Contribuições da fisioterapia neurofuncional na reabilitação da marcha após acidente vascular cerebral isquêmico: uma revisão de literatura

Ischemic stroke is one of the leading causes of disability in adults, and gait impairment is among the sequelae that most limit functional independence. Neurofunctional physiotherapy, grounded in neuroplasticity, offers resources to reorganize the motor and postural control required for locomotion. Objective: To analyze the contributions of neurofunctional physiotherapy to gait recovery after ischemic stroke, identifying the alterations that compromise it, the techniques used and their effects on balance, coordination, motor control and functional independence. Methodology: Descriptive, qualitative literature review conducted in 2026 in ten databases, including PubMed, VHL, ScienceDirect and Google Scholar, covering full articles published between 2019 and 2026, in Portuguese or English, on physiotherapy interventions aimed at post-stroke gait, excluding duplicates, abstracts, editorials and papers without a described method. Results: Seven studies were analyzed: four randomized clinical trials, one longitudinal cohort and two systematic reviews with meta-analysis. Treadmill training with functional electrical stimulation, supplemental robotic training, lower-extremity constraint-induced therapy, gaze stabilization exercises, ankle-foot orthosis and plantar sensory stimulation improved balance, speed, symmetry and functional independence, whereas perturbation-based treadmill training did not outperform conventional training. Discussion: Gains were attributed to intensive, task-specific practice, which induces cortical reorganization, and to the integration between sensory input and motor control. The evidence, however, is uneven, with small samples, short follow-up, low certainty of evidence in one meta-analysis, high heterogeneity in the other and the combined inclusion of ischemic and hemorrhagic stroke. Final considerations: Neurofunctional physiotherapy consistently contributes to gait recovery, especially when started early, with adequate dosage and monitoring with standardized instruments. Trials with larger samples, prolonged follow-up and separate analysis of ischemic stroke are recommended.