Author(s): CHEN, Y., HE, C.S., WANG, H.H., Institution: NATIONAL CHUNG CHENG UNIVERSITY, Country: TAIWAN, Abstract-ID: 837

INTRODUCTION:
Falls in older adults are frequently associated with cognitive-motor interference (CMI), in which declining executive function competes with postural control processes [1]. Although dual-task training (DTT) has been shown to improve functional gait performance [2,3], its underlying effects on intrinsic sensory integration and micro-level control strategies remain insufficiently understood. This review aimed to synthesize recent evidence to clarify how DTT influences proprioceptive acuity and micro-postural control mechanisms (e.g., muscle synergy, entropy) in older adults. We propose that DTT may function as sensory integration training through sensory re-weighting.
METHODS:
A targeted mechanistic search (2000-2025) of PubMed, WoS, and Scopus retrieved studies in older adults (>=60 years) or mild cognitive impairment undergoing structured cognitive-motor DTT. We summarized 15 representative studies reporting joint repositioning error (JRE), entropy-based nonlinear metrics, or muscle synergy.
RESULTS:
Two core mechanistic adaptations were identified. First, proprioceptive recalibration was suggested. DTT is associated with a measurable reduction in knee and ankle joint repositioning error, indicating enhanced proprioceptive acuity [4]. This is consistent with a sensory re-weighting account: cognitive load challenges sensory integration and may reduce visual over-reliance while increasing reliance on proprioceptive feedback. Second, training optimizes micro-level postural control strategies. Nonlinear analyses indicate increased postural complexity and more adaptive variability during gait, reflecting improved sensorimotor adaptability [6]. Additional evidence from muscle synergy studies demonstrates more efficient organization of locomotor modules and reduced excessive co-contraction during dual-task conditions [5]. Comparative findings further indicate that integrative cognitive-motor protocols may yield superior improvements in executive function compared to sequential or separated training approaches [2].
CONCLUSION:
DTT facilitates sensorimotor reorganization beyond observable functional improvements. Evidence suggests that DTT enhances proprioceptive accuracy and promotes adaptive postural control strategies. We propose a neurocognitive-sensorimotor reorganization model, in which improved cognitive resource allocation supports proprioceptive processing and micro-strategy optimization. Clinically, DTT serves as a sensory integration-oriented intervention for fall prevention.

References:
1. Al-Yahya E et al. (2011) Neurosci Biobehav Rev 35:715-728
2. Eggenberger P et al. (2015) Clin Interv Aging 10:1711-1722
3. Ercan Yildiz S et al. (2024) Arch Gerontol Geriatr 121:105368
4. Nieto-Guisado A et al. (2024) Healthcare 12:2297
5. Sadeghi S et al. (2024) Motor Control (Ahead of Print)
6. Trombini-Souza F et al. (2025) Gait Posture 120:88-97