Open-label or unblinded (moderate): No blinding reported

Compared with the control group, the single-task exercise group improved TUG performance under both single-task and dual-task conditions. However, the normalized dual-task impact score did not clearly improve, so the benefit appears meaningful but not complete across all dual-task metrics.

The single-task exercise group improved more than the control group on BESS and Four Square Step Test results. Lower error counts and faster stepping performance support a clear improvement in balance.

Functional mobility improved in the single-task exercise group compared with control. TUG functional mobility time decreased while Functional Reach Test distance increased, showing better movement performance across complementary mobility measures.

The single-task exercise group improved on MoCA total score, delayed recall, digit span, Stroop D, and verbal fluency compared with baseline and generally performed better than control on change scores. Still, not every cognitive subdomain changed significantly, so the cognitive benefit is best described as broad but not universal.

A supervised 8-week program of progressive balance and gait exercises performed twice weekly without added cognitive tasks.

Compared with control, the dual-task exercise group showed larger improvements in TUG performance under both single-task and dual-task conditions. As with the single-task group, the normalized dual-task impact score was not clearly different, so the benefit is clear for performance times but less clear for interference itself.

The dual-task exercise group improved substantially on BESS and Four Square Step Test measures compared with control. These changes support a strong benefit for balance and movement control.

The dual-task group improved on both functional mobility measures versus control. Timed Up and Go performance became faster and Functional Reach distance increased, indicating better practical movement capacity.

The dual-task exercise group improved on overall MoCA score and on several specific cognitive measures, including delayed recall, digit span, Stroop D, and verbal fluency. MoCA total score improved more in this group than in both the single-task and control groups, which supports a stronger cognitive effect for the dual-task approach.

A supervised 8-week progressive balance and gait program performed twice weekly while participants simultaneously completed structured cognitive tasks targeting attention, memory, executive function, language, and processing speed.

Positive: 8; Negative: 0; No effect: 0; Mixed: 0

Direction counts recalculated from intervention outcomes due to mismatch with AI-provided counts.

Extracted 8 outcome signals across the study

Both exercise interventions improved many balance, mobility, and cognitive measures compared with control, although the dual-task impact score did not clearly improve and dual-task exercise was not superior on most outcomes.

Direction counts were recalculated from extracted outcomes because the AI-provided totals did not match.

Dual-task walking performance ↓ improved in both exercise groups versus control

Mostly intermediate or surrogate outcomes

Both exercise groups improved TUG performance under single-task and dual-task conditions more than the control group.

Both exercise groups improved balance and functional mobility measures, including BESS, FSST, TUG, and FRT.

Cognitive outcomes improved in both exercise groups, and MoCA total score improved more in the dual-task group than in the other groups.

Aslan Kolukisa S, Taspinar F, Taspinar B. Examining the Effects of Dual and Single Task Exercises in Individuals with Type 2 Diabetes: A Randomized Controlled Trial. J Clin Med. 2026;15(7):2761. doi:10.3390/jcm15072761

Participants and therapists were not blinded.

The follow-up lasted only 8 weeks with no longer-term outcome assessment.

People with diabetic complications were excluded, which limits generalizability.

In adults with type 2 diabetes, both supervised dual-task and single-task exercise programs improved balance, functional mobility, and cognitive performance over 8 weeks compared with no exercise.

Balance test errors and completion times ↓ after both exercise programs

Cognitive screening scores ↑, with the largest MoCA gain in the dual-task group

This ADA guideline reviews lifestyle behaviors, exercise, and self-management strategies that support health outcomes in diabetes. It helps place this trial's supervised exercise program in the context of standard diabetes care recommendations.

5. Facilitating Positive Health Behaviors and Well-Being to Improve Health Outcomes: Standards of Care in Diabetes-2025

This consensus statement outlines exercise prescription principles for adults with type 2 diabetes. It directly supports the rationale for the supervised balance and gait exercise structure used in this trial.

Exercise/Physical Activity in Individuals with Type 2 Diabetes: A Consensus Statement from the American College of Sports Medicine

This systematic review summarizes evidence on exercise, cognitive training, and dual-task approaches in type 2 diabetes. It provides broader context for why both exercise groups in the present trial may have shown cognitive gains.

Effects of Exercise, Cognitive, and Dual-Task Interventions on Cognition in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis

This review examines how exercise affects dynamic balance in people with type 2 diabetes. It helps interpret the present findings on BESS, Four Square Step Test, and functional balance outcomes.

Effects of Exercise on Dynamic Balance in People with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Limited population scope (moderate): Narrow population scope

Limited safety reporting (moderate): Safety reporting depth: limited

No post-intervention follow-up (moderate): 0 weeks of follow-up after treatment ended

Open-label or unblinded study (moderate): No blinding reported

Exercise improved balance and cognition in adults with type 2 diabetes

This trial tested two supervised exercise programs in adults with type 2 diabetes: one used balance training alone and the other paired balance training with cognitive tasks. After 8 weeks, both exercise groups improved balance, mobility, and several cognitive measures more than the control group, while dual-task training showed an extra advantage mainly for overall MoCA score.

The benefits were shown in a relatively small supervised program with one-on-one physiotherapist support, so results may not be identical in routine unsupervised care. Also, the dual-task program was not clearly better than the single-task program on most outcomes, so the safest conclusion is that structured exercise helped, while added cognitive tasks may offer selective extra benefit.

Supervised dual-task and single-task exercise programs in adults with type 2 diabetes

This study applies most directly to middle-aged adults with type 2 diabetes who can walk independently and do not have major diabetes-related complications, severe sensory loss, or medical conditions that would limit exercise participation.

Exercise improved balance and cognition in adults with type 2 diabetes

Multidisciplinary Digital Publishing Institute (MDPI)

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