Abstract
BACKGROUND: The clinical application of dual-task training based on movement and cognition in stroke population is still controversial. This study used a systematic review and meta-analysis to compare the effects of dual-task exercise versus single-task training including cognitive-only, exercise-only, and usual rehabilitation for motor function and cognitive function in stroke patients. METHODS: Extensive electronic database search (from inception to November 27, 2024) was conducted in 8 databases to identify randomized controlled trials that investigated the effects of dual task-based training on motor and cognitive function in stroke patients. RESULTS: 30 RCTs involving 1,588 people were included in the analysis. The study found that compared with the control group, dual-task cognitive motor training can improve the walking performance of stroke patients (WMD = 3.19, 95%CI: 2.26, 4.12), the recovery of lower limb motor function (WMD = 2.78, 95% CI: 1.38, 4.18), cognitive function (WMD = 2.93, 95% CI: 0.95, 4.91) and mental state (WMD = 3.39, 95% CI: 0.06, 6.72), and the functional state of activities of daily living (WMD = 7.47, 95% CI: 3.97, 10.96). Subgroup analyses showed that cognitive-motor dual-task training was more likely to have a clinical effect after at least 3 weeks of intervention. CONCLUSIONS: Dual-task training significantly improves walking ability, lower limb motor function, cognitive function, mental status, and activities of daily living in stroke patients. No significant effects were found for basic mobility and gait speed. These findings support its clinical application, with personalized programs recommended based on patient needs. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12883-025-04305-2.