The effects of dual task training to improve self-efficacy, functional performance, and quality of life in individuals with Parkinson’s disease: A study protocol

Introduction Dual tasking is impaired in Parkinson’s disease (PD) and adversely impacts activities of daily living and quality of life. The benefits of different dual-task training modalities and the prioritization strategy (directing attention to both tasks versus shifting between them) in individuals with or without cognitive impairment are unclear. It is also unknown whether motor-cognitive benefits from dual-task training are associated with reduced attentional demand. In addition, lower perceived ability to succeed at a specific task (self-efficacy) is associated with worse motor and non-motor symptoms and quality of life. Higher dual-task performance may be associated with higher self-efficacy, which in turn improves dual-task performance. This protocol describes a study evaluating the effectiveness of different dual-task training modalities (motor-motor vs. motor-cognitive) and attentional prioritization strategies (fixed vs. variable) on self-efficacy, functional performance, and quality of life in people with PD, with and without cognitive impairments. Methodology Using a factorial design nested within cognitive status, participants will be randomized into one of four groups combining task type (motor-cognitive or motor-motor) with priority instruction (fixed or variable). An interdisciplinary team will design individualized programs. In fixed-priority training, attention is maintained on both tasks, in variable-priority training, attention alternates, focusing on the motor task for half the session and on the secondary task for the remainder. All participants will complete 24 individual sessions (3x/week for 8 weeks, 60 minutes each). Outcomes include self-efficacy, motor and cognitive performance, quality of life, and prefrontal cortex activity. Expected results This protocol will introduce a person-centered approach to dual-task training, comparing modalities and attentional strategies tailored to cognitive status. It also addresses a key gap by examining neurophysiological mechanisms of dual-task interference through real-time brain activity, potentially identifying biomarkers linking neural changes to clinical outcomes. Findings will inform targeted, evidence-based neurorehabilitation strategies for PD. Protocol registration The protocol of this study is registered in Clinical Trials Registry with a registration number NCT07611578. Date registered: 05/07/2026. https://clinicaltrials.gov/study/NCT07611578?