Dual task training prepares athletes to excel at a specific task even when faced with distractions. Distractions come in many ways, the crowd when trying to shoot a free throw, defenders trying to sack you when throwing a football, mental pressure of serving for match point during volleyball. But training your brain to filter and process information coming at you will improve your ability to perform.
Progressive overload is a basic concept in physical training. Generally, we increase our training load by increasing the amount of weight to get stronger, number of repetitions to build endurance, speed to build power, or complexity to build stability and coordination. These are all important in athletic performance, but focusing your training solely around these purely physical parameters may leave you unprepared for the mental load of game-time situations.
During training, you can focus almost all your attention on the task and maintaining proper form, but during a game or daily life, you will be experiencing distractions that will pull your attention away from your form.
This is where dual-task training is important.
Simply put dual-task refers to the ability to perform two tasks at the same time.
Dual-task training is based on dual-process theory.
Dual-process theory proposes that when performing multiple tasks, human performance is determined by two types of processing systems: Automatic processing and controlled processing.
Automatic processing refers to the intuitive and fast forms of processing that use low amounts of attentional resources. Automatic processing is reactive to triggers, for example the question “What is your name”.
Opposite of automatic processing, controlled processing is slow and requires conscious interpretation of requisite information and processing as well as the attentional control (ability to ignore irrelevant factors and concentrate on what’s important) to complete the task.
Dual-tasks involve the simultaneous performance of both automatic and controlled processing.
Dual-tasks are relevant in everyday life when walking and talking. Walking is primarily an automatic task while talking requires controlled processing.
In sports, a soccer player can receive the ball, realize his teammate is open, assess the positions of opponents, and pass the ball. Dribbling and passing the ball are automatic processes for experienced soccer players. Assessing the field for open teammates, opponents, and considering the team’s strategy would require controlled processing.
Dual-task training has 3 forms:
Cognitive-motor dual task involves simultaneously performing a cognitive task and a motor task. To improve cognitive function and motor skills by challenging the brain to multitask. Example: performing balancing exercises while answering simple personal questions.
Motor-motor dual task involves simultaneously performing two different motor tasks. To improve coordination, balance, and the ability to multitask. Example: dribbling a basketball while performing a reaction drill.
Cognitive-cognitive dual task involves simultaneously performing two different cognitive tasks. To improve cognitive flexibility, attention, working memory, and the ability to efficiently process information. Example: Reading a passage while recalling a list of words.
Sports are one of the main examples of activities that innately have dual-tasks due to the complex and dynamic environments. To have success in a sport, an athlete frequently performs dual-tasks. Athletes simultaneously consider themself, the ball, teammates, opponents, rules, and situational requirements such as attacking or defending. When competing in a sport, there could be even more variables such as referees, coaches, spectators, and competitive pressure.
As mentioned earlier, those who have a high capacity for attentional control tend to fare better when faced with dual tasks.
To improve your attentional control, work on improving your working memory capacity.
Working memory capacity refers to the amount of information you can actively hold and manipulate in your mind at any given time.
Attentional control and working memory capacity are closely intertwined.
While attentional control is the ability to pay attention to relevant information while ignoring distractions; working memory capacity allows you to store that information and manipulate it for success.
Many athletes who struggle with performance issues incorrectly continue their training program but at higher intensity to overcome choking.
Based on dual-process theory, focusing on single-task more intensely will not provide a meaningful benefit to one’s working memory capacity and therefore choking will persist. For these athletes, dual-task training can help to improve working memory capacity and reduce choking.
Dual task exercises with cognitive component to enhance working memory capacity.
With all we have learned about dual-task training, how can dual-task training be used in a physical therapy setting?
Here are some examples where we apply dual-task training in physical therapy. It is important to assess the outcome of each training session to determine if progression to the next phase is appropriate. As each injury advances into later stages of healing, the complexity, speed, and duration of each exercise can all be manipulated to mimic sport.
ACL Tear
Traumatic injuries, such as ACL tears are associated with alterations in sensorimotor cortical activation. Ness et al. found that these changes can persist for months and even years following injury or surgery. Post-op ACLR patients demonstrated no differences in postural stability during single task balance exercises when compared to controls. However, during dual-task balance exercises, these patients would sacrifice cognitive ability to maintain postural stability.
These results indicate that relying solely on single tasks during balance can overestimate an individual’s physical ability. Performing balance exercises and measuring physical efficacy as well as cognitive accuracy would better demonstrate the dual-task cost and potential re-injury risks.
Ankle (anterior talofibular ligament) sprain
Incorporating dual-task-training in a physical therapy setting allows an athlete to develop a more well-rounded therapy program complete with physical and mental acuity as they prepare for return to sport. This will not only minimize the risk of reinjury, but also strengthen working memory capacity to come back better than ever. Our physical therapists in San Diego have helped many people return to the activities they love. Reach out to us when you are ready to achieve real results with your physical therapy program.
This blog post is based on an in-service presentation developed by a Stretch Affect intern. The original post can be found here.
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