Task-oriented circuit training to improve adaptive walking and cognitive-motor function after stroke: a clinical review

Abstract

Abstract Background The evaluation of ambulation recovery after stroke commonly involves the use of linear outcomes such as walking speed and endurance. Task-oriented circuit training (TOCT) is commonly used in stroke rehabilitation to improve walking performance, but most existing reviews focus on motor outcomes and provide limited information on adaptive walking and cognitive–motor function. Objectives This narrative review aimed to synthesize current evidence on the role of TOCT in improving adaptive walking and cognitive–motor function after stroke. Methods A structured narrative literature search was conducted using PubMed/MEDLINE and Scopus databases. Randomized controlled trials, systematic reviews, meta-analyses, and mechanistic studies published between 2000 and 2025 were included. Evidence related to adaptive walking tasks, the integration of cognitive and motor functions, and functional walking outcomes following TOCT was reviewed. Results TOCT improves walking endurance, gait speed, balance and functional mobility in ambulatory stroke survivors during sub-acute and chronic phases. Studies suggest that TOCT programs incorporating task variability, obstacle negotiation and simultaneous cognitive challenges may enhance gait adaptability and cognitive-motor performance, particularly in domains related to attention and executive control. These effects are supported by the principles of task-specific practice, repetition, progressive challenge and aerobic loading relevant to functional recovery. Conclusions TOCT is a promising rehabilitation approach for improving adaptive walking and cognitive–motor function after stroke. Incorporating obstacle negotiation and cognitive demands into TOCT may encourage safer community ambulation and facilitate more transferable functional improvements. Further studies with standardized protocols and outcome measures are required to strengthen the evidence and guide clinical implementation.