{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T04:54:56Z","timestamp":1781758496612,"version":"3.54.5"},"reference-count":51,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:00:00Z","timestamp":1781740800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012226","name":"Fundamental Research Funds for the Central Universities","doi-asserted-by":"publisher","award":["2024TNJN008"],"award-info":[{"award-number":["2024TNJN008"]}],"id":[{"id":"10.13039\/501100012226","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Physiol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>After stroke, patients often exhibit abnormal gait and cortical activation patterns during obstacle crossing, which heightens their risk of falls. This study aimed to examine the effects of Motor dual-task gait training (MDTG) and cognitive dual-task gait training (CDTG) on gait and cortical activation during obstacle crossing in stroke patients, to clarify their differential effects and underlying neural mechanisms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      35 stroke patients were recruited and randomly assigned to either the MDTG group (\n                      <jats:italic>n<\/jats:italic>\n                      = 17) or the CDTG group (\n                      <jats:italic>n<\/jats:italic>\n                      = 18), and were assigned to receive the corresponding intervention training. Participants in both groups underwent a 4 week training program, consisting of three sessions per week. Spatio-temporal parameters, lower limb joint angles and moments, and changes in oxyhemoglobin concentrations (\u0394HbO\n                      <jats:sub>2<\/jats:sub>\n                      ) were assessed in patients during obstacle crossing both pre- and post-training.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Following training, both groups demonstrated significant improvements in stride length, step length, step width, gait speed, toe-obstacle clearance of the leading and trailing limb, toe-obstacle distance of the trailing limb, anteroposterior and mediolateral COM displacement, mediolateral COM mean velocity, anteroposterior COM-COP distance, hip flexion angle of the leading limb, knee flexion angle of the trailing limb, and peak hip flexion moment of the trailing limb (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.05). Concurrently, following the training, \u0394HbO\n                      <jats:sub>2<\/jats:sub>\n                      in the bilateral prefrontal cortex was significantly reduced during obstacle crossing (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.05). However, no significant differences were observed between the two groups for any parameters (\n                      <jats:italic>P<\/jats:italic>\n                      &amp;gt;0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A 4-week program of either MDTG or CDTG effectively improved postural stability, enhanced control of the swing limb and COM, and increased efficiency in cortical resource utilization during obstacle crossing in stroke patients. However, no differences in these effects were observed between the two training modalities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.chictr.org.cn\/showproj.html?proj=200755<\/jats:ext-link>\n                      , identifier ChiCTR2300077304.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fphys.2026.1869914","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T04:38:40Z","timestamp":1781757520000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of different dual-task trainings on gait and cortical activation during obstacle crossing in stroke patients: a randomized controlled trial"],"prefix":"10.3389","volume":"17","author":[{"given":"Xianglin","family":"Wan","sequence":"first","affiliation":[{"name":"School of Sport Science, Beijing Sport University","place":["Beijing, China"]},{"name":"Key Laboratory for Performance Training & Recovery of General Administration of Sport of China, Beijing Sport University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zihao","family":"Zhu","sequence":"additional","affiliation":[{"name":"School of Sport Science, Beijing Sport University","place":["Beijing, China"]},{"name":"Key Laboratory for Performance Training & Recovery of General Administration of Sport of China, Beijing Sport University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, People\u2019s Hospital of Queshan","place":["Zhumadian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiujie","family":"Li","sequence":"additional","affiliation":[{"name":"Key Laboratory for Performance Training & Recovery of General Administration of Sport of China, Beijing Sport University","place":["Beijing, China"]},{"name":"China Institute of Sport and Health Science, Beijing Sport University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"715","DOI":"10.1016\/j.neubiorev.2010.08.008","article-title":"Cognitive motor interference while walking: a systematic review and meta-analysis","volume":"35","author":"Al-Yahya","year":"2011","journal-title":"Neurosci. Biobehav. Rev."},{"key":"B2","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1177\/1545968315613864","article-title":"Prefrontal cortex activation while walking under dual-task conditions in stroke","volume":"30","author":"Al-Yahya","year":"2016","journal-title":"Neurorehabil. Neural Repair"},{"key":"B3","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1016\/j.humov.2018.09.009","article-title":"Identifying trippers and non-trippers based on knee kinematics during obstacle-free walking","volume":"62","author":"Benson","year":"2018","journal-title":"Hum. Mov. Sci."},{"key":"B4","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1016\/j.gaitpost.2023.02.016","article-title":"Acute effects of kinesio taping on lower-limb coordination of gait in hemiplegic patients","volume":"102","author":"Chen","year":"2023","journal-title":"Gait. Posture."},{"key":"B5","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1186\/s13102-025-01511-w","article-title":"The effects of different types of dual-task gait training on lower-limb coordination during dual-task gait in patients with stroke: a single-blind randomized controlled trial","volume":"18","author":"Chen","year":"2026","journal-title":"BMC Sport. Sci. Med. Rehabil."},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2024.106208","article-title":"The impact of whole-body vibration training and proprioceptive neuromuscular facilitation on biomechanical characteristics of lower extremity during cutting movement in individuals with functional ankle instability: a parallel-group study","volume":"113","author":"Chen","year":"2024","journal-title":"Clin. Biomech. (Bristol)."},{"key":"B7","first-page":"334","article-title":"Kinematic analysis of crossing obstacle with different height following stroke","volume":"30","author":"Chen","year":"2015","journal-title":"Chin. J. Rehabil. Med."},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2019.00813","article-title":"Identify the alteration of balance control and risk of falling in stroke survivors during obstacle crossing based on kinematic analysis","volume":"10","author":"Chen","year":"2019","journal-title":"Front. Neurol."},{"key":"B9","volume-title":"The Effects of Tai Chi Practice on the Prefrontal Cortex Activation and Postural Contol Ability During Dual-Task Obstacle Negotiation in Older Adults","author":"Chen","year":"2022"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1599","DOI":"10.1177\/02692155211017360","article-title":"Dual-task walking and automaticity after stroke: insights from a secondary analysis and imaging sub-study of a randomised controlled trial","volume":"35","author":"Collett","year":"2021","journal-title":"Clin. Rehabil."},{"key":"B11","doi-asserted-by":"publisher","first-page":"180","DOI":"10.1007\/s00221-004-2057-0","article-title":"Step characteristics during obstacle avoidance in hemiplegic stroke","volume":"161","author":"Den Otter","year":"2005","journal-title":"Exp. Brain Res."},{"key":"B12","volume-title":"Use of Attention Demanding Tasks to Estimate Fall Risk and Daily Walking Activity in Subacute Stroke","author":"Feld","year":"2020"},{"key":"B13","doi-asserted-by":"publisher","first-page":"126","DOI":"10.2340\/16501977-1903","article-title":"Stride frequency and length adjustment in post-stroke individuals: influence on the margins of stability","volume":"47","author":"Hak","year":"2015","journal-title":"J. Rehabil. Med."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1041","DOI":"10.1016\/j.clinbiomech.2013.10.010","article-title":"Stepping strategies used by post-stroke individuals to maintain margins of stability during walking","volume":"28","author":"Hak","year":"2013","journal-title":"Clin. Biomech."},{"key":"B15","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1016\/j.humov.2018.03.010","article-title":"Prefrontal over-activation during walking in people with mobility deficits: interpretation and functional implications","volume":"59","author":"Hawkins","year":"2018","journal-title":"Hum. Mov. Sci."},{"key":"B16","doi-asserted-by":"publisher","first-page":"713","DOI":"10.1589\/jpts.23.713","article-title":"Effects of balance training with various dual-task conditions on stroke patients","volume":"23","author":"Her","year":"2011","journal-title":"J. Phys. Ther."},{"key":"B17","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1016\/j.gaitpost.2019.07.378","article-title":"Tempo-spatial gait adaptations in stroke patients when approaching and crossing an elevated surface","volume":"73","author":"H\u00f6sl","year":"2019","journal-title":"Gait. Posture."},{"key":"B18","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1016\/j.gaitpost.2025.03.021","article-title":"The effects of cognitive dual-task gait training and motor dual-task gait training on lower-limb coordination during walking in subacute stroke patients: a randomized controlled trial","volume":"120","author":"Huimeng","year":"2025","journal-title":"Gait. Posture."},{"key":"B19","doi-asserted-by":"publisher","first-page":"D280","DOI":"10.1364\/ao.48.00d280","article-title":"HomER: a review of time-series analysis methods for near-infrared spectroscopy of the brain","volume":"48","author":"Huppert","year":"2009","journal-title":"Appl. Optics. Opt. Technol. Biomed. Opt."},{"key":"B20","doi-asserted-by":"publisher","first-page":"7","DOI":"10.47391\/JPMA.10443","article-title":"Comparison of dual task specific training and conventional physical therapy in ambulation of hemiplegic stroke patients: a randomized controlled trial","volume":"70","author":"Iqbal","year":"2020","journal-title":"Pak. Med. Assoc."},{"key":"B21","first-page":"33","article-title":"Differences in center of pressure trajectory between normal and steppage gait","volume":"15","author":"Jamshidi","year":"2010","journal-title":"J. Res. Med. Sci."},{"key":"B22","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1016\/j.gaitpost.2018.03.048","article-title":"Comparison of segmental analysis and sacral marker methods for determining the center of mass during level and slope walking","volume":"62","author":"Jeong","year":"2018","journal-title":"Gait. Posture."},{"key":"B23","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1007\/s00221-001-0905-8","article-title":"Attention to movement modulates activity in sensori-motor areas, including primary motor cortex","volume":"142","author":"Johansen-Berg","year":"2002","journal-title":"Exp. Brain Res."},{"key":"B24","doi-asserted-by":"publisher","first-page":"1332","DOI":"10.1111\/j.1532-5415.1996.tb01404.x","article-title":"The relationship between physical performance measures and independence in instrumental activities of daily living. The FICSIT group. Frailty and injury: cooperative studies of intervention trials","volume":"44","author":"Judge","year":"1996","journal-title":"J. Am. Geriatr. Soc"},{"key":"B25","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1177\/1545968311420845","article-title":"Rewiring the brain: potential role of the premotor cortex inmotor control, learning, and recovery of function following brain injury","volume":"26","author":"Kantak","year":"2012","journal-title":"Neurorehabil. Neural Repair"},{"key":"B26","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1016\/j.gaitpost.2014.05.014","article-title":"Dynamic instability during post-stroke hemiparetic walking","volume":"40","author":"Kao","year":"2014","journal-title":"Gait. Posture."},{"key":"B27","doi-asserted-by":"publisher","first-page":"821","DOI":"10.12965\/jer.1836370.185","article-title":"Progressive treadmill cognitive dual-task gait training on the gait ability in patients with chronic stroke","volume":"14","author":"Kim","year":"2018","journal-title":"J. Exerc. Rehabil."},{"key":"B28","doi-asserted-by":"publisher","first-page":"2044","DOI":"10.1589\/jpts.28.2044","article-title":"Effect of aquatic dual-task training on balance and gait in stroke patients","volume":"28","author":"Kim","year":"2016","journal-title":"J. Phys. Ther. Sci."},{"key":"B29","doi-asserted-by":"publisher","first-page":"107","DOI":"10.3969\/j.issn.1001-1242.2024.01.018","article-title":"A meta-analysis of the effects of dual-task walking training on walking function in stroke patients with hemiplegia","volume":"39","author":"Liu","year":"2024","journal-title":"Chin. J. Rehabil. Med."},{"key":"B30","doi-asserted-by":"publisher","first-page":"4070","DOI":"10.1038\/s41598-017-04165-y","article-title":"Cognitive and motor dual task gait training improve dual task gait performance after stroke - a randomized controlled pilot trial","volume":"7","author":"Liu","year":"2017","journal-title":"Sci. Rep."},{"key":"B31","volume-title":"Improving Community Walking After Stroke; the Effect of Dual Task Treadmill Training on Gait, Cognition and Brain Control Mechanisms of Dual Task Walking in Chronic Stroke Survivors","author":"Meester","year":"2016"},{"key":"B32","doi-asserted-by":"publisher","first-page":"1338","DOI":"10.1016\/j.neuroimage.2007.06.014","article-title":"Sustained prefrontal activation during ataxic gait: a compensatory mechanism for ataxic stroke","volume":"37","author":"Mihara","year":"2007","journal-title":"Neuroimage"},{"key":"B33","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1146\/annurev.neuro.24.1.167","article-title":"An integrative theory of prefrontal cortex function","volume":"24","author":"Miller","year":"2001","journal-title":"Annu. Rev. Neurosci."},{"key":"B34","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1016\/j.gaitpost.2017.09.032","article-title":"Prefrontal cortex activation during a dual task in patients with stroke","volume":"59","author":"Mori","year":"2018","journal-title":"Gait. Posture."},{"key":"B35","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1016\/j.apmr.2006.10.025","article-title":"Determinants of walking function after stroke: differences by deficit severity","volume":"88","author":"Patterson","year":"2007","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/538602","article-title":"Feasibility of dual-task gait training for community-dwelling adults after stroke: a case series","volume":"2014","author":"Plummer","year":"2014","journal-title":"Strok. Res. Treat."},{"key":"B37","doi-asserted-by":"publisher","first-page":"3281","DOI":"10.1161\/STROKEAHA.109.554055","article-title":"Risk of hip\/femur fracture after stroke: a population-based case-control study","volume":"40","author":"Pouwels","year":"2009","journal-title":"Stroke"},{"key":"B38","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1093\/ptj\/85.5.413","article-title":"Control of lead and trail limbs during obstacle crossing following stroke","volume":"85","author":"Said","year":"2005","journal-title":"Phys. Ther."},{"key":"B39","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1016\/j.gaitpost.2006.12.009","article-title":"Balance during obstacle crossing following stroke","volume":"27","author":"Said","year":"2008","journal-title":"Gait. Posture."},{"key":"B40","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1310\/tsr1605-357","article-title":"Poststroke fear of falling in the hospital setting","volume":"16","author":"Schmid","year":"2009","journal-title":"Top. Strok. Rehabil."},{"key":"B41","doi-asserted-by":"publisher","first-page":"362","DOI":"10.1016\/j.gaitpost.2004.11.005","article-title":"Gait termination: a review of experimental methods and the effects of ageing and gait pathologies","volume":"22","author":"Sparrow","year":"2005","journal-title":"Gait. Posture."},{"key":"B42","doi-asserted-by":"publisher","first-page":"314","DOI":"10.1046\/j.1532-5415.2003.51104.x","article-title":"Physical performance measures in the clinical setting","volume":"51","author":"Studenski","year":"2003","journal-title":"J. Am. Geriatr. Soc"},{"key":"B43","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1097\/NPT.0000000000000056","article-title":"A cognitive-balance control training paradigm using wii fit to reduce fall risk in chronic stroke survivors","volume":"38","author":"Subramaniam","year":"2014","journal-title":"J. Neurol. Phys. Ther."},{"key":"B44","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1177\/1545968312462070","article-title":"Deficits in motor response to avoid sudden obstacles during gait in functional walkers poststroke","volume":"27","author":"van Swigchem","year":"2013","journal-title":"Neurorehabil. Neural Repair"},{"key":"B45","doi-asserted-by":"publisher","first-page":"896","DOI":"10.1093\/gerona\/glp033","article-title":"Quantitative gait markers and incident fall risk in older adults","volume":"64","author":"Verghese","year":"2009","journal-title":"J. Gerontol. Ser. A-Biol. Sci. Med. Sci."},{"key":"B46","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/j.gaitpost.2025.03.022","article-title":"Association between gait characteristics during obstacle crossing and fall risk in stroke patients: a prospective cohort study","volume":"120","author":"Wan","year":"2025","journal-title":"Gait. Posture."},{"key":"B47","doi-asserted-by":"publisher","first-page":"453","DOI":"10.3390\/biomechanics2030035","article-title":"Gait kinematics and asymmetries affecting fall risk in people with chronic stroke: a retrospective study","volume":"2","author":"Wang","year":"2022","journal-title":"Biomechanics"},{"key":"B48","doi-asserted-by":"publisher","first-page":"112","DOI":"10.3760\/cma.j.issn.0254-1424.2024.02.003","article-title":"Improving the lower limb functioning and walking ability of stroke survivors with robot-assisted dual-task training","volume":"46","author":"Xie","year":"2024","journal-title":"Chin. J. Phys. Med. Rehabil."},{"key":"B49","doi-asserted-by":"publisher","first-page":"1236","DOI":"10.1016\/j.apmr.2007.06.762","article-title":"Dual-task exercise improves walking ability in chronic stroke: a randomized controlled trial","volume":"88","author":"Yang","year":"2007","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"B50","doi-asserted-by":"publisher","first-page":"1186","DOI":"10.1177\/02692155221097033","article-title":"Effects of dual-task training on gait and balance in stroke patients: a meta-analysis","volume":"36","author":"Zhang","year":"2022","journal-title":"Clin. Rehabil."},{"key":"B51","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1186\/s12883-025-04131-6","article-title":"Gait spatio-temporal characteristics during obstacle crossing as predictors of fall risk in stroke patients","volume":"25","author":"Zhu","year":"2025","journal-title":"BMC Neurol."}],"container-title":["Frontiers in Physiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphys.2026.1869914\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T04:39:02Z","timestamp":1781757542000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphys.2026.1869914\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,18]]},"references-count":51,"alternative-id":["10.3389\/fphys.2026.1869914"],"URL":"https:\/\/doi.org\/10.3389\/fphys.2026.1869914","relation":{},"ISSN":["1664-042X"],"issn-type":[{"value":"1664-042X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,18]]},"article-number":"1869914"}}