Do proprioceptive training strategies with dual-task exercises positively influence gait parameters in chronic stroke? A systematic review.

The studies were too different in design, gait measures, equipment and dose to be combined, so no overall estimate of effect could be calculated. The studies were small, averaging about 35 participants each, with group sizes ranging from 19 to 64. Follow-up after training was not clearly reported, so it is not known whether any gait gains lasted. In one study the comparison group received no rehabilitation at all, so a difference there does not show the training beat a real alternative. Information that could affect walking, such as arthritis, medications, orthoses or depression after stroke, was often missing, and educational status, which could affect attendance, was rarely recorded. Dual-task and proprioceptive training were always delivered alongside walking practice, so the review cannot separate the effect of any one component. The training sometimes relied on treadmill or instrumented equipment that many clinics do not have, which limits how easily it could be adopted. The paper states that specific nutraceuticals might improve adherence to rehabilitation and are often added to recovery programmes, a claim unrelated to the review question and not supported by any of the 11 included studies.

The authors declare no conflicts of interest. No funding source is named in the paper.

Do not read this as proof that dual-task proprioceptive training works. The 11 studies were small, too different to pool, and not clearly followed up after the training ended, and in one study the comparison group received no rehabilitation at all. The authors' own conclusion stops short of certainty, saying the training might lead to improvements.