Improving Post-Stroke Cognitive Impairment via Cognitive and Motor Dual Task Gait Training: Potential Mechanisms and Clinical Value

Post-stroke cognitive impairment (PSCI) severely impacts patients' quality of life and functional recovery, with its incidence rising alongside global population aging. Cognitive-walking dual-task training, which integrates cognitive and motor elements, has emerged as a key focus in rehabilitation research in recent years. This review summarizes its value and neural mechanisms in improving PSCI. By integrating randomized controlled trials and functional imaging studies, it assesses the training's effects on cognitive and motor functions and reveals the association between brain region activation and cognitive recovery. The training can enhance cognitive abilities such as attention and executive function, improve motor functions including gait and balance, and boost quality of life. It promotes neuroplasticity, strengthens activation and connectivity of key brain regions like the prefrontal cortex, and regulates Brain-derived neurotrophic factor (BDNF) expression. Technologies such as Functional Near-Infrared Spectroscopy (fNIRS) and Functional magnetic resonance imaging (fMRI) confirm its role in brain function remodeling, and it outperforms traditional training and aerobic exercise alone in enhancing dual-task performance. This training provides a basis for PSCI rehabilitation. Future research should optimize individualized protocols, verify long-term efficacy, and advance the application of multimodal imaging and intelligent platforms to refine rehabilitation strategies.