Efficacy of dual-task training on motor performance and cognitive function in patients with stroke disease: an umbrella review comprising meta-analyses of randomized controlled trials

Stroke poses a major threat to human health, often causing motor, balance, and cognitive impairments that profoundly disrupt patients’ daily lives and markedly reduce their quality of life. The objective was to summarize current study findings, evaluate the reliability of the evidence, and provide a thorough summary of the results concerning dual-task training in improving motor performance and cognitive function for stroke patients. Four electronic databases were searched for studies published in English from inception to June 2025. The Assessment of the quality of the evidence was assessed using the AMSTAR2 scoring system and GRADE system. For the meta-analysis, we recalculated the effect sizes for dual-task training using DerSimonian and Laird (DL) random effects models. Five meta-analysis with eighteen outcomes included in the umbrella review were recalculated for effect size. For motor performance, pooled results found dual-task training can improve the step speed (SMD = 0.36, 95% CI: 0.13,0.59), step frequency (SMD = 0.53, 95% CI: 0.23, 0.83), stride length (SMD = 0.69, 95% CI: 0.14, 1.24), walking endurance (SMD = 0.47, 95% CI: 0.12, 0.81), 10MWT (SMD = -0.80, 95% CI: -1.33, -0.28), and BBS (SMD = 0.39, 95% CI: 0.15, 0.64). For cognitive function, dual-task training can improve total execution function (SMD = 0.48, 95% CI: 0.16, 0.80), total cognitive function (SMD = 0.58, 95% CI: 0.25, 0.91), working memory (SMD = 0.80, 95% CI: 0.26, 1.33), and cognitive flexibility (SMD = 0.84, 95% CI: 0.51, 1.17). In this umbrella review, we found a statistically significant effect between dual-task training and step speed, step frequency, stride length, walking endurance, 10MWT, BBS, total execution function, total cognitive function, working memory, and cognitive flexibility. Overall, despite the moderate to very low quality of evidence, the findings support dual-task training as a viable rehabilitation approach for stroke patients.