Abstract
Knee osteoarthritis (KOA) is primarily recognized for structural joint degeneration and pain, yet growing evidence highlights that gait and postural stability rely heavily on cognitive control. Cognitive-motor interference (CMI) occurs when concurrent cognitive and motor tasks degrade performance. While widely studied in neurological populations, CMI's role in early KOA remains undercharacterized. Synthesizing recent dual-task research, this narrative synthesis examines the mechanisms, assessment protocols, and clinical relevance of CMI in early KOA. Evidence shows that dual-task conditions trigger significant motor deficits in KOA populations—such as a 9% reduction in gait speed and up to 26% greater step-duration variability compared to single-task walking. These alterations demonstrate that KOA reduces motor automaticity, forcing greater reliance on prefrontal executive control during movement. Ultimately, CMI serves as a novel functional marker in early KOA. Incorporating dual-task gait evaluations can uncover hidden motor-control deficits, refine fall-risk assessments, and inform targeted cognitive-motor rehabilitation strategies.
