The Laryngoscope V C 2010 The American Laryngological, Rhinological and Otological Society, Inc. Rapid Communication European Society for Clinical Evaluation of Balance Disorders: Discussion About Dual-Task Conditions Combining Postural Control With Cognitive Tasks Raphae ¨l Maire, MD; Ge ´rome C. Gauchard, PhD; Dominique Deviterne, PhD; Mans Magnusson, MD, PhD; Herman Kingma, PhD; Philippe P. Perrin, MD, PhD INTRODUCTION Since 2005, the European Society for Clinical Eval- uation of Balance Disorders (ESCEBD) has met annually in Nancy, France. The ESCEBD includes spe- cialists who have a specific interest in balance disorders with the following background: neurophysiology; ear, nose, and throat; neurology; ophthalmology; physical medicine and rehabilitation; geriatrics; cardiology; sport medicine; and physiotherapy. Each year, the society focuses on one or two problematic themes related to equilibrium and aims to obtain the standardization of balance testing and clinical recommendations. A panel of experts leads the proceedings, synthesizes the most rele- vant opinions of the discussion, and suggests solutions. The main topic of the 4th Annual Meeting held on June 6, 2008, was the dual-task condition in balance evalua- tion. Concurrently performing tasks, in situations such as using a handheld phone when driving or managing organizational and environmental constraints in occu- pational activities, have broader implications in understanding motor coordination degradation. Perform- ance is more affected with the novelty of the task, especially in elderly persons. Our purpose was to discuss the paradigm of the dual-task during postural control and the clinical application of such a condition in the assessment of balance. We report here a brief summary of our discussion. DEFINITION OF A DUAL-TASK CONTEXT DURING POSTURAL CONTROL The panel agreed that the dual-task condition exists if the subject is asked to simultaneously perform two dif- ferent tasks that interact together. This context allows the evaluation of a subject’s ability to manage a complex situation, combining two tasks that are unrelated to each other and necessitating the sharing of the atten- tional resources that could be allocated to their fulfillment. A dual-task situation during gait or standing posture must imply the combination of balance control processes with a cognitive task (see below). As both tasks need attention, the dual-task testing in this con- text should measure the importance of cognition in the control of posture. The question arose whether freely thinking during gait or standing should be considered as a dual-task situation or not. The majority of the board answered no, because free thought is immediately stopped if the postural control requires more attention or stability is threatened. On the other hand, walking requires little attention, and freely thinking in this sit- uation usually has no significant impact on the automated gait control processes. From the Department of Otolaryngology, Head and Neck Surgery, Neurotology Unit, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland (R.M.); Nancy-University, Henri Poincare ´ University, Balance Control and Motor Performance, UFR STAPS, Villers-le `s -Nancy, France (G.C.G., P .P .P .); INSERM U 954, Group Neurodegenerative Diseases, Neuroplasticity, Cognition, Faculty of Medicine, Vandoeuvre-le `s-Nancy, France (G.C.C., P.P.P.); Conditions and Processes of Learning and Socialisation (GECPAS), IUFM de Lorraine, Maxe ´ville, France (D.D.); Department of Oto-Rhino-Laryngology and Head and Neck Surgery, Clinical Sciences, University Hospital of Lund, Lund, Sweden (M.M.); Department of Oto-Rhino-Laryngology and Head and Neck Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands (H.K.); Department of Biomedical Technology, Technical University Eindhoven, Eindhoven, The Netherlands (H.K.); Department of Oto- Rhino-Laryngology and Head and Neck Surgery, University Hospital of Nancy, Vandoeuvre-le `s-Nancy, France (P .P .P .). Editor’s Note: This Manuscript was accepted for publication June 16, 2010. The authors have no funding, financial relationships, or conflicts of interest to disclose. Send correspondence to Raphae ¨l Maire, MD, Department of Otolar- yngology, Head and Neck Surgery, Neurotology Unit, University Hospital CHUV, 1011 Lausanne, Switzerland. E-mail: raphael.maire@chuv.ch DOI: 10.1002/lary.21113 Laryngoscope 120: October 2010 Maire et al.: Dual-Task Condition in Balance Evaluation 2108