Effects of dual-task training on gait and balance in stroke patients: A meta-analysis

Abstract

Objective To assess the effects of dual-task training on gait and balance in stroke patients. Data sources: A systematic review of PubMed, Web of Science, Embase and Cochrane Library from their inception through 20 August 2021. Review methods The bibliography was screened to identify randomized controlled trials that applied dual-task training to rehabilitation function training in stroke patients. Two reviewers independently screened references, selected relevant studies, extracted data and assessed risk of bias using the Cochrane tool of bias. The primary outcome was the gait and balance parameters. Results A total of 1992 studies were identified and 15 randomized controlled trials were finally included (512 individuals) were analyzed. A meta-analysis was performed and a beneficial effect on rehabilitation training was found. Compared to patients who received conventional rehabilitation therapy, those who received dual-task training showed greater improvement in step length (MD = 3.46, 95% CI [1.01, 5.92], P = 0.006), cadence (MD = 4.92, 95% CI [3.10, 6.74], P < 0.001) and berg balance scale score (MD = 3.10, 95% CI [0.11, 6.09], P = 0.040). There were no differences in the improvements in gait speed (MD = 2.89, 95% CI [ − 2.02, 7.80], P = 0.250) and timed up and go test (MD = −2.62, 95% CI [ − 7.94, 2.71], P = 0.340) between dual-task and control groups. Conclusion Dual-task training is an effective training for rehabilitation of stroke patients in step length and cadence, however, the superiority of dual-task training for improving balance function needs further discussion.

The Effectiveness of Goal-Oriented Dual Task Proprioceptive Training in Subacute Stroke: A Retrospective Observational Study

“…Indeed, in stroke patients, despite the high heterogeneity of proposed exercises, all integrated cognitive and motor tasks with proprioceptive exercises proved effective, independently from the rehabilitation session’s organization and timing [ 37 , 38 , 39 ]. In particular, dual task training shows an improvement in step length, cadence [ 18 ], balance, and a reduction of the risk of falling [ 40 ].…”

“…As well as the proprioceptive and reactive balance impairment, the severity of somatosensory impairments, and the degree of mobility-interference during dual task activities can help to predict the risk of falling and guide the therapeutic strategies to maximize long-term participation, minimize disability and reduce the risk of falls [ 12 , 18 , 19 ]. To obtain these goals, the rehabilitation must focus not only on autonomy, but also on balance, and task performance, and on falls prevention [ 20 , 21 ].…”

Current Trends in Balance Rehabilitation for Stroke Survivors: A Scoping Review of Experimental Studies

“…This approach involves the simultaneous performance of cognitive tasks alongside motor activities, effectively mimicking real-world scenarios. This approach addresses the physical impairments associated with stroke and challenges cognitive processes, fostering improved coordination and adaptability in daily activities [47,53].…”

The effect of balance and gait training on specific balance abilities of survivors with stroke: a systematic review and network meta-analysis

“…The GRADE approach was used to assess the quality of evidence from studies on the effect of different BGTs on the different balance abilities of patients with stroke through an NMA. Table 3 presents a summary of the certainties of evidence based on four balance types [all details of the GRADE assessment for all pairwise comparisons are presented in Appendix 10 (p. 56)]. The main reasons for downgrading were imprecision, inconsistency, and the risk of bias.…”