Should Physios be Using Dual Tasking More in Rehab?

When we think of Dual Tasking (DT) as physios, it’s often in the context of falls and balance rehabilitation. But, If we really think about it, DT is something patients use all the time in a variety of contexts, whether it be playing sports, or something as simple as crossing the street.

So maybe we should start extending our use of DT into other areas; it’s likely that many physios are already using DT without even thinking about it, but applying it in a more systematic and measurable way might help our patients get better results. Expert physio Mike Studer’s Masterclass on DT is an excellent way to learn the ins and outs, this blog provides a few key insights from his lesson.

If you want to learn how an expert applies DT watch Mike Studer’s full Masterclass HERE.

What is DT?

Dual tasking or cognitive motor interference involves performing two distinct, independently measurable tasks with separate goals simultaneously—for example, walking while recalling a grocery list, or balancing on one leg while naming animals. It’s important to delineate this from multitasking, which involves three or more tasks and often implies rapid task-switching and divided attention, limiting the effective completion of each task. Dual tasking trains the brain and body to function in parallel, just as they must in daily life.

But DT is more than just doing two things at once. It’s a rehabilitation strategy that taps into procedural memory by engaging the brain’s automatic motor systems—like the cerebellum and basal ganglia—while challenging cognitive control. Research shows that dual task training leads to superior outcomes compared to purely cognitive or motor training, as it enhances motor control, balance, and attention simultaneously. While it’s something often used neurological rehabilitation, Mike points out it can be used with a range of other presentations as well, see him explain some examples in this clip from his Masterclass:

How to apply DT

1. Personalise

One size doesn’t fit all. Effective DT training begins with tasks tailored to your patient’s goals and lifestyle. A busy parent may benefit from practicing cognitive tasks while chopping vegetables, mimicking the real-world demands of managing children and household responsibilities. On the other hand, an athlete recovering from an ACL injury may combine reactive auditory cues with agility drills to mimic the in-game environment in which they are required to respond to the coach’s instructions during play.

By matching task types—manual, cognitive, visual, or auditory—to the individual’s daily challenges, you make therapy more functional and meaningful.

2. Measure

One great benefit of DT is that it’s measurable. Mike explains a great formula to quantify the cost of completing a dual tasks, as opposed to a single task, see this video from his Masterclass:

Measurement also allows for gamification, as patients may become motivated not just by recovery, but by beating their previous best.

3. Respect autonomy and tune the challenge

Allowing your patients choice in rehab will foster autonomy. Offering things like choices in difficulty levels or equipment enhances autonomy and accountability. When patients feel a sense of ownership, they are more likely to stay committed. Apply the Challenge Point Hypothesis by aiming for the ‘sweet spot’ where tasks are neither too easy nor too difficult. If a task is too simple, your patient may lose interest due to a lack of challenge. On the other hand, if it’s too difficult, it can feel overwhelming and discouraging. Finding that optimal level keeps your patient engaged, motivated, and progressing.

4. Some examples

Broadly, you can separate tasks into:

1. Cognitive task training options (e.g., relaying direction to a location, explaining rules to a sport, listing birthdays of friends and family)
2. Manual (e.g., buttoning a shirt, pouring a jug of water, texting)
3. Visual (e.g., matching photos of faces to names, adding coins presented visually)
4. Auditory (e.g., remembering a phone number being read out to you, listening to a coaches instructions from the sideline)

Obviously, whatever tasks you choose should be relevant to the patient’s needs, and it’s important to progress these tasks as the patient progresses, making sure you’re maintaining an achievable challenge point to maintain motivation.

Wrapping up

Dual tasking is an evidence-based approach that blends cognitive and motor challenges to optimise recovery and patient readiness for real-world situations. It’s measurable, motivating, and, when combined with gamification, can reshape how patients experience rehabilitation. So no matter what setting you’re working in, it’s something to think about the next time you’re struggling with which direction to take a patient’s rehab!

If you want to learn more about dual tasking from an expert, watch Mike Studer’s full Masterclass HERE.