Gait characteristics in people with central nervous system disorders under dual-task experimental paradigms: a scoping review.

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BackgroundDual-task (DT) paradigms are widely used for gait assessment in patients with central nervous system diseases. However, previous studies have primarily focused on specific diseases and a limited range of DT paradigms, making it difficult to obtain an overall understanding of the application patterns of different paradigms and their associated gait changes. This scoping review aimed to identify and classify the DT paradigms used in DT gait studies of Alzheimer's disease (AD), Parkinson's disease (PD), and stroke; describe the application and distribution of these paradigms across studies of different diseases; further examine changes in gait characteristics under different DT paradigms.MethodsThe Web of Science Core Collection, PubMed, and the Cochrane Library were systematically searched for relevant studies published between January 1, 2005, and April 30, 2026. DT paradigms were classified, and their distribution was mapped by disease category. Dual-task cost (DTC) for gait speed, stride length, and cadence was also summarized descriptively.ResultsA total of 84 studies were included, and 26 DT paradigms were identified, including 21 cognitive tasks, four motor tasks, and one combined cognitive-motor task. Serial subtraction by 3s and 7s were more frequently used in studies of PD, whereas the counting task was more frequently used in studies of AD. The verbal fluency task was relatively evenly distributed across studies of the three diseases, whereas the object-carrying task was used primarily in studies of PD and stroke. Among the paradigms included in the descriptive synthesis, mean gait speed DTC was numerically highest under the verbal fluency task in patients with AD, under serial subtraction by 7s in patients with PD and healthy controls, and under the counting task in patients with stroke. Available data on stride length and cadence were relatively limited.ConclusionThe paradigms used in DT gait studies of AD, PD, and stroke were primarily concentrated in a small number of commonly used paradigms, and their distribution was uneven across diseases. The descriptive DTC findings suggest that patterns of gait change may differ according to disease and DT paradigm.

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