Tao Weiyuan, Chen Jiawei, Peng Jiahui, Xiao Wenwu
Department of Rehabilitation Medicine, People's Hospital of Yangjiang, Yangjiang City, Guangdong, China.
College of Sports Science, Shenyang Normal University, Shenyang City, Liaoning, China.
Medicine (Baltimore). 2025 Mar 7;104(10):e41776. doi: 10.1097/MD.0000000000041776.
Stroke is a prevalent neurological disease with high morbidity and disability. Single-task walking training has limitations, and dual-task walking training has emerged. Yet, research on the relative effectiveness of dual- and single-task training for stroke patients' walking function is inconclusive. This study aims to systematically compare the efficacy of dual-task with single-task training interventions on improving walking function among stroke survivors.
A comprehensive search of electronic databases was conducted to identify randomized controlled trials investigating the application of dual-task training on walking function in stroke patients. Two reviewers independently screened the references, selected relevant studies, extracted data, and assessed the risk of bias. The primary outcome measures related to walking function included step speed, step length, stride length, step frequency, Berg balance scale (BBS), and timed up and go (TUG) test. The Cochrane risk of bias tool was used for methodological quality assessment of the included literature. Statistical analysis was performed using RevMan 5.4 software. Furthermore, the quality of evidence of the outcome measures was evaluated using the GRADEPro software.
A total of 17 studies were enrolled in this systematic review and meta-analysis. The results revealed that dual-task training exhibited significantly superior efficacy compared to single-task training in enhancing step speed, step length, stride length, step frequency, and BBS score (P < .05). However, no significant difference was observed in the TUG test (P = .100).
Compared with traditional single-task training, dual-task training could be more effective in improving walking function among stroke patients, especially with regard to temporal and spatial parameters such as step length and speed, stride frequency and BBS score, but the effect on enhancing TUG test still remains unclear. These findings would help clinicians to formulate a more rational stroke rehabilitation strategy.
中风是一种常见的神经系统疾病，发病率和致残率都很高。单任务步行训练存在局限性，双任务步行训练应运而生。然而，关于双任务训练和单任务训练对中风患者步行功能的相对有效性的研究尚无定论。本研究旨在系统比较双任务训练与单任务训练干预对改善中风幸存者步行功能的疗效。
对电子数据库进行全面检索，以确定调查双任务训练在中风患者步行功能中应用的随机对照试验。两名评审员独立筛选参考文献，选择相关研究，提取数据，并评估偏倚风险。与步行功能相关的主要结局指标包括步速、步长、步幅、步频、伯格平衡量表（BBS）和定时起立行走（TUG）测试。采用Cochrane偏倚风险工具对纳入文献进行方法学质量评估。使用RevMan 5.4软件进行统计分析。此外，使用GRADEPro软件评估结局指标的证据质量。
本系统评价和荟萃分析共纳入17项研究。结果显示，在提高步速、步长、步幅、步频和BBS评分方面，双任务训练的疗效显著优于单任务训练（P < 0.05）。然而，在TUG测试中未观察到显著差异（P = 0.100）。
与传统的单任务训练相比，双任务训练在改善中风患者步行功能方面可能更有效，尤其是在步长和速度、步频和BBS评分等时空参数方面，但对提高TUG测试的效果仍不明确。这些发现将有助于临床医生制定更合理的中风康复策略。
