Resistance training for gait rehabilitation in people with stroke. A systematic review and meta-analysis

Stroke is a leading cause of long-term disability, significantly impacts gait and mobility. Resistance training (RT) has shown promise in improving gait parameters, but the evidence remains mixed. Our aim was to assess the effectiveness of RT on walking function in people with stroke (PwS). A comprehensive database search was conducted in June 2025 to find Randomized Controlled Trials (RCTs) on RT’s effect on gait in PwS. Key search terms were: "resistance training", "stroke", and “gait”. Included studies involved PwS with gait issues, comparing RT to controls examined walking speed and endurance. The review followed PRISMA guidelines and was registered in PROSPERO (ID: CRD42024505882). Of 2341 studies, 12 RCTs in the meta-analysis. Results showed a significant improvement in comfortable walking speed (0.082 m/s, 95% CI [0.005, 0.160]) with RT. No significant changes in fast walking speed (0.040 m/s, 95% CI [-0.041, 0.12 identified, 20 1]) or walking endurance (24,044 meters, 95% CI [-0.685, 48.772]). Findings suggest RT can improve comfortable walking speed in PwS, but not fast speed or endurance. Variations in protocols and study designs may cause mixed results. Future research should standardize RT to optimize rehabilitation. Stroke is a leading cause of long-term disability, frequently resulting in gait impairments that limit mobility and independence.Resistance training (RT) shows potential for improving comfortable walking speed in people with stroke (PwS), although its effects on fast walking speed and endurance remain inconclusive.Future rehabilitation strategies should integrate RT with other training modalities to address multiple facets of gait and mobility in PwS. Stroke is a leading cause of long-term disability, frequently resulting in gait impairments that limit mobility and independence. Resistance training (RT) shows potential for improving comfortable walking speed in people with stroke (PwS), although its effects on fast walking speed and endurance remain inconclusive. Future rehabilitation strategies should integrate RT with other training modalities to address multiple facets of gait and mobility in PwS.