Effects of task-oriented circuit class training on walking ability after stroke: a meta-analysis.

Abstract

<h4>Objective</h4>Task-oriented circuit class training (CCT) is increasingly used in the rehabilitation of post-stroke gait dysfunction; however, current research findings remain inconsistent. This study aimed to further investigate its therapeutic efficacy.<h4>Methods</h4>Randomized controlled trials (RCTs) evaluating task-oriented CCT in stroke patients were identified through a systematic search of PubMed, the Cochrane Library, and EMBASE, covering the period from database inception to February 25, 2025. Studies were included if they assessed lower limb functional outcomes. Only publications in English were considered. Two independent reviewers conducted literature screening, data extraction, and risk-of-bias assessment. Meta-analysis was performed using Review Manager 5.4 and Stata 18.0 software.<h4>Results</h4>Twelve RCTs comprising 652 patients were included. Meta-analysis demonstrated significant, homogeneous effect sizes in favor of task-oriented CCT for the 6-min walk test (mean difference (MD) = 57.88, 95% CI 33.43 to 82.32, <i>p</i> < 0.00001), the Timed Up-and-Go test (MD = -1.74, 95% CI: -2.92 to -0.57, <i>p</i> = 0.004), and gait speed (MD = 0.13, 95% CI: 0.06 to 0.20, <i>p</i> = 0.0002). Subgroup analysis indicated that in patients within 3 months post-stroke, implementing task-oriented CCT with increased training frequency (≥3 times/week) was associated with improvements in 6-min walk distance and gait speed. In patients more than 3 months post-stroke, higher training frequency (≥3 times/week) or longer session duration (≥1 h) was linked to greater gains in 6-min walk distance and Timed Up-and-Go test (TUG) performance.<h4>Conclusion</h4>These findings support the beneficial effects of task-oriented CCT in improving walking ability after stroke. Future large-scale, multicenter RCTs are warranted to compare the effects of varying training components, including content, intensity, single-session duration, and intervention timing, on post-stroke walking function.<h4>Systematic review registration</h4>https://www.crd.york.ac.uk/PROSPERO/home, identifier CRD420250652683.