Uneven Landscape of Cognitive-Motor Dual-Task Research Across Rehabilitation Fields: A State-of-the-Field and Pattern Analysis.

Cognitive-motor dual-task (CMDT) research has expanded rapidly over the past 2 decades, yet this growth has occurred almost exclusively within geriatric and neurologic rehabilitation. In contrast, musculoskeletal, sports, cardiopulmonary, pediatric, and pain rehabilitation fields demonstrate markedly limited engagement with CMDT despite its relevance to motor control and functional performance. This Special Communication synthesizes the current state-of-the-field and examines the structural mechanisms that have produced this persistent interdisciplinary imbalance. Drawing from existing literature, the analysis identifies a set of recurring patterns: (1) CMDT emerged historically within domains where gait, balance, and cognitive decline are central clinical outcomes, creating an early advantage for geriatric and neurologic research; (2) CMDT-sensitive outcomes are not equally prioritized across all rehabilitation fields, reducing its perceived relevance in others; (3) standardization of dual-task assessments has developed primarily within neurologic and aging research, limiting methodological accessibility elsewhere; (4) clinician-level barriers-including time, expertise, and tool availability-restrict CMDT implementation even within well established settings; and (5) evidence and expertise have accumulated most rapidly in the fields where CMDT was first adopted, reinforcing its continued concentration in those domains. Collectively, these patterns suggest that the uneven distribution of CMDT research is not a transient artifact but a reflection of deeper disciplinary structures within rehabilitation science. By clarifying these mechanisms, this work provides a conceptual foundation for understanding why CMDT has flourished in some fields but not others, without presuming uniform applicability or advocating for indiscriminate expansion.