Introduction: Walking in the community can be challenging for stroke survivors. The fact that community walking often requires performing a secondary task while walking further adds to this challenge and can lead to a deterioration of performance in one or both tasks.
Objective: To review the existing literature about the effect of dual-task walking in patients with stroke. 
Methods: A literature search was conducted in 4 databases (Medline, CINHAL, EMBASE and PeDRO). Two authors independently identified relevant studies based on predetermined selection criteria and assessed methodological quality of the studies using a standardized checklist (Kmet et al.). 
Results: Twenty-one studies were included in this systematic review. Methodological quality scores ranged from 50 to 95%. Participants were mainly in the chronic phase of recovery. Participants had to walk with (number of studies =4) or without obstacle (n=20) while performing an additional cognitive. The most frequently used cognitive tasks were serial subtractions, the Stroop Test and verbal tasks. Dual-task interference was observed in the primary task (locomotion), the secondary task (cognitive) or both depending on task complexity and individual capacities. Individuals with stroke prioritized the locomotor task when walking in more challenging conditions (e.g. obstacle avoidance). 
Conclusion: Dual-task walking may induce interference in both the locomotor and secondary tasks in stroke survivors. Results also highlight the lack of meaningful and ecologically-valid dual-task paradigms to assess community walking skills after stroke.

Dual-task interference while walking in stroke survivors: a systematic review