Intensity of task-specific training for functional ability post-stroke

Systematic review and meta-analysis

  • Ibrahim, Rabi’u
  • Abdullahi, Auwal
  • Salihu, Abubakar Tijjani
  • Lawal, Isa Usman

  • 1Department of Hospital Services, Physiotherapy Division, Directorate of Health Services, National Assembly Abuja, Abuja, Nigeria

    2Department of Physiotherapy, Faculty of Allied Health Sciences, 361004College of Health Sciences, Bayero University, Kano, Nigeria

    3Department of Physiotherapy, Hasiya Bayero Pediatric Hospital, Kano, Nigeria

    4National Centre for Healthy Ageing Monash University/ Peninsula Health, Monash University, Frankston, Victoria, Australia

Rabi’u Ibrahim, Department of Hospital Services, Physiotherapy Division, Directorate of Health Services, National Assembly Abuja, Abuja 900001, Nigeria. Email: [email protected]

Received September 23, 2024

Accepted June 6, 2025

Clinical Rehabilitation 39(9):p 1133-1155, September 2025. | DOI: 10.1177/02692155251351906

Objectives

To evaluate the effectiveness of intensities of task-specific training on upper and lower limbs functions, balance, and quality of life post-stroke.

Data sources

Six electronic databases (Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, PsycINFO, and Clinical trials.gov registries) were searched up to 19 April 2025.

Review methods

We selected randomized controlled trials with at least one group involving an active repetitive motor sequence. Using an online systematic review application (Covidence), two reviewers screened the studies and extracted the data. Risk of bias was appraised using the standard Cochrane tool. Review Manager 5.4 was used for analysis.

Results

Twenty-six randomized controlled trials involving 1431 stroke survivors were included, with moderate to high risk of bias. Subgroup analyses across most outcomes (arm/hand function, lower limb function, balance, quality of life) showed no significant effects of task-specific training based on dosage variables (frequency, sessions, duration, and repetitions). Although some trends favored higher-dose task-specific training or control, only hand function improved significantly in studies with >20 sessions (SMD = 0.57, p = 0.02; I2 = 69). A significant effect on arm function was seen with >50 repetitions (p = 0.001), but evidence quality was very low.

Conclusions

There is insufficient evidence to determine whether higher-intensity task-specific training leads to improved functional outcomes in stroke rehabilitation. Future well-designed trials are needed to explore optimal training intensities and their impact on recovery.

International prospective register of systematic reviews ID CRD42020130991.

Copyright ©2025Sage Publications