Effect of Interactive Cognitive-Motor Training on Balance, Mobility, and Cognition in Chronic Stroke Survivors: A Systematic Review and Meta-analysis.

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.