Combination Training, Twice As Good?

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Written by Jesse Muijsenberg
With our cognitive training software, it is possible to train in a dual-task manner. But what does this, “combination or dual-task training” mean? What types of dual-task training are already known?

In the article “Translating combination training to everyday functioning”. We already talked about combination or dual-task training. We saw how combination training could benefit a striker in a counterattack. We also saw how physical training should be complemented with cognitive tasks to gain improvement in cognitive performance. However, we didn’t mention yet that combination training could also benefit physical functioning. 

Dual-task training requires the performance of two tasks simultaneously. This can be two motor function tasks, but it can also mean that someone executes one motor function task together with a cognitive training task. The conventional approach to training does not focus on dual-task training but focuses on single-task training methods. However, in daily life, it is not realistic that someone uses only, for example, their working memory without doing another task. It is necessary to simultaneously control both motor and cognitive functioning while at the same time observing external information in almost all daily activities, including sports, this is also something we saw in our previous article. Let’s give you a new example. Think about that time when you were driving to your work. To drive, you needed to activate specific muscles in a specific order. While driving, you were probably going over the list of tasks you had to finish that day at work. In order for you to drive safely, you had to observe the traffic around you. This is just a simplified example of a daily activity that is divided into a lot of different tasks, using both cognitive and motor functioning. 

It is found that some people are better at performing dual-tasks than others. When zooming in on the so-called motor-cognitive dual-tasks it is stated in the literature that for example, older people have more trouble performing a dual-task than younger people. It is hypothesized that the following theories explain the variation in dual-task performance. The first theory is the central bottleneck theory. This theory states that there is a bottleneck in the information processing whereby only one task can be progressed at a time, causing an increase in reaction time when performing dual-tasks. A second theory is that variation in dual-task performance is due to the four-dimensional multiple resource model. This model states that when the interference between two tasks will be greater when the following factors are present: “sharing of stages, sharing the channels of visual information processing, sharing sensory modalities and the processing of codes”. The third and last theory, the attentional resource theory, suggests that variation in motor-cognitive dual-task functioning could be due to competing demands for attentional resources. This means that a person needs to divide their attention over several tasks, the more tasks, the less attention is available for each task. To give an example, it is shown that a relatively simple motor control task, like walking, exerts a higher demand on the attentional resources for older people compared to younger people. The goal of training in a dual-task manner is to free up the cognitive resources that were previously used to monitor motor or cognitive performance.

Wollesen, et al. investigated whether elderly could benefit from dual-task training compared to single-task training when focussing on balance control while standing or walking in combination with a secondary cognitive task. They separated four different intervention groups all focussing on the standing or walking performance respectively: A) General single-task training (GST), an intervention in which the single-tasks differed pre- during, and post-intervention. B) Specific single-task training (SST), an intervention in which the single training tasks are the same as the tested tasks. C) General dual-task training (GDT) an intervention in which training included a variety of dual-tasks. D) Specific dual-task training (SDT), an intervention in which the dual training tasks are the same as the tested tasks. They found some promising results, showing that overall most benefits for standing and walking dual-task conditions seem to be reached by dual-task training. However, the task complexity and other factors weren’t examined sufficiently. For example, one of the studies that were included in this article pointed out that not only the type of training but also the training load is an important factor in whether dual-task training increases the performance in both physical and cognitive functions. This specific study found that training with rising demands gained higher training effects than training with only one level cognitive load or motor demands. These factors weren’t taken into account in all the studies included in the article of Wollesen. 

Increasing the cognitive training load is often correlated with increasing the stress for the performer. The body sees this cognitive overload as a potential harm. Therefore the body makes sure to use all its cognitive abilities as efficiently as possible. This means the performer will think functional and attention is focussed. Jaeggi et al. conducted a study in which brain-imaging was used to evaluate individual differences in cognitive performance during cognitive overload. They showed that the activation pattern in the brain was load-dependent. There were also individual differences found. They found that the high-performing group showed lower activations than the low-performing group. This difference was especially pronounced when the load increased. They state that this could indicate that “some areas in the brain keep cool in order to lead to the excellent performance”. This is shown in the figure below.

(A) Significant main effect of load. (B) Significant interactions (load x performance group), to visualize individual differences. Represented are the mean activation changes in response to the three load conditions for each column of interest, ordered by their activation patterns. Increases: red lines (increase from 1- to 3-back and/or 1- to 2-back). Inverted U-shaped curve: blue lines (increase from 1- to 2-back and decrease from 2- to 3-back). Decreases: green lines (decrease from 1- to 3-back and/or from 2- to 3-back). No load-dependent activation change: black lines. Significant differences between the various load conditions and between groups are indicated (*p < 0.05; **p < 0.01; ***p < 0.001; all corrected for multiple comparisons). DLPFC, dorsolateral prefrontal cortex; IFG, inferior frontal gyrus; sf, superior frontal sulcus; cau, caudate nucle; cale, intracalcarine cortex; thal, thalamus; st, superior temporal sulcus; it, inferior temporal sulcus. (Jaeggi et al.)

With our software, it is possible to train in both a single-task and a dual-task manner. Furthermore, we have taken into account that there are several levels of each cognitive task available, which means that the training load can be adjusted to the performer.


  • Bherer, L., Kramer, A.F., Peterson, M.S., Colcombe, S., Erickson, K., Becic, E. (2008). Transfer Effects in Task-Set Cost and Dual-Task Cost After Dual-Task Training in Older and Younger Adults: Further Evidence for Cognitive Plasticity in Attentional Control in Late Adulthood. Experimental Aging Research. 23: 188-219. (3) Wollesen, Bettina. Voelcker-Rehage, C. (2013). Training effects
  • He, Y., Yang, L., Zhou, J., Yao, L., Pang, M.Y.C. (2018). Dual-task training effects on motor and cognitive functional abilities in individuals with stroke: a systematic review. Clinical rehabilitation. Volume 32(7): 865-877.
  • Jaeggi, S.M., Buschkuehl, M. Etienne, A., Ozdora, C., Perrig, W.J., Nirkko, A.C. (2007). On how high performers keep cool brains in situations of cognitive overload. Cognitive, Affective, & Behavioral Neuroscience. 7(2): 75-89.
  • Wollesen, Bettina. Voelcker-Rehage, C. (2013). Training effects on motor-cognitive dual-task performance in older adults. European Review of Aging and Physical Activity. 11: 5-24.

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