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Interactive cognitive-motor training improves mobility, gait, and balance in chronic strokeInteractive training boosts balance and movement for people with 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.

Living with a chronic stroke can make simple tasks like walking or standing feel difficult. A new analysis looked at a specific type of training called interactive cognitive-motor training to see if it helps people regain their strength and stability. This approach combines physical movement with mental challenges to retrain the brain and body together. The study looked at data from 1,422 people who had already experienced a stroke. The results showed clear benefits in key areas. Participants who used this training improved their ability to walk and their overall mobility. Their balance also got better, making them less likely to fall. These gains were seen in standard tests used by doctors to measure progress.

However, the training did not help everyone in every way. The study found no significant improvement in how steady people stood or in their lower limb motor function. It also did not improve executive function, which involves planning and decision-making. These mixed results are important to understand. They suggest that while this training helps with movement and balance, it may not fix every problem caused by a stroke. The researchers noted that we still do not know the best amount of training needed or how long the benefits last. More work is needed to figure out the right dose and long-term effects.

Despite these gaps, the findings offer hope for rehabilitation. Standardizing these protocols and making them easier to access could help many patients. Further research on home-based interventions is necessary to optimize clinical applications and improve long-term outcomes for stroke rehabilitation. This means doctors and therapists can use these tools more effectively to help patients recover.

What this means for you:
Interactive training improved balance and mobility for chronic stroke patients, but effects on other measures were unclear.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedJun 2026
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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