Interactive cognitive-motor training improves mobility, gait, and balance in chronic stroke
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Key Takeaway
Consider interactive cognitive-motor training to improve mobility, gait, and balance in chronic stroke, but note unclear optimal dosing and long-term effects.
This systematic review and meta-analysis synthesized data from 1422 people with chronic stroke to evaluate the effects of interactive cognitive-motor training on balance, mobility, and cognition. The analysis found significant improvements in mobility (Timed Up and Go Test and Dynamic Gait Index), gait speed, and dynamic balance (Berg Balance Scale and Functional Reach Test). However, postural sway, lower limb motor function (Fugl-Meyer Assessment of Lower Extremity), and executive function (Trail Making Test-B) did not show significant improvement.
The authors note that the optimal intervention dose and long-term effects remain unclear, as these were not adequately addressed in the included studies. Adverse events, serious adverse events, and discontinuations were not reported, limiting safety conclusions. The comparator was also not reported, which may affect the strength of the evidence.
For practice, standardized protocols, increased accessibility, and further research on home-based interventions are necessary to optimize clinical applications and improve long-term outcomes for stroke rehabilitation. Clinicians should consider these findings cautiously, given the lack of clarity on dosing and long-term efficacy.
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View Original Abstract ↓
OBJECTIVE: The aim of the study was to evaluate the effects of interactive cognitive-motor training on balance, mobility, and cognition in people with chronic stroke.
DESIGN: This study used a systematic search of the Medline, Embase, Cochrane Library, and PsycINFO databases from inception to 11 June 2025 to identify relevant randomized controlled trials. This study involved trials investigating the effects of cognitive-motor training interventions with balance, mobility, and cognition outcomes in chronic stroke survivors.
RESULTS: Forty-four trials involving 1422 people with chronic stroke were included. The meta-analyses revealed interactive cognitive-motor training significantly improved mobility (Timed Up and Go Test and Dynamic Gait Index), gait speed, and dynamic balance (Berg Balance Scale and Functional Reach Test), but not postural sway, lower limb motor function (Fugl-Meyer Assessment of Lower Extremity) or executive function (Trail Making Test-B). No subgroup differences were observed with respect to intervention type, dose, or duration.
CONCLUSIONS: Interactive cognitive-motor training represents a promising approach for improving balance, mobility, and gait speed in people with chronic stroke. However, the optimal intervention dose and long-term effects remain unclear. Standardized protocols, increased accessibility, and further research on home-based interventions are necessary to optimize clinical applications and improve long-term outcomes for stroke rehabilitation.
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