Dual-task gait assessment using n-back testing during self-paced treadmill walking in virtual reality: reliability and baseline characterisation for future clinical application

Al-Amri, Mohammad ORCID: https://orcid.org/0000-0003-2806-0462, Abdallat, Rula, Mashabi, Abdulrhman and Al Balushi, Hilal 2026. Dual-task gait assessment using n-back testing during self-paced treadmill walking in virtual reality: reliability and baseline characterisation for future clinical application. Frontiers in Human Neuroscience 20 , 1807769. 10.3389/fnhum.2026.1807769

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Abstract

Background: Dual-task gait paradigms are widely used to assess cognitive–motor integration, however considerable methodological heterogeneity remains. Fixed-speed locomotion and limited assessment of repeatability have contributed to inconsistent baseline findings in healthy adults, complicating interpretation of dual-task effects reported in clinical populations.Objective: This study aimed to examine the reliability and baseline gait behaviour associated with a dual-task paradigm combining non-immersive virtual reality (VR)-based self-paced treadmill walking and parametrically modulated working memory load. The purpose was to establish a robust reference profile in healthy adults to support subsequent clinical and reliability and baseline characterisation studies.Methods: Twenty-three healthy adult males (34.56 ± 5.12 years) completed two gait assessment sessions using a self-paced treadmill within a non-immersive VR environment. Walking was assessed under three conditions: single-task walking, dual-task walking with a 1-back task, and dual-task walking with a 2-back task. Spatiotemporal gait parameters and dual-task costs were analysed across sessions and task conditions to evaluate between-session consistency and sensitivity to graded cognitive demand.Results: Most spatiotemporal gait parameters demonstrated good consistency between sessions, with no statistically significant differences observed across days or task conditions (p ≥ 0.05). A reduction in step length was observed during dual-task walking in the first session (p = 0.02), alongside consistent directional modulation of stride-related measures with increasing cognitive load. These changes were modest and consistent with adaptive gait regulation in neurologically intact adults.Conclusion: The findings demonstrate that a self-paced treadmill VR dual-task gait protocol yields stable and repeatable gait measures following familiarisation in healthy adults. Rather than establishing criterion validity, this study provides baseline characterisation and reliability evidence necessary for future work evaluating clinical sensitivity, diagnostic utility, and intervention responsiveness in patient populations.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Schools > Healthcare Sciences
Publisher:	Frontiers Media
ISSN:	1662-5161
Date of First Compliant Deposit:	7 July 2026
Last Modified:	07 Jul 2026 16:00
URI:	https://orca.cardiff.ac.uk/id/eprint/188049

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