensitive walkway (GAITRite) using the coefficient of variation (CV).
- Direction it states for the claim's outcome
- Improved
- How it was read
- read in full text
meta-analysis · 2022
Li et al. (2022) — Effect of Exercise Cognitive Combined Training on Physical Function in Cognitively Healthy Older Adults: A Systematic Review and Meta-Analysis.
- What it measured
- Physical function (gait speed, balance, functional mobility)
- How it was read
- based on the abstract, not the full text
- What the review says it includes
- Systematic review and meta-analysis (of RCTs)
- Studies and participants, as stated
- 22 studies, 1,091 participants
systematic review · 2020
Gallou-Guyot et al. (2020) — Effects of exergames and cognitive-motor dual-task training on cognitive, physical and dual-task functions in cognitively healthy older adults: an overview.
- What it measured
- Cognitive, physical and dual-task functions
- How it was read
- based on the abstract, not the full text
- What the review says it includes
- Overview of systematic reviews/meta-analyses
- Studies and participants, as stated
- 18 reviews
systematic review · 2017
Levin et al. (2017) — The beneficial effects of different types of exercise interventions on motor and cognitive functions in older age: a systematic review
- What it measured
- Improvements in motor and cognitive functions.
- How it measured it
- Not explicitly detailed.
- How it was read
- read in full text
- What the review says it includes
- Systematic review of 19 studies
- Heterogeneity, as stated
- Heterogeneous intervention protocols and test batteries
systematic review · 2023
Yu et al. (2023) — Effects of Combining Physical and Cognitive Training on Older Adults’ Physical Performance and Functional Abilities: A Systematic Review
- What it measured
- Improvement in physical performance and functional capacity (gait, strength, mobility, balance, falls).
- How it measured it
- GAITRite Electronic Walkway, Functional Gait Assessment, Wearable Physiology, Wearable Accelerometers, Photocell System, Matscan floor mat, Falls Efficacy Scale International.
- How it was read
- read in full text
- What the review says it includes
- Systematic review of 23 studies
- Studies and participants, as stated
- N=1,585 participants across 23 studies
meta-analysis · 2024
Luo et al. (2024) — The effectiveness of multicomponent exercise in older adults with cognitive frailty: a systematic review and meta-analysis
- What it measured
- Cognitive function, frailty status and other health-related outcomes
- How it was read
- screened only, not extracted
- What the review says it includes
- Systematic review and meta-analysis
- Studies and participants, as stated
- 11 trials; 2222 participants
meta-analysis · 2026
Qian et al. (2026) — Evaluating the cognitive impact of exergames on community-dwelling older adults beyond laboratory settings: a systematic review and meta-analysis
- What it measured
- Cognitive effects of exercise games (global cognition, memory, executive function, attention, processing speed)
- How it was read
- screened only, not extracted
- What the review says it includes
- Systematic review and meta-analysis
- Studies and participants, as stated
- 10 RCTs; 690 participants (mean age 74 years)
systematic review · 2025
Liang et al. (2025) — The efficacy versus evidence quality of multicomponent exercise for cognitive health in older adults: an umbrella review
- What it measured
- Cognition (global cognitive function, executive function, memory, attention/processing speed) plus evidence quality
- How it was read
- screened only, not extracted
- What the review says it includes
- Umbrella review of systematic reviews with/without meta-analysis (AMSTAR-2, GRADE)
- Studies and participants, as stated
- 27 systematic reviews
systematic review · 2024
Kong et al. (2024) — Effects of exercise interventions on physical, psychological and social outcomes in frail older adults: An overview of systematic reviews.
- What it measured
- Physical, psychological and social outcomes
- How it was read
- screened only, not extracted
- What the review says it includes
- Overview of systematic reviews (PRISMA)
- Studies and participants, as stated
- 17 systematic reviews (methodological quality moderate to critically low)
- Heterogeneity, as stated
- Exercise interventions had positive effects on most physical outcomes and depression, but inconsistent effects on cognitive function and quality of life; quality of evidence for most outcomes was low and very low
meta-analysis · 2023
Silva et al. (2023) — Does Multicomponent Training Improve Cognitive Function in Older Adults Without Cognitive Impairment? A Systematic Review and Meta-analysis of Randomized Controlled Trials.
- What it measured
- Global cognitive function (MMSE/MoCA) and Trail-Making Test performance
- How it was read
- screened only, not extracted
- What the review says it includes
- Systematic review and meta-analysis of RCTs
- Studies and participants, as stated
- 10 RCTs in review; 6 (166 participants) in meta-analysis
- Heterogeneity, as stated
- Multicomponent training increased global cognitive function (SMD=0.58, 95% CI 0.34–0.81, I²=11%, P<.001); decreased TMT-A time (MD=−6.70, 95% CI −10.19 to −3.21) and TMT-B time (MD=−8.80, 95% CI −17.59 to −0.01, P=.05)
Key sources (10)
Every source below is shown with its study design and links to the original study. This is the audit trail.
randomised controlled trialEffects of Dalcroze Eurhythmics Exercise Versus Multicomponent Exercise on Physical and Cognitive Function, and Falls in Older Adults: The EPHYCOS Randomized Controlled Trial
meta-analysisEffect of Exercise Cognitive Combined Training on Physical Function in Cognitively Healthy Older Adults: A Systematic Review and Meta-Analysis.
systematic reviewEffects of exergames and cognitive-motor dual-task training on cognitive, physical and dual-task functions in cognitively healthy older adults: an overview.
systematic reviewThe beneficial effects of different types of exercise interventions on motor and cognitive functions in older age: a systematic review
systematic reviewEffects of Combining Physical and Cognitive Training on Older Adults’ Physical Performance and Functional Abilities: A Systematic Review
meta-analysisThe effectiveness of multicomponent exercise in older adults with cognitive frailty: a systematic review and meta-analysis
meta-analysisEvaluating the cognitive impact of exergames on community-dwelling older adults beyond laboratory settings: a systematic review and meta-analysis
systematic reviewThe efficacy versus evidence quality of multicomponent exercise for cognitive health in older adults: an umbrella review
systematic reviewEffects of exercise interventions on physical, psychological and social outcomes in frail older adults: An overview of systematic reviews.
meta-analysisDoes Multicomponent Training Improve Cognitive Function in Older Adults Without Cognitive Impairment? A Systematic Review and Meta-analysis of Randomized Controlled Trials.
“Abstract only” means the review read that paper’s abstract, not its full text; “screened only” means it was included at re-screening and not extracted. Both stay in the trail with their DOI, because how a source was read is part of the audit.
Explore all 718 studies in Neuromotor (Balance/Agility/Coordination) →
The full evidence base this focus area draws on, every study with its design and DOI.What it is for
Feel steadier on my feetMove with better coordination and quicknessReduce my risk of fallingStay capable as I get older